Clinical Endoscopy

Review

Core curriculum for sedation in gastrointestinal endoscopy with a focus on practice: a proposal from the Korean Society of Gastrointestinal Endoscopy: Hong Sub Lee, Yun Jeong Lim, Jong-Jae Park, Endoscopic Sedation Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2025;58(2):218-224. Published online March 10, 2025; DOI: https://doi.org/10.5946/ce.2024.215

Abstract PDF PubReader ePub: Ideal sedation education for gastrointestinal endoscopy should encompass all medications used in sedation therapy, and facilitate appropriate application in clinical practice by combining theoretical and practical education according to each country’s situation. The educational goals for endoscopic sedation in Korea have already been announced, and theoretical training is regularly conducted by the Korean Society of Gastrointestinal Endoscopy (KSGE). However, no official core curriculum for sedation during gastrointestinal endoscopy exists in Korea. Therefore, a practical curriculum aligned with Korea’s clinical context should be developed. The Endoscopic Sedation Committee of KSGE has identified these challenges and proposed a core curriculum for sedation during endoscopy. Firstly, in terms of theory, it would be beneficial to maintain current education. Secondly, since practical training is still lacking, it would be beneficial to have practical hands-on training. To accomplish this, each simulation center should provide basic practical training such as airway maintenance and advanced teamwork skills. This review presents a detailed curriculum for safe sedation in gastrointestinal endoscopy, developed based on Korea’s specific needs and supported by current literature.

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Original Articles

Effectiveness of a novel ex vivo training model for gastric endoscopic submucosal dissection training: a prospective observational study conducted at a single center in Japan: Takahito Toba, Tsuyoshi Ishii, Nobuyuki Sato, Akira Nogami, Aya Hojo, Ryo Shimizu, Ai Fujimoto, Takahisa Matsuda; Clin Endosc 2025;58(1):94-101. Published online November 4, 2024; DOI: https://doi.org/10.5946/ce.2024.108

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: The efficacy of endoscopic submucosal dissection (ESD) for early-stage gastric cancer is well established. However, its acquisition is challenging owing to its complexity. In Japan, G-Master is a novel ex vivo gastric ESD training model. The effectiveness of training using G-Master is unknown. This study evaluated the efficacy of gastric ESD training using the G-Master to evaluate trainees’ learning curves and performance.
Methods
Four trainees completed 30 ESD training sessions using the G-Master, and procedure time, resection area, resection completion, en-bloc resection requirement, and perforation occurrence were measured. Resection speed was the primary endpoint, and learning curves were evaluated using the Cumulative Sum (CUSUM) method.
Results
All trainees completed the resection and en-bloc resection of the lesion without any intraoperative perforations. The learning curves covered three phases: initial growth, plateau, and late growth. The transition from phase 1 to phase 2 required a median of 10 sessions. Each trainee completed 30 training sessions in approximately 4 months.
Conclusions
Gastric ESD training using the G-Master is a simple, fast, and effective method for pre-ESD training in clinical practice. It is recommended that at least 10 training sessions be conducted.

Citations

Citations to this article as recorded by

Meaningful progress towards a high-fidelity endoscopic submucosal dissection training simulator model
Gin Hyug Lee, So Young Byun
Clinical Endoscopy.2025; 58(1): 77. CrossRef
Beyond the scope: unveiling the future of digestive endoscopy through experimental models
Federico Soria Gálvez
Revista Española de Enfermedades Digestivas.2025;[Epub] CrossRef

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Development of colonic stent simulator using three-dimensional printing technique: a simulator development study in Korea: Hyundam Gu, Suyoung Lee, Sol Kim, Hye-Lim Jang, Da-Woon Choi, Kyu Seok Kim, Yu Ri Shin, Dae Young Cheung, Bo-In Lee, Jin Il Kim, Han Hee Lee; Clin Endosc 2024;57(6):790-797. Published online September 23, 2024; DOI: https://doi.org/10.5946/ce.2024.110

