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“Into the fire” approach to teaching endoscopic foreign body removal using a modular simulation curriculum

  • 2022 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

As flexible endoscopy becomes an increasingly valuable minimally invasive approach to surgical challenges, an efficient and comprehensive training curriculum is needed to train surgeons in therapeutic endoscopy. We developed a modular curriculum utilizing a simulation-based, “into the fire” approach to endoscopic foreign body removal for practicing physicians with task performance pre- and post-testing.

Methods

From 2020 to 2021, two sessions of our advanced flexible endoscopy course were taught by two expert surgical endoscopists using ex-vivo porcine models. The course focused on safe removal techniques for various foreign bodies as part of an overall endoscopy curriculum that uses hands-on simulation-based pre-testing, didactics, and mentored practice sessions, followed by post-course examination. Pre- and post-course assessments and surveys were used to evaluate knowledge, performance, and confidence of participants, and subsequently analyzed using the Wilcoxon-signed rank test.

Results

Of the 16 practicing physicians who participated in the course, 43.8% were certified in Fundamentals of Endoscopic Surgery, and 62.5% had completed > 200 prior upper endoscopies. Upon course completion, scoring on knowledge-based written examinations improved from 3.4 ± 1.9 to 5.8 ± 2.0 (p < 0.001). Technical facility of each participant demonstrated significant overall improvement with post-course score increased from 15.8 ± 2.5 to 23.6 ± 1.6 (p < 0.001), with skill refinement noted in technical subcategories of appropriate instrument use (p < 0.001), foreign body manipulation (p < 0.001), and successful foreign body removal (p < 0.001). Confidence surveys likewise demonstrated significant increase in confidence after completion of the curriculum 11.6 ± 3.4 to 23.0 ± 5.5 (p < 0.001).

Conclusions

The “into the fire” approach to teaching endoscopic foreign body removal utilizing our simulation module provides an effective curriculum to improve knowledge, confidence, and overall technical performance. Our methodology utilizes hands-on, simulation-based pre-testing prior to instruction. This introduces clinical scenarios and technical challenges, while accounting for and tailoring to provider-specific variation in knowledge and experience, facilitating training efficiency.

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Authors and Affiliations

  1. Department of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, GCSI rmB665, Evanston, IL, 60201, USA

    Vanessa N. VanDruff, Harry J. Wong, Julia R. Amundson, Hoover Wu, Michelle Campbell, Kristine Kuchta, H. Mason Hedberg, John Linn, Stephen Haggerty, Woody Denham & Michael B. Ujiki

  2. Department of Surgery, University of Chicago, Chicago, USA

    Vanessa N. VanDruff, Harry J. Wong, Julia R. Amundson, Hoover Wu & Michelle Campbell

Authors
  1. Vanessa N. VanDruff
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  2. Harry J. Wong
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  3. Julia R. Amundson
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  4. Hoover Wu
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  5. Michelle Campbell
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  6. Kristine Kuchta
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  7. H. Mason Hedberg
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  8. John Linn
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  9. Stephen Haggerty
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  10. Woody Denham
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  11. Michael B. Ujiki
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Corresponding author

Correspondence to Vanessa N. VanDruff.

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Disclosures

Drs. VanDruff, Wong, Amundson, Wu, Campbell, Hedberg, Denham, and Kristine Kuchta have no financial interests or conflicts of interest to disclose. Dr Ujiki is a board member of Boston Scientific, and a paid consultant for Olympus and Cook. Dr. Ujiki also receives grant funding from Medtronic [ERP-2020 1228] and receives payment lectures from Medtronic, Erbe, and Gore. Dr. Haggerty is a paid consultant to Medtronic and receives payment for lectures for Gore. Dr. Linn also receives payment lectures for lectures for Gore.

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This manuscript was accepted for an oral presentation at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2022 Annual Meeting in Denver Colorado from March 16th to March 19th, 2022.

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VanDruff, V.N., Wong, H.J., Amundson, J.R. et al. “Into the fire” approach to teaching endoscopic foreign body removal using a modular simulation curriculum. Surg Endosc 37, 1412–1420 (2023). https://doi.org/10.1007/s00464-022-09382-9

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  • DOI: https://doi.org/10.1007/s00464-022-09382-9

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