Background and Aims: The WIMAT colonoscopy suitcase is an ex-vivo, porcine, polypectomy simulator. This has been developed in response to the increasing demand for polypectomy training following the introduction of the National Bowel Cancer Screening Programme. The aims of this thesis are to establish if the simulator is a valid form of polypectomy skills training and to identify if this model can be used to develop objective parameters for polypectomy assessment. Materials and Methods: A series of clinical trials were systematically conducted to test the validity of the WIMAT colonoscopy suitcase. This included evaluating its content, construct and concurrent validity and conducting a skills transfer study comparing the WIMAT colonoscopy suitcase with a virtual reality simulator. Objective assessment parameters were examined by measuring the accuracy of self-assessment and using video coding software to analyse the hand movements performed during simulated polypectomy tasks. Results: Content validity was demonstrated by experts who scored the model’s anatomical, mechanical and visual realism favourably across multiple parameters (p=<0.01). Construct and concurrent validity were confirmed by participants performing simulated polypectomy in accordance with their “real-life” level of expertise (p=<0.01). Skills transfer to the clinical setting was demonstrated in a pilot randomised controlled study. Self-assessment following simulated polypectomy is inaccurate as experts tend to overestimate ability whereas novices underestimate ability (p=>0.05). The ratio of rotational hand movements to endoscopic tip angulation (RoTA) was significantly different when comparing novices to experts (p=<0.05). Discussion: The WIMAT colonoscopy suitcase is a valid form of polypectomy skills training. The simulator can be used to address the increasing demand for training in this procedure. Further work is needed to assess the reliability of the RoTA score at different stages of the polypectomy procedure before it is used as an assessment tool.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:620135 |
| Date | January 2014 |
| Creators | Ansell, James |
| Publisher | Cardiff University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://orca.cf.ac.uk/64961/ |
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