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Colonic stenting plays a vital role in the management of acute malignant colonic obstruction. The increasing use of self-expandable metal stents (SEMS) and the diverse challenges posed by colonic obstruction at various locations underscore the importance of effective training for colonic stent placement.
Methods
All the components of the simulator were manufactured using silicone molding techniques in conjunction with three-dimensional (3D) printing. 3D images sourced from computed tomography scans and colonoscopy images were converted into a stereolithography format. Acrylonitrile butadiene styrene copolymers have been used in fused deposition modeling to produce moldings.
Results
The simulator replicated the large intestine from the rectum to the cecum, mimicking the texture and shape of the human colon. It enables training for colonoscopy insertion, cecum intubation, loop reduction, and stenting within stenotic areas. Interchangeable stenotic modules for four sites (rectum, sigmoid colon, descending colon, and ascending colon) were easily assembled for training. These modules integrate tumor contours and blood vessel structures with a translucent center, allowing real-time visualization during stenting. Successful and repeatable demonstrations of stent insertion and expansion using the reusable SEMS were consistently achieved.
Conclusions
This innovative simulator offers a secure colonic stenting practice across various locations, potentially enhancing clinical outcomes by improving operator proficiency during actual procedures.

Citations

Citations to this article as recorded by

Novel minimally invasive strategies for achieving source control in intra-abdominal infections
Clayton Wyland, Desmond Zeng, Robert G. Sawyer
Current Opinion in Critical Care.2025; 31(2): 228. CrossRef

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Usefulness of a new polyvinyl alcohol hydrogel (PVA-H)-based simulator for endoscopic submucosal dissection training: a pilot study: Dong Seok Lee, Gin Hyug Lee, Sang Gyun Kim, Kook Lae Lee, Ji Won Kim, Ji Bong Jeong, Yong Jin Jung, Hyoun Woo Kang; Clin Endosc 2023;56(5):604-612. Published online May 18, 2023; DOI: https://doi.org/10.5946/ce.2022.163

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: We developed a new endoscopic submucosal dissection (ESD) simulator and evaluated its efficacy and realism for use training endoscopists.
Methods
An ESD simulator was constructed using polyvinyl alcohol hydrogel sheets and compared to a previous ESD simulator. Between March 1, 2020, and December 30, 2021, eight expert endoscopists from three different centers analyzed the procedure-related factors of the simulator. Five trainees performed gastric ESD exercises under the guidance of these experts.
Results
Although the two ESD simulators provided overall favorable outcomes in terms of ESD-related factors, the new simulator had several benefits, including better marking of the target lesion’s limits (p<0.001) and overall handling (p<0.001). Trainees tested the usefulness of the new ESD simulator. The complete resection rate improved after 3 ESD training sessions (9 procedures), and the perforation rate decreased after 4 sessions (12 procedures).
Conclusions
We have developed a new ESD simulator that can help beginners achieve a high level of technical experience before performing real-time ESD procedures in patients.

Citations

Citations to this article as recorded by

The Current Landscape of Endoscopic Submucosal Training in the United States
Mike T. Wei, Shai Friedland, Joo Ha Hwang
Current Gastroenterology Reports.2025;[Epub] CrossRef
Meaningful progress towards a high-fidelity endoscopic submucosal dissection training simulator model
Gin Hyug Lee, So Young Byun
Clinical Endoscopy.2025; 58(1): 77. CrossRef
There is no royal road: a shortcut for endoscopic submucosal dissection training
Seong Woo Jeon
Clinical Endoscopy.2023; 56(5): 590. CrossRef

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Reviews

Quality indicators in endoscopic retrograde cholangiopancreatography: a brief review of established guidelines: Zubin Dev Sharma, Rajesh Puri; Clin Endosc 2023;56(3):290-297. Published online April 11, 2023; DOI: https://doi.org/10.5946/ce.2022.210

Abstract PDF PubReader ePub

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic technique that has many diagnostic and therapeutic implications. It is a procedure with small but significant life-threatening complications. To ensure the best possible care, minimize complications, and improve the quality of health care, a constant review of the performance of the operator using ideal benchmark standards is needed. Hence, quality indicators are necessary. The American and European Societies of Gastrointestinal Endoscopy have provided guidelines on quality measures for ERCP, which describe the skills to be developed and training to be implemented in performing quality ERCP. These guidelines have divided the indicators into pre-procedure, intraprocedural, and post-procedure measures. The focus of this article was to review the quality indicators of ERCP.

