A Simulation Study to Investigate the Usefulness of a Novel Stricture Model for Training Esophageal Metallic Stent Placement

Abstract Background and Aims The training in esophageal self-expanding metallic stent (SEMS) placement for postgraduates needs an efficient and effective simulation model. The aim of the study was to evaluate the usefulness of a novel stricture model for training in esophageal SEMS placement. Methods The study was a pre-test and post-test design without any control group. Three advanced flexible endoscopic courses were conducted from 2022 to 2024. The training sessions involved 20 final-year postgraduate fellows in each session from different centers. The stenting module consisted of a non-tissue esophageal model with deployment of esophageal SEMS. The trainees received a pre-test, followed by an hour of didactic lecture, mentored hands-on sessions on SEMS deployment on the model using stepwise stenting module, and ended by post-test. Assessments included verbal feedbacks and knowledge-based test scores. Results Sixty final-year postgraduate fellows with varying endoscopic experiences participated in the training programs. All the participants had completed more than 100 therapeutic procedures. Three fellows had deployed esophageal SEMS earlier. All the trainees and the instructor had rated the model as excellent or good with stiffer haptics than real tissue. The mean (%) pre-test scores of 17 (29%) improved significantly to 57 (95%) in the mean post-test (%) questionnaire (p < 0.05). There was significant improvement in test questionnaire after the training modules. Conclusion The simulation model using the novel esophageal model for SEMS deployment is effective with good performance evaluation and can be used to train SEMS deployment procedures.