Telementoring for endoscopic submucosal dissection in-vivo training

Dig Endosc. 2022 Sep 22. doi: 10.1111/den.14440. Online ahead of print.

ABSTRACT

The provision of endoscopic training was significantly disrupted during COVID pandemic. It is difficult to provide training on Endoscopic submucosal dissection (ESD) due to the complexity of procedure and shortage of local trainer. We have designed and conducted a simulation training course with telementoring incorporating concept of Rapid Cycle Deliberate Practice. After a short tutorial on basic setup and manoeuvring, the participants undergo 2 hours training on live anaesthetized pig to acquire the necessary skills for ESD. Two overseas experts were involved virtually in real time as telementors. Video camera was set up at each station, and both external and endoscopic view were transmitted live between the animal laboratory and telementors via Zoom application. The overseas experts actively engaged in simulation by giving live feedbacks and instructions to participants using visual aids supported by the meeting application. The training model utilized concept of Rapid Cycle Deliberate Practice, where repeated immediate feedback and discussion would be carried out to enhance efficiency of learning. Eighteen trainees were invited to participate in the course, 6 of them instructed by overseas telementors. Four ESD procedures were performed by participants under telementoring and achieved 100% en-bloc resection without perforation. The time required for each ESD were similar with telementoring than that of on-site mentors. The establishment of tele-mentoring has enabled knowledge and skill transfer of complex endoscopic procedures of ESD. With the limitation of international travelling, this could be an alternative model allowing remote training particularly when local experts are not readily available.

PMID:36135946 | DOI:10.1111/den.14440