Citations

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Endoscopic retrograde cholangiopancreatography training using a silicone simulator fabricated using a 3D printing technique (with videos)
Suk Pyo Shin, Kyong Joo Lee, Min Je Sung, Jong Chan Kim, Guk Bae Kim, Moo Yeop Kim, Sung Yong Han, Sung Ill Jang, Mamoru Takenaka, Chang-Il Kwon
Scientific Reports.2025;[Epub] CrossRef
How to measure quality in ERCP?
Franco Ana Rita, Arvanitakis Marianna, Teles de Campos Sara
Best Practice & Research Clinical Gastroenterology.2025; : 101999. CrossRef
Advancements in Research on Challenges in Selective Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography (ERCP)
天雨张
Journal of Clinical Personalized Medicine.2024; 03(01): 100. CrossRef
Development of an Automated Endoscopic Retrograde Cholangiopancreatography Quality Report Card Using an Integrated Analytics Suite
Anmol Singh, Eric Swei, Celestina Tolosa, Matthew Alverson, Todd A. Brenner, Avleen Kaur, Aida Metri, Mohammed Rifat Shaik, Nikhil Bush, Branislav Bujnak, Alexandra T. Strauss, Mouen Khashab, Eun Ji Shin, Vikesh K. Singh, Venkata S. Akshintala
Techniques and Innovations in Gastrointestinal Endoscopy.2024; 26(3): 230. CrossRef
Endoscopic retrograde cholangiopancreatography training conditions, results from a pan‐European survey: Between vision and reality
Karim Hamesch, Oscar Cahyadi, Stavros Dimitriadis, Marcus Hollenbach, Pilar Acedo, Myriam Ayari, Helena Dauvarte, Egle Dieninyte, Viktor Domislovic, Ana Dugic, Martin Ďuriček, Omar Elshaarawy, Anne Fennessy, Mark Enrik Geissler, Zornitsa Gorcheva, Amer Ha
United European Gastroenterology Journal.2024;[Epub] CrossRef
Validity of a virtual reality endoscopic retrograde cholangiopancreatography simulator: can it distinguish experts from novices?
Konstantinos Georgiou, Nikola Boyanov, Pantelis Antonakis, Dimitrios Thanasas, Gabriel Sandblom, Lars Enochsson
Frontiers in Surgery.2023;[Epub] CrossRef

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Simulator-based training method in gastrointestinal endoscopy training and currently available simulators: Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung; Clin Endosc 2023;56(1):1-13. Published online January 6, 2023; DOI: https://doi.org/10.5946/ce.2022.191

Abstract PDF PubReader ePub

The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM’s advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator’s validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.

Citations

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Meaningful progress towards a high-fidelity endoscopic submucosal dissection training simulator model
Gin Hyug Lee, So Young Byun
Clinical Endoscopy.2025; 58(1): 77. CrossRef
Effects of a training system that tracks the operator’s gaze pattern during endoscopic submucosal dissection on hemostasis
Takao Tonishi, Fumiaki Ishibashi, Kosuke Okusa, Kentaro Mochida, Sho Suzuki
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Impact and assessment of training models in interventional endoscopic ultrasound
Bogdan Miutescu, Vinay Dhir
Digestive Endoscopy.2024; 36(1): 59. CrossRef
A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
Gut and Liver.2024; 18(1): 77. CrossRef
Exploring Endoscopic Competence in Gastroenterology Training: A Simulation-Based Comparative Analysis of GAGES, DOPS, and ACE Assessment Tools
Faisal Wasim Ismail, Azam Afzal, Rafia Durrani, Rayyan Qureshi, Safia Awan, Michelle R Brown
Advances in Medical Education and Practice.2024; Volume 15: 75. CrossRef
Assemblage of a functional and versatile endoscopy trainer reusing medical waste: Step‐by‐step video tutorial
Riccardo Vasapolli, Jörg Schirra, Christian Schulz
Digestive Endoscopy.2024; 36(5): 634. CrossRef
Navigating the learning landscape: Comprehensive training in third space endoscopy - training, techniques, and practical recommendations
D. Roser, S. Nagl, A. Ebigbo
Best Practice & Research Clinical Gastroenterology.2024; 71: 101918. CrossRef
Systematic review of subjective validation methods for computerized colonoscopy simulators
Adrián Lugilde-López, Manuel Caeiro-Rodríguez, Fernando A. Mikic-Fonte, Martín Llamas-Nistal
Health Informatics Journal.2024;[Epub] CrossRef
Development of colonic stent simulator using three-dimensional printing technique: a simulator development study in Korea
Hyundam Gu, Suyoung Lee, Sol Kim, Hye-Lim Jang, Da-Woon Choi, Kyu Seok Kim, Yu Ri Shin, Dae Young Cheung, Bo-In Lee, Jin Il Kim, Han Hee Lee
Clinical Endoscopy.2024; 57(6): 790. CrossRef
EUS and ERCP training in Europe: Time for simulation, optimization, and standardization
Selma J. Lekkerkerker, Rogier P. Voermans
United European Gastroenterology Journal.2023; 11(5): 407. CrossRef
There is no royal road: a shortcut for endoscopic submucosal dissection training
Seong Woo Jeon
Clinical Endoscopy.2023; 56(5): 590. CrossRef
Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends
Caesar Ferrari, Micheal Tadros
Gastroenterology Insights.2023; 15(1): 1. CrossRef

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Original Articles

Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?: Shyam Vedantam, Sunil Amin, Ben Maher, Saqib Ahmad, Shanil Kadir, Saad Khalid Niaz, Mark Wright, Nadeem Tehami; Clin Endosc 2022;55(3):426-433. Published online February 4, 2022; DOI: https://doi.org/10.5946/ce.2021.239

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Cholangiogram interpretation is not used as a key performance indicator (KPI) of endoscopic retrograde cholangiopancreatography (ERCP) training, and national societies recommend different minimum numbers per annum to maintain competence. This study aimed to determine the relationship between correct ERCP cholangiogram interpretation and experience.
Methods
One hundred fifty ERCPists were surveyed to appropriately interpret ERCP cholangiographic findings. There were three groups of 50 participants each: “Trainees,” “Consultants group 1” (performed >75 ERCPs per year), and “Consultants group 2” (performed >100 ERCPs per year).
Results
Trainees was inferior to Consultants groups 1 and 2 in identifying all findings except choledocholithiasis outside the intrahepatic duct on the initial or completion/occlusion cholangiogram. Consultants group 1 was inferior to Consultants group 2 in identifying Strasberg type A bile leaks (odds ratio [OR], 0.86; 95% confidence interval [CI], 0.77–0.96), Strasberg type B (OR, 0.84; 95% CI, 0.74–0.95), and Bismuth type 2 hilar strictures (OR, 0.81; 95% CI, 0.69–0.95).
Conclusions
This investigation supports the notion that cholangiogram interpretation improves with increased annual ERCP case volumes. Thus, a higher annual volume of procedures performed may improve the ability to correctly interpret particularly difficult findings. Cholangiogram interpretation, in addition to bile duct cannulation, could be considered as another KPI of ERCP training.

Citations

Citations to this article as recorded by

UK ERCP sedation practices, patient comfort and endoscopist characteristics: National Endoscopy Database (NED) analysis on behalf of the JAG and BSG
David Beaton, Matt Rutter, Linda Sharp, Kofi W Oppong, Bidour Awadelkarim, Simon M Everett, Vikramjit Mitra
Frontline Gastroenterology.2023; 14(5): 384. CrossRef

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Impact of COVID-19 on Endoscopy Training: Perspectives from a Global Survey of Program Directors and Endoscopy Trainers: Shivakumar Vignesh, Amna Subhan Butt, Mohamed Alboraie, Bruno Costa Martins, Alejandro Piscoya, Quang Trung Tran, Damien Tan Meng Yew, Shahriyar Ghazanfar, Pezhman Alavinejad, Edna Kamau, Ajay M Verma, Robin B Mendelsohn, Christopher Khor, Alan Moss, David Wei Chih Liao, Christopher S Huang, Franklin C Tsai; Clin Endosc 2021;54(5):678-687. Published online September 30, 2021; DOI: https://doi.org/10.5946/ce.2021.140

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical trainees internationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective of endoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education.
Methods
Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-based survey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopy training, including what factors decisions were based on.
Results
The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training, with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with European programs reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americas were allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support for endoscopy teaching.
Conclusions
This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopy training internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competencies are necessary to ensure adequate endoscopy training.

Citations

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Telementoring for endoscopic submucosal dissection in vivo training
Hon Chi Yip, Noriya Uedo, Louis Ho‐Shing Lau, Daizen Hirata, Yasushi Sano, Philip Wai‐yan Chiu
Digestive Endoscopy.2023; 35(1): 140. CrossRef
Gastrointestinal Bleeding in COVID-19-Infected Patients
Mitchell S. Cappell, David M. Friedel
Gastroenterology Clinics of North America.2023; 52(1): 77. CrossRef
Simulator-based training method in gastrointestinal endoscopy training and currently available simulators
Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung
Clinical Endoscopy.2023; 56(1): 1. CrossRef
Endoscopy After the COVID-19 Pandemic—What Will Be Different?
Rashid N. Lui, Raymond S. Y. Tang, Philip W. Y. Chiu
Current Treatment Options in Gastroenterology.2022; 20(1): 46. CrossRef
A Simulation Study to Investigate the Usefulness of a Novel Stricture Tool for Training Wire Guided Balloon Dilation
Avinash Bhat Balekuduru, Manoj K. Sahu
Journal of Digestive Endoscopy.2022; 13(03): 141. CrossRef

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Validation of a Novel Endoscopic Retrograde Cholangiopancreatography Cannulation Simulator: Pichamol Jirapinyo, Andrew C. Thompson, Hiroyuki Aihara, Marvin Ryou, Christopher C. Thompson; Clin Endosc 2020;53(3):346-354. Published online February 17, 2020; DOI: https://doi.org/10.5946/ce.2019.105

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) requires a unique skill set. Currently, there is no objective methodology to assess and train a professional to perform ERCP. This study aimed to develop and validate a novel ERCP simulator.
Methods
The simulator consists of papillae presenting different anatomy and positioned in varied locations. Deep cannulation of the pancreatic duct, followed by the bile duct, was performed. The time allotted was 5 minutes. The content validity indexes (CVIs) for realism, relevance, and representativeness were calculated. Correlation between ERCP experience and simulator score was determined.
Results
Twenty-three participants completed the simulation. The CVIs for realism were orientation of duodenoscope to papilla (1.00), angulation of papillotome to achieve cannulation (0.71), and haptic feedback during cannulation (0.80). The CVIs for relevance were use of elevator (1.00), wheels to achieve en face orientation (1.00), and papillotome for selective cannulation (1.00). Regarding CVI for representativeness, the results were as follows: basic cannulation (0.83), papilla locations (0.83), and papilla anatomies (0.80). The novice, intermediate, and experienced groups scored 6.7±8.7, 30.0±16.3, and 74.4±43.9, respectively (p<0.0001). There was a strong correlation between the ERCP experience level and the individual’s simulator score (Pearson value of 0.77, R2 of 0.60).
Conclusions
This simulator appears to be realistic, relevant, and representative of ERCP cannulation techniques. Additionally, it is effective at objectively assessing basic ERCP skills by differentiating scores based on clinical experience.

Citations

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Morfología de la papila de Vater como factor que influye en el éxito en canulación durante el entrenamiento del Residente en Endoscopia Avanzada. Estudio clínico prospectivo
D.E. Benavides-Salgado, R.A. Jiménez-Castillo, J.E. Cuéllar-Monterrubio, J.O. Jáquez-Quintana, A. Garza-Galindo, C. Cortes-Hernández, H.J. Maldonado-Garza, D. García-Compeán, J.A. González-González
Revista de Gastroenterología de México.2024; 89(2): 237. CrossRef
Papilla of Vater morphology as an influencing factor in successful cannulation during resident training in advanced endoscopy. A prospective clinical study
D.E. Benavides-Salgado, R.A. Jiménez-Castillo, J.E. Cuéllar-Monterrubio, J.O. Jáquez-Quintana, A. Garza-Galindo, C. Cortes-Hernández, H.J. Maldonado-Garza, D. García-Compeán, J.A. González-González
Revista de Gastroenterología de México (English Edition).2024; 89(2): 237. CrossRef
Anatomical endoscopic retrograde cholangiopancreatography simulator using moulded meshed silicone: A novel simulator pilot study
Alen Maximillian Brodaric, Ngar Lok Joshua Wong, Jessica Falon, Jean Wong, Kai Cheng, Sarah Whereat, David Storey
ANZ Journal of Surgery.2023; 93(7-8): 1817. CrossRef
The use of simulators to acquire ERCP skills: a systematic review
Konstantinos Georgiou, Kiril T. Atliev, Ninos Oussi, Nikola Boyanov, Gabriel Sandblom, Lars Enochsson
Annals of Medicine & Surgery.2023; 85(6): 2924. CrossRef
There is no royal road: a shortcut for endoscopic submucosal dissection training
Seong Woo Jeon
Clinical Endoscopy.2023; 56(5): 590. CrossRef
Validity of a virtual reality endoscopic retrograde cholangiopancreatography simulator: can it distinguish experts from novices?
Konstantinos Georgiou, Nikola Boyanov, Pantelis Antonakis, Dimitrios Thanasas, Gabriel Sandblom, Lars Enochsson
Frontiers in Surgery.2023;[Epub] CrossRef
Training in endoscopic retrograde cholangio-pancreatography: a critical assessment of the broad scenario of training programs and models
Camilla Gallo, Ivo Boškoski, Maria Valeria Matteo, Beatrice Orlandini, Guido Costamagna
Expert Review of Gastroenterology & Hepatology.2021; 15(6): 675. CrossRef

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Focused Review Series: Updates on endoscopic bariatric and metabolic therapies

Training in Bariatric and Metabolic Endoscopic Therapies: Pichamol Jirapinyo, Christopher C. Thompson; Clin Endosc 2018;51(5):430-438. Published online September 30, 2018; DOI: https://doi.org/10.5946/ce.2018.148

Abstract PDF PubReader ePub

Bariatric endoscopy is an emerging subspecialty for gastroenterologists encompassing a broad array of procedures including primary endoscopic bariatric and metabolic therapies and the treatment of complications of bariatric surgery. In addition, comprehensive understanding of lifestyle intervention and pharmacotherapy are essential to successful outcomes. This review summarizes goals and steps of training for this emerging field.

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Primary Bariatric Procedures
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Review

Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy: Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee; Clin Endosc 2017;50(4):345-356. Published online July 31, 2017; DOI: https://doi.org/10.5946/ce.2017.106

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The Korean Society of Gastrointestinal Endoscopy (KSGE) developed a gastrointestinal (GI) endoscopy board in 1995 and related regulations. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. During GI fellowship training, obtaining sufficient exposure to some types of endoscopic procedures is difficult. Fellows should acquire endoscopic skills through supervised endoscopic procedures during GI fellowship training. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform independent endoscopic procedures without supervision. This document is intended to provide principles that the Committee of Education and Training of the KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. The KSGE will improve the quality of GI endoscopy by providing guidelines for fellowships and supervisors.

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Focused Review Series: Training in Endoscopy

Training in Endoscopy: Endoscopic Ultrasound: Chang Min Cho; Clin Endosc 2017;50(4):340-344. Published online July 31, 2017; DOI: https://doi.org/10.5946/ce.2017.067

Abstract PDF PubReader ePub

Endoscopic ultrasound (EUS) has been recently established as an indispensable modality for the diagnosis and management of pancreatobiliary and gastrointestinal (GI) disorders. EUS proficiency requires both cognitive and technical abilities, including an understanding of the appropriate indications, the performance of appropriate evaluations before and after the procedure, and the management of procedure-related complications. An increasing demand for skills to handle a growing range of interventional EUS procedures and a continual shortage of EUS training programs are two major obstacles for EUS training. Acquiring the skills necessary to comprehend and conduct EUS often requires training beyond the scope of a standard GI fellowship program. In addition to traditional formal EUS training and preceptorships, regular short-term intensive EUS training programs that provide training at various levels may help EUS practitioners improve and maintain EUS-related knowledges and skills. Theoretical knowledge can be acquired from lectures, textbooks, atlases, slides, videotapes, digital video discs, interactive compact discs, and websites. Informal EUS training is generally based on 1- or 2-day intensive seminars, including didactic lectures, skills demonstrated by expert practitioners through live video-streaming of procedures, and hands-on learning using animal or phantom models.

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Focused Review Series: Globalization and Universalizations of ESD

ESD Hands-on Course Using Ex Vivo and In Vivo Models in South Korea: Gene Hyun Bok, Joo Young Cho; Clin Endosc 2012;45(4):358-361. Published online November 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.4.358

Abstract PDF PubReader ePub

Endoscopic submucosal dissection (ESD) is an established treatment for gastric neoplasias especially in regions with a high volume of gastric cancer. Although ESD has many advantages over endoscopic mucosal resection, ESD is technically more difficult and can result in severe complications. Therefore establishment of an effective training system is required to help endoscopists climb the ESD learning curve. Although a standard training system for ESD remains to be established, some centers are incorporating ex vivo and/or in vivo animal models to provide a safe and effective means of ESD training. However, it is unknown if these animal models are more effective than other programs. Moreover the efficacy of the animal model may vary according to socio-economic status and the volume of gastric cancer. In this article we introduce the basic and advanced ESD training model using the ex vivo and in vivo animal model from South Korea and review the associated literature from other regions.

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Ex Vivo and In Vivo Models for Endoscopic Submucosal Dissection Training: Adolfo Parra-Blanco, Nicolas Gonzalez, Maria Rosa Arnau; Clin Endosc 2012;45(4):350-357. Published online November 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.4.350

Abstract PDF PubReader ePub

Endoscopic submucosal dissection is a technically challenging but highly effective technique for the treatment of well selected early neoplasms in the digestive tract. Although it is frequently performed in East Asian countries, the Western world has not adopted this technique yet, probably due in part to the difficulty to learn it. Ex vivo and in vivo animal models are invaluable tools to overcome at least the beginning of the learning curve, although the initial step is the acquisition of basic knowledge about early diagnosis of neoplasias, and observing real procedures in expert centers. The practical issues, advantages, and disadvantages of the ex vivo and in vivo models are discussed.

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Endoscopic Submucosal Dissection (ESD) Training and Performing ESD with Accurate and Safe Techniques: Chang-Il Kwon; Clin Endosc 2012;45(4):347-349. Published online November 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.4.347

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Introduction of endoscopic submucosal dissection (ESD) has brought about a renaissance in therapeutic endoscopy. For the globalization and universalization of ESD, the number of physicians who can perform ESD has rapidly increased with general ex vivo and in vivo training using animal models and hand-on courses. In this focused review series, world-renowned ESD experts described the published studies or their own precious experiences about ESD training and performing ESD with accurate and safe techniques. First, Dr. Adolfo Parra-Blanco reviewed on ex vivo and in vivo models for ESD training. Next, Dr. Joo Young Cho described detailed practical settings and current status of hands-on courses using ex vivo and in vivo models in Korea. Dr. Takashi Toyonaga described quality controlled ESD and basic techniques to prevent complications. Dr. Tsuneo Oyama reviewed recently published methods to facilitate ESD. Dr. Jae-Young Jang reviewed the usefulness of magnifying and narrow band imaging to measure the depth of invasion before ESD.

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Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy: Kee Myung Lee, M.D., Seok Reyol Choi, M.D.*, Byung Ik Jang, M.D.^†, Seong Hwan Kim, M.D.^‡, Chang Don Kang, M.D.^§, Young Dae Kim, M.D.^∥, Jeong Youp Park, M.D.^¶ and Il-Kwun Ch; Korean J Gastrointest Endosc 2011;42(4):207-214. Published online April 28, 2011

Abstract PDF: The Korean Society of Gastrointestinal Endoscopy (KSGE) developed regulations and a gastrointestinal endoscopy board in 1995. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. Although endoscopic examinations are supervised by a specialist during a GI fellowship, some types of GI endoscopic examinations and treatments are difficult to obtain exposure. Fellows should acquire endoscopic skills through repeated independent endoscopic examinations after a GI fellowship. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform endoscopic examinations without a supervisor. This document is intended to provide the principles that the Committee of Education and Training of KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. KSGE will contribute to improving the quality of GI endoscopy by providing guidelines for fellowships and supervisors. (Korean J Gastrointest Endosc 2011;42:207-214)

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