Simulated Clinical Experience Training

Simulated Clinical Experience Training

[Name of the Institute]Simulated Clinical Experience Training

Types of studies

We considered only randomised controlled trials and quasi-randomised studies (method of allocating participants to treatment not strictly random), irrespective of language, blinding or publication status. Cohort studies and case-control studies were excluded. In addition, we considered abstracts reporting randomised controlled trials and quasi-randomised studies presented since November 2011. Studies published in abstract format were only considered if original outcome data could be retrieved from the abstract or following contact with the authors.

 

Types of participants

Health professions trainees including physicians (medical students, residents, fellows and practitioners), nurses and physician assistants with limited or no prior endoscopy experience. For the purposes of this review, limited endoscopic experience is defined as (1) previous performance of no greater than 10 cases of the procedure under study in the clinical or simulated setting and/or (2) any level of experience in performing other gastrointestinal endoscopic procedures (oesophagogastroduodenoscopy, colonoscopy and sigmoidoscopy).

 

Types of interventions

We included trials comparing virtual reality endoscopy (oesophagogastroduodenoscopy, colonoscopy and sigmoidoscopy) simulation training versus any other method of endoscopy training including conventional patient-based training, in-job training, training using another form of endoscopy simulation (e.g. low-fidelity simulator), or no training.  We also included trials comparing one method of virtual reality training versus another method of virtual reality training (e.g. comparison of two different virtual reality simulators).

 

Types of outcome measures

We included only trials measuring outcomes on humans (as opposed to animals or simulators) in the clinical setting.

 

Secondary outcomes

(1) Independent procedure completion (objective measure).

(2) Performance time (objective measure of the time taken to perform the evaluation task(s) post-training).

(3) Complication or critical flaw occurrence.

(4) Independent insertion depth (objective measure of the distance to which the participant passed the endoscope unassisted).

(5) Patient discomfort (Sedlack, 2002).

(6) A single measure providing an overall global rating of performance or competency in performing endoscopy (as defined by the authors).

(7) Error Rate (number of undesirable movements, as defined by the authors).

(8) Visualization of mucosa (as defined by authors).

 

Electronic searches

We searched the following electronic health professions, educational and computer literature databases for publications addressing the above clinical problem:

(1) The Cochrane Central Register of Controlled Trials (CENTRAL)

(2) MEDLINE

(3) EMBASE

(4) Scopus

(5) Web of Science

Data collection and analysis

Data were collected on customised data extraction forms and analysis was performed as described below.

 

Selection of studies

All titles and abstracts identified by the literature search, ...