Simulation of gastroscopy and endoscopic retrograde cholangiopancreatography for medical student education

Background: Simulation training has become part of medical student education, however endoscopy simulators have mostly been reserved for speciality training. Evidence suggests that simulation training has the potential to educate future doctors about endoscopy procedures and improve their communication with patients. Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure that is technically challenging and poorly understood by medical students. This study aimed to investigate whether simulating gastroscopy and ERCP using an anatomical model of the upper gastrointestinal tract improves procedural knowledge, confidence, and performance in medical students. Methods: Students completed three attempts at gastroscopy and one attempt at ERCP using the model. Participants rated knowledge and confidence relating to endoscopic procedures before and after completing the simulation. Students also reported their attitudes towards endoscopic simulation training after their participation. Results: There was a significant increase in self-perceived knowledge of the purpose of and steps involved in endoscopy (P < 0.001), gastrointestinal anatomy (P = 0.003), and biliary system anatomy (P = 0.002) after using the simulator. Participants also reported significantly increased skills confidence in performing gastroscopy and duodenoscopy (P < 0.001), including in their ability to explain endoscopic procedures to a patient (P < 0.001). All participants agreed (5%) or strongly agreed (95%) that simulation training is a useful addition to their learning, and that they would like more simulation training in the medical curriculum. Conclusion: Simulation training is an effective and engaging method of promoting procedural awareness and understanding of basic endoscopic procedures in medical students, with the potential to improve doctor-patient interactions in early clinical practice.