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- Advancing colonoscopy training: tailored strategies and simulation-based models for skill mastery
- Nilanga Nishad, Malith Nandasena, Andreas Hadjinicolaou, Mo Hameed Thoufeeq
- Clin Endosc 2025;58(6):808-816. Published online June 9, 2025
- DOI: https://doi.org/10.5946/ce.2025.019
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Abstract
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ePub - Effective endoscopy training begins by assessing the trainee’s experience and identifying their skill level: beginners, learners, independent practitioners, or experts. Beginners focus on basic tasks, such as cecal intubation, while advanced trainees refine efficiency and complex techniques. Training prioritizes conscious competence through deliberate practice, reflection, and verbalizing actions; this enhances mindfulness and procedural expertise. Clear communication, standardized terminology, and constructive feedback ensure safety, confidence, and skill retention. SMART objectives—specific, measurable, achievable, relevant, and timely—help structure sessions for skill development and mastery. Simulation-based models support training at all the levels. Beginners benefit from cost-effective low-fidelity bench models and virtual reality (VR) simulators, which offer realistic tactile feedback and customizable scenarios. Studies have shown that both low- and high-fidelity models can effectively teach basic skills, although VR is preferred for foundational training. Advanced trainees utilize animal-based models for therapeutic interventions, three-dimensional printed models for pathology-specific practice, and hybrid models that combine VR and physical elements for enhanced realism. Augmented reality and haptic feedback systems refine advanced skills, but face developmental and cost challenges. Mentored live patient models excel in real-world decision-making, but raise ethical concerns. Training is tailored to individual needs, and competency-based training ensures mastery at each stage, from beginners to advanced practitioners.
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- 266 Download
- Post-polypectomy colorectal bleeding: current strategies and the way forward
- Nilanga Nishad, Mo Hameed Thoufeeq
- Clin Endosc 2025;58(2):191-200. Published online November 27, 2024
- DOI: https://doi.org/10.5946/ce.2024.241
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Abstract
PDFPubReaderePub
- Post-endoscopic mucosal resection (EMR) bleeding, or clinically significant post-EMR bleeding, is influenced by factors such as polyp size, right-sided colonic lesions, laterally spreading tumors, anticoagulant use, and comorbidities like cardiovascular or chronic renal disease. The optimal prophylactic therapy for post-EMR bleeding remains unknown, with no consensus on specific criteria for its application. Moreover, prophylactic measures, including clipping, suturing, and coagulation, have produced mixed results. Selective clipping in high-risk patients is cost-effective, whereas universal clipping is not. Studies and meta-analyses indicate that routine prophylactic clipping does not generally reduce post-polypectomy bleeding but may be beneficial in cases of large proximal lesions. Some studies have revealed that the post-polypectomy bleeding risk after EMR of transverse colonic lesions is lower than that of the ascending colon and caecum, suggesting limited efficacy of clipping in the transverse colon. Cost-effectiveness studies support selective clipping in high-risk groups, and newer static agents such as PuraStat are alternatives; however, their cost-effectiveness is undetermined. Further research is required to establish clear guidelines and refine prophylactic strategies to prevent post-EMR bleeding.
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Citations
Citations to this article as recorded by
- Prophylactic clipping versus no clipping after endoscopic mucosal resection of large nonpedunculated colon polyps: a cost-effectiveness analysis
Sneh Sonaiya, Raj Patel, Charmy Parikh, Magnus Chun, Amrit Narwan, Karan Yagnik, Pranav Patel, Bradley Confer, Harshit Khara, Babu P. Mohan
Gastrointestinal Endoscopy.2026; 103(3): 494. CrossRef - Iatrogenic colon perforation: endoscopic management or surgery
Seung Bum Lee
Clinical Endoscopy.2026; 59(1): 33. CrossRef - Distinct Clinical and Outcome Profiles Across Six Subtypes of Acute Gastrointestinal Bleeding: A Comprehensive Analysis of 1021 Patients
Nóra Vörhendi, Levente Frim, Orsolya Anna Simon, Eszter Boros, Brigitta Teutsch, Dániel Pálinkás, Edina Tari, Dávid Berki, Patrícia Kalló, Edina Ecsedy, Endre Botond Gagyi, Armand Csontos, Zoltán Sipos, Nelli Farkas, Áron Vincze, Ferenc Izbéki, Andrea Sze
Journal of Clinical Medicine.2026; 15(5): 1998. CrossRef - Over-the-Scope Clip vs Standard Endoscopic Therapy as First-Line Intervention for Nonvariceal Upper Gastrointestinal Bleeding: A Cost-Effectiveness Analysis
Sneh Sonaiya, Sahib Singh, Tooba Laeeq, Vaishnavi Modi, Magnus Chun, Pranav Patel, Vignan Manne, Babu P. Mohan
Techniques and Innovations in Gastrointestinal Endoscopy.2025; 27(4): 250935. CrossRef - Cold snare polypectomy versus hot snare polypectomy for small pedunculated polyps: a cost-effectiveness analysis
Sneh Sonaiya, Raj Patel, Dushyant Singh Dahiya, Shahryar Khan, Charmy Parikh, Mark Stasiewicz, Pranav D. Patel, Kyaw Min Tun, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Vignan Manne, Babu P. Mohan, Douglas G. Adler
Gastrointestinal Endoscopy.2025;[Epub] CrossRef - Cold Versus Hot Endoscopic Mucosal Resection for ≥15 mm Large Nonpedunculated Colorectal Polyps
Sneh Sonaiya, Dushyant S. Dahiya, Raj Patel, Shahryar Khan, Charmy Parikh, Karan Yagnik, Chun-Han Lo, Kyaw Min Tun, Pranav D. Patel, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Babu P. Mohan
Journal of Clinical Gastroenterology.2025;[Epub] CrossRef
- Prophylactic clipping versus no clipping after endoscopic mucosal resection of large nonpedunculated colon polyps: a cost-effectiveness analysis
- 15,480 View
- 705 Download
- 2 Web of Science
- 6 Crossref
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