Assessing the realism of colonoscopy simulation: The development of an instrument and systematic comparison of 4 simulators

Abstract

Background: No useful comparative data exist on the relative realism of commercially available devices for simulating colonoscopy. Objectives: To develop an instrument for quantifying realism and provide the first wide-ranging empiric comparison. Design: Repeated measures, observational study. Nineteen experienced colonoscopists completed cases on 4 colonoscopy simulators (AccuTouch, GI Mentor II, Koken, and Kyoto Kagaku) and evaluated each device. Setting: A medical simulation center in a large tertiary hospital. Main Outcome Measures: For each device, colonoscopists completed the newly developed Colonoscopy Simulator Realism Questionnaire (CSRQ), which contains 58 items grouped into 10 subscales measuring the realism of different aspects of the simulation. Subscale scores are weighted and combined into an aggregated score, and there is also a single overall realism item. Results: Overall, current colonoscopy simulators were rated as only moderately realistic compared with real human colonoscopy (mean aggregated score, 56.28/100; range, 48.3960.45, where 0 = "extremely unrealistic" and 100 = "extremely realistic"). On both overall realism measures, the GI Mentor II was rated significantly less realistic than the AccuTouch, Kyoto Kagaku, and Koken (P