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Design and validation of a therapeutic EUS training program using a live animal model: Taking training to the next level
Leonardo Sosa-Valencia1, Jerôme Huppertz1, Fanélie Wanert1, Francois Haberzetser1, Lee Swanström1, Benedetto Mangiavillano2, Pierre Eisendrath3, Pierre Deprez4, Carlos Robles-Medranda5, Silvia Carrara6, Mohammad A Al-Haddad7, Peter Vilmann8, Stephane Koch9, Alberto Larghi10, Mouen Khashab11
1 IHU Strasbourg – The Institute of Image-Guided Surgery, Strasbourg, France
2 Gastrointestinal Endoscopy Unit, Humanitas, Mater Domini – Castellanza (VA) and Humanitas University, Italy
3 Department of hepato-gastroenterology, CHU Saint-Pierre, ULB, Brussels, Belgium
4 Department of Hepato-Gastroenterology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
5 Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador
6 Humanitas Clinical and Research Center – IRCCS -, via Manzoni, Rozzano (Mi), Italy
7 Indiana University School of Medicine, Indiana, USA
8 Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
9 University Hospital (CHU) of Besançon, France
10 Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
11 John Hopkins University, Baltimore, Maryland, USA
Correspondence Address:
Leonardo Sosa-Valencia
IHU - Institute of Image-Guided Surgery. 1 Place de l'Hôpital 67000, Strasbourg
France
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/EUS-D-21-00124
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Background and Objectives: EUS has evolved into a therapeutic modality for gastrointestinal disorders. Simulators, ex vivo models, and phantoms are the current teaching methods for therapeutic EUS (TEUS). We create and evaluate a high-fidelity simulated live animal model (HiFi SAM) for teaching endoscopists TEUS. Materials and Methods: Designing a curriculum that uses HiFi SAM and enables trainees to perform realistic procedures with expert mentors. Results: Twenty-seven trainees participated in a 3-day program with 6 h of theoretical and 14 h of hands using life HiFi SAM. Eighteen experts participated. Twenty-two (20–25) TEUS were defined for each HiFi SAM, and 616 were performed in all. Of 616/264 (43%) were evaluated with a mean of 88 per course (ranging between 80 and 95). Ninety-one percent (240/264) of the procedures were completed successfully. In 24, success was not achieved due to technical and/or model problems. Student rating of HiFi SAM was: 71% excellent rating (scale 8–10) and 95% excellent/good. The HiFi SAM procedure evaluation was (scale 1–5): fine-needle biopsy: 4.79, radiofrequency: 4.76, common bile duct and gallbladder drainage: 4.75, cystic drainages: 4.72, neurolysis: 4.55, microbiopsy: 4.50, and hepatogastric drainage: 4.04, with an overall satisfaction rate of 4.56 (91%). A short survey showed: 83% would recommend absolutely (17% most likely), 33% think that ITEC training was sufficient for their practice, and 66% would like additional training, especially more practice in specific techniques rather than more clinical case discussion. Regarding impact on their practice, 66% of the trainees started a new procedure and/or noted improvement in previous ones. Conclusion: HiFi SAM is a complex model; however, experts and trainees are satisfied with the training this new curriculum provided.
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