Use of a Colonoscopy Simulator for Resident Teaching: Application of a Mastery Learning Model

A study of the application of mastery-based learning principles to computerized colonoscopy simulation was performed. Resident performance was assessed using a performance checklist. A group of expert endoscopists determined the appropriate mastery standard using a modified Angoff standard setting method. Seventeen general surgery and gastroenterology residents with no prior endoscopic training participated in the study. Demographic information was collected as well as measures of previous endoscopic exposure, simulator exposure, and video game experience. Residents completed a pre-test on the simulator, and if they did not meet the mastery criterion, they proceeded to simulator training. The amount of time spent on deliberate practice on the simulator varied between learners, but all needed to meet the mastery criterion at a simulator post-test to proceed to live colonoscopy training. Residents were more likely to meet the minimum passing score at the post-test. Overall scores improved from pre-test to post-test, and the number of egregious errors was significantly lower at the post-test. Only one resident failed the post-test, and this resident ultimately met the mastery criterion after additional simulator practice. Residents expressed satisfaction with the use of the simulator as an adjunct to early colonoscopy skills training, and felt that the mastery criterion was reasonable and improved their confidence at performing colonoscopy.