A Structured, Repetitive Simulation Program for Endoscopic Coagulation Hemostasis with Hemostatic Forceps: An Assessor-Blinded Randomized Controlled Trial Using a Bleeding Ulcer Model.
6 affiliations
- 1Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
- 2Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan, [email protected].
- 3R and D Division of Career Education for Medical Professionals, Medical Education Center, Jichi Medical University, Shimotsuke, Japan, [email protected].
- 4Graduate Medical Education Center, Tohoku University Hospital, Sendai, Japan.
- 5Houen-Home Medical Care Support Clinic-Hachiman, Sendai, Japan.
- 6Division of Promotion for Gastroenterological Medical Innovation, Tohoku University, Sendai, Japan.
Abstract
Introduction
Prompt endoscopic hemostasis is required to control upper gastrointestinal bleeding. Current training relies on on-the-job exposure, with limited evidence supporting the use of dry-lab simulators. This study aimed to develop a structured, repeatable simulation-based training (SBT) program for thermal coagulation hemostasis and evaluate its efficacy.Methods
This single-center, assessor-blinded, randomized controlled trial was conducted at Tohoku University Hospital from December 2023 to June 2025. Nonexpert endoscopists were randomized into either an intervention group (five SBT sessions, including basic and hemostasis tasks, over 2 months) or a control group. Co-primary outcomes were procedure time and blinded video-based rubric scores for hemostasis at both low- and high-difficulty sites. Changes in self-efficacy were assessed using a visual analog scale (VAS). The analysis followed intention-to-treat principles.Results
Twenty participants were enrolled, with nine in the intervention group and 11 in the control group. At the final assessment, the intervention group demonstrated shorter procedure times at both the antrum (43.6 vs. 51.3 s, p = 0.02) and the upper gastric body (32.6 vs. 59.7 s, p < 0.01). Significant within-group reductions were observed only in the intervention group (effect sizes of 0.62 in the antrum and 0.80 in the upper body). Rubric-based scores improved at high-difficulty sites (p = 0.03). All five VAS domains improved significantly in the intervention group, whereas two domains increