Gastrointestinal endoscopy clinics of North America
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Gastrointest. Endosc. Clin. N. Am. · Jul 2006
ReviewLessons from the surgical experience with simulators: incorporation into training and utilization in determining competency.
Simulation technology in laparoscopic surgery has developed in response to a need to teach fundamental surgical skills in a safe environment. The skill set needed was defined carefully according to the classic educational model of needs assessment. Once defined, the skills were modeled in a simulator. ⋯ Simulation training is most beneficial when incorporated into a curriculum that teaches the accompanying knowledge and judgment essential for safe practice of the skills taught in the simulator. The FLS program distributed by the Society of American Gastrointestinal and Endoscopic Surgeons and the American College of Surgeons is an example of a carefully planned and validated program that incorporates these principles in laparoscopic surgery education. The lessons learned from development of the FLS program can be useful in designing a similar program for flexible gastrointestinal endoscopy.
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A variety of endoscopy simulators have been produced during the last several decades. Multiple factors have influenced the types of simulators that have been developed and the ongoing evolution of existing models. ⋯ Table 1 summarizes the logistical factors for the different types of endoscopy simulator. These considerations clearly are of major importance in simulator design and development and in the conceptualization and organization of simulator-based curricula and courses.
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Gastrointest. Endosc. Clin. N. Am. · Jul 2006
Simulators in training: defining the optimal role for various simulation models in the training environment.
Clearly, the potential applications for simulation training in endoscopy are vast. Endoscopy models may serve as a platform to introduce new skills, to maintain proficiency, or even to assess competency. As these applications are explored fully, the strengths and weaknesses of specific devices will dictate their roles. Educators must ensure that these roles are founded on reliable research but remain mindful that simulators are only tools to augment clinical training, with the goal of benefiting both student and patient, and are not a replacement for patient-based experience.
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Gastrointest. Endosc. Clin. N. Am. · Oct 2005
ReviewSedation and the technical performance of colonoscopy.
The use of sedation for routine endoscopic procedures, including colonoscopy, varies widely across cultures. This variation in sedation practice is greater than any other culturally based variation in the technical performance of endoscopy. This article sequentially reviews the technical performance of colonoscopy in patients who undergo unsedated colonoscopy, sedation with narcotics and benzodiazepines, and deep sedation with propofol. For each of these approaches to colonoscopy, the advantages and disadvantages also are listed and discussed.