Virtual Reality Simulator: Unveiling the "Inner" Skills of Endoscopists

Abstract

Abstract Background This study aimed to create a simulation-based assessment system for evaluating endoscopist proficiency due to the absence of evidence-based scoring systems. Methods After feasibility and clinical relevance assessments of simulator modules by gastroenterology experts, a colonoscopy module with relatively high operational difficulty was chosen for testing and underwent preliminary validation. Additionally, a questionnaire was designed to collect information about endoscopist experience, including the number of colonoscopy and gastroscope performed, insertion time, cecal intubation rate, early colorectal cancer detection rate. Subsequently, 38 physicians from our hospital's endoscopy center completed the questionnaire and underwent virtual reality simulator training. The endoscopist's proficiency was assessed in real-time based on scoring criteria, including total operation time, percentage of examined mucosa, time to reach the cecum, screening efficiency, proportion of time with clear vision, and total time spent on colonoscope looping. Results In our study, no statistically significant differences were found among endoscopy experts, specialist attending physicians, and resident physicians in terms of their experience and early cancer detection rates (P > 0.05). However, the VR system scores, including operational completion time, time to reach the cecum, and the percentage of observed mucosa, were correlated with the number of colonoscopies completed by the endoscopists (P < 0.05). Operational completion time and time to reach the cecum were strongly correlated with usual insertion times (P < 0.001), and the percentage of observed mucosa score was related to early disease detection rates. Notably, screening efficiency and endoscopic clarity scores were not correlated with physicians' disease detection rates (P > 0.05). Conclusion Virtual reality endoscopy can be utilized to assess endoscopist proficiency and provide targeted guidance to enhance their clinical practice. Based on these findings, further expansion and enrichment of simulator content, as well as optimization of training methods, can be pursued promisingly in the future.