Simulators and Gastrointestinal Endoscopy Training

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Abstract
Over the last decades, training in gastrointestinal endoscopy has evolved from demonstrations via a lecture scope (passed around to as many as 25 colleagues [ 1 ]), over the use of live courses, to the present situation with emerging guidelines on competence thresholds, training programs, and training facilities from national and international committees and societies [ 2 ]. Recently, refinement of simulators has opened up the potential for training in scenarios very close to real life, as described in this issue of Endoscopy [ 3 ] [ 4 ] [ 5 ] [ 6 ] . Studies on technical competency in endoscopy have - with a few exceptions [ 7 ] [ 8 ] - not been published until recent years [ 9 ] [ 10 ] [ 11 ] , with accumulating data showing that the numbers of procedures required to achieve competence are indeed significantly higher than anticipated [ 12 ]. But even though developments such as the real-time magnetic endoscope imager and the variable-stiffness colonoscope make colonoscopy significantly easier [ 13 ] [ 14 ] and may thus modify the quantitative requirements in skills acquisition in colonoscopy, systematic teaching of correct and safe techniques will never be outdated. Mastering the technical aspects is obviously of key importance, but obtaining technical proficiency does not stand alone: all aspects surrounding the endoscopic procedure, such as informing the patient, obtaining consent, interpreting findings, planning further investigations, etc., must be considered significant parameters of competency [ 15 ].

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