Brief Article
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World J Gastroenterol. Nov 7, 2011; 17(41): 4619-4624
Published online Nov 7, 2011. doi: 10.3748/wjg.v17.i41.4619
Training gastroenterology fellows to perform gastric polypectomy using a novel ex vivo model
Ming-Jen Chen, Ching-Chung Lin, Chia-Yuan Liu, Chih-Jen Chen, Chen-Wang Chang, Ching-Wei Chang, Chien-Wei Lee, Shou-Chuan Shih, Horng-Yuan Wang
Ming-Jen Chen, Ching-Chung Lin, Chia-Yuan Liu, Chih-Jen Chen, Chen-Wang Chang, Ching-Wei Chang, Chien-Wei Lee, Shou-Chuan Shih, Horng-Yuan Wang, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan, China
Ming-Jen Chen, Ching-Chung Lin, Chia-Yuan Liu, Chih-Jen Chen, Chen-Wang Chang, Ching-Wei Chang, Chien-Wei Lee, Shou-Chuan Shih, Horng-Yuan Wang, Mackay Medicine, Nursing and Management College, Taipei 11260, Taiwan, China
Ming-Jen Chen, Ching-Chung Lin, Chia-Yuan Liu, Chih-Jen Chen, Clinical Skills Training Center, Department of Medical Education, Mackay Memorial Hospital, Taipei 10449, Taiwan, China
Ming-Jen Chen, Shou-Chuan Shih, Horng-Yuan Wang, Mackay Medical College, Taipei 10449, Taiwan, China
Author contributions: Chen MJ designed the experiments and wrote this article; Lin CC, Liu CY and Chen CJ participated in experimental design, data analysis and discussion; Wang CW and Chang CW conducted the literature review; Lee CW coordinated the ex vivo experimental design; Shih SC supported this work and performed critical reading of the manuscript; Wang HY supported this work and supervised the final editing. All authors read and approved the final manuscript.
Correspondence to: Dr. Horng-Yuan Wang, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Chungshan North Road, Taipei 10449, Taiwan, China. hywang@ms2.mmh.org.tw
Telephone: +886-2-25433535-2260 Fax: +886-2-25433642
Received: February 20, 2011
Revised: June 9, 2011
Accepted: June 16, 2011
Published online: November 7, 2011
Abstract

AIM: To evaluate the effect of hands-on training of gastroenterology fellows in gastric polypectomy using an ex vivo simulator.

METHODS: Eight gastroenterology fellows at Mackay Memorial Hospital, Taipei were evaluated in gastric polypectomy techniques using a pig stomach with artificial polyps created by a rubber band ligation device. The performance of four second year (year-2) fellows who had undergone one year of clinical training was compared with that of four first year (year-1) fellows both before and after a 4-h workshop using the ex vivo simulator. The workshop allowed for hands-on training in the removal of multiple artificial polyps and the placement of hemoclips at the excision site. Evaluation included observation of technical skills, procedure time, and the fellows’ confidence scale.

RESULTS: One week after the workshop, the year-1 fellows were re-evaluated and had significantly improved mean performance scores (from 17.9 ± 1.8 to 22.5 ± 0.7), confidence scale (from 4.5 ± 1.0 to 7.8 ± 0.5) and procedure time (from 615.0 ± 57.4 s to 357.5 ± 85.0 s) compared with their baseline performance. After 4 h of training using the ex vivo simulator, the skills of the year-1 fellows were statistically similar to those of the year-2 fellows.

CONCLUSION: Use of this ex vivo simulator significantly improved the endoscopic gastric polypectomy skills of gastroenterology fellows who had not had previous clinical training in gastric polypectomy.

Keywords: Ex vivo; Animal tissue model; Hands-on training; Pig stomach; Polypectomy