Simulation-based training of endoscopic hemostasis for Japanese pediatric endoscopy learners: a pilot program

Background and Aims

Endoscopic hemostasis training, often in emergencies, can be challenging for pediatric endoscopists. This study aimed to establish hands-on seminar sessions using the novel clip hemostasis simulator and to explore the underlying concerns about endoscopic hemostasis among pediatric endoscopists and the potential of simulator-based training (SBT).

Methods

An SBT course was incorporated into seminars by the Japanese Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Surveys using the visual analog scale (VAS; 0-100) completed by consenting pediatricians during 4 seminars from October 2021 to March 2023 were compared with responses of adult GI residents and junior residents.

Results

Fifty-two pediatric endoscopists (median age, 31 year; postgraduate year 7) were enrolled. A median VAS score of 47 (interquartile range [IQR], 23.5-65) for understanding endoscopic hemostasis was significantly lower than that of adult GI residents (median, 76; IQR, 58-82; P < .001) and comparable with junior residents (median, 54; IQR, 50-65). Pediatric endoscopists' confidence in independently performing hemostasis was low, with a median score of 0 (IQR, 0-16.5), which was below adult GI residents (median, 67; IQR, 49-77; P < .001) and junior residents (median, 11.5; IQR, 10-39; P = .014). Regarding skill enhancement by SBT, a median score of 94.5 showed high and no significant difference from junior residents and adult GI residents, respectively. All pediatric endoscopists expressed an interest in repeated SBT sessions.

Conclusions

Pediatric endoscopists were concerned about their competence in endoscopic hemostasis. The simplified SBT programs with the simulator may potentially improve their skills and confidence. (Clinical trial registration number: UMIN000035735.)