Face validity of a new mixed-reality simulator for training endoscopic submucosal dissection: a Western pilot study

iGIE Pub Date : 2026-09-01 Epub Date: 2025-10-31 DOI:10.1016/j.igie.2025.10.018

Henriette Heinrich MD, Pieter Dewint MD, Phillipe Leclercq MD, Jelle Haringsma MD

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Abstract

Background and Aims

Endoscopic submucosal dissection (ESD) is an effective but technically demanding procedure with a steep learning curve. Traditional training methods, including master courses, apprenticeship, and animal models, have ethical, financial, and logistical constraints. This pilot study evaluates the face validity of a novel mixed-reality simulator designed to enhance and maintain endoscopic dexterity in ESD training.

Methods

In this exploratory, prospective observational cohort study, 8 ESD trainees with prior advanced endoscopy experience, but limited ESD exposure, underwent a 2-day structured training using the EndoCubot (EndoRobotics, Seoul, South Korea) simulator with artificial laminated tissue (VTT [Versatile Training Tissue], KOTOBUKI Medical, Yashio, Japan). Performance was assessed pre- and post-training through a 5-minute dexterity test simulating circular incision with 40 achievable points, and a questionnaire evaluating simulator realism, satisfaction, and training effectiveness. Paired sample t tests (α = 0.05) and descriptive statistics were used for analysis. Results were reported as mean with standard deviation.

Results

On a 40-point scale, mean postcourse scores (34.7 [4.86]) were significantly higher than precourse scores (25.50 [0.76], P < .001), with a mean improvement of 9.25 points (95% confidence interval, 4.993-13.507, Hedges’ g correction = 1.613). Survey results indicated high satisfaction (mean rating: 9.125/10) and strong agreement on the simulator's realism and effectiveness.

Conclusions

The simulator demonstrates strong face validity and supports a realistic standardized skill acquisition in ESD. The simulator could provide a realistic and ethical alternative to current animal models and requires further study.

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用于内镜下粘膜剥离训练的新型混合现实模拟器的面部有效性：一项西方试点研究

背景与目的内镜下粘膜下剥离术（ESD）是一种有效但技术要求高且学习曲线陡峭的手术。传统的培训方法，包括硕士课程、学徒制和动物模型，在伦理、财政和后勤方面都有限制。本初步研究评估了一种新型混合现实模拟器的面部有效性，该模拟器旨在增强和保持ESD培训中的内窥镜灵活性。方法在这项探索性、前瞻性观察队列研究中，8名具有高级内窥镜检查经验的ESD受训者接受了为期2天的结构化培训，使用endocbot （EndoRobotics, Seoul, South Korea）模拟器和人工层状组织（VTT [Versatile training tissue], KOTOBUKI Medical, Yashio, Japan）进行了结构化培训。通过模拟圆形切口的5分钟灵巧性测试（40个可实现点）和评估模拟器真实性、满意度和训练效果的问卷来评估训练前和训练后的表现。采用配对样本t检验（α = 0.05）和描述性统计进行分析。结果以平均值和标准差报道。结果在40分制量表中，术后平均得分（34.7[4.86]）显著高于术前得分（25.50 [0.76],P < 0.001），平均提高9.25分（95%可信区间4.993 ~ 13.507,Hedges’g修正率= 1.613）。调查结果表明，模拟器的真实性和有效性得到了很高的满意度（平均评分：9.125/10）和强烈的认同。结论该模拟器具有较强的人脸效度，支持ESD中现实的标准化技能习得。该模拟器可以为目前的动物模型提供一个现实和道德的选择，需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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