How Do Nurses and Physicians Learn Gastrointestinal Endoscopy: Assessment of Learning Curves Using a High-fidelity Virtual Reality Simulator

Recently, it has been suggested that nurses can perform diagnostic endoscopic procedures, which traditionally have been a physician’s responsibility. The existing studies concerning quality of sigmoidoscopy performed by nurses are small, used assessment tools with insufficient validation and to date there is very little knowledge of the learning curve patterns for physicians and nurses. The aim of a present study was to assess learning curves on a virtual reality colonoscopy simulator of untrained residents as compared to that of nurses with and without endoscopy assistance experience.
Materials and methods: 30 subjects were included in the study: 10 female residents (median age 30.5 years) without colonoscopy experience, 10 female nurses (median age 27.5 years) without endoscopy assistance experience and 10 female nurses (median age 42 years) with endoscopy assistance experience. All participants performed ten repetitions of task 6 from the Introduction colonoscopy module of the Accu Touch Endoscopy simulator.
Results: All subjects completed the virtual colonoscopy without complications. Significant differences existed between residents and nurses with respect to time to complete the procedure. Residents and nurses showed similar learning curve patterns. There were not significant differences between the groups in the volume of the insufflated air, % of time without discomfort and % of mucosa seen.
Conclusions: Nurses performed virtual colonoscopy as accurately and safely as residents. Although the residents performed significantly faster, time differences showed tendency towards decreasing and appraisement of the numeric time differences seemed of minor practical importance. Nurses can achieve competency with the endoscopic technique after appropriate training.

Session: Podium Presentation

Program Number: S112

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