Simulation-based training of endoscopic hemostasis for Japanese pediatric endoscopy learners: a pilot program

Background and Aims: Endoscopic hemostasis training, often in emergencies, can be challenging for pediatric endoscopists. This study aimed to establish hands-on seminar sessions using the novel clip hemostasis simulator and to explore the underlying concerns about endoscopic hemostasis among pediatric endoscopists and the potential of simulator-based training (SBT). Methods: An SBT course was incorporated into seminars by the Japanese Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Surveys using the visual analog scale (VAS; 0-100) completed by consenting pediatricians during 4 seminars from October 2021 to March 2023 were compared with responses of adult GI residents and junior residents. Results: Fifty-two pediatric endoscopists (median age, 31 year; postgraduate year 7) were enrolled. A median VAS score of 47 (interquartile range [IQR], 23.5-65) for understanding endoscopic hemostasis was significantly lower than that of adult GI residents (median, 76; IQR, 58-82; P < .001) and comparable with junior residents (median, 54; IQR, 50-65). Pediatric endoscopists' confidence in independently performing hemostasis was low, with a median score of 0 (IQR, 0-16.5), which was below adult GI residents (median, 67; IQR, 49-77; P < .001) and junior residents (median, 11.5; IQR, 10-39; P = .014). Regarding skill enhancement by SBT, a median score of 94.5 showed high and no significant difference from junior residents and adult GI residents, respectively. All pediatric endoscopists expressed an interest in repeated SBT sessions. Conclusions: Pediatric endoscopists were concerned about their competence in endoscopic hemostasis. The simplified SBT programs with the simulator may potentially improve their skills and confidence. (Clinical trial registration number: UMIN000035735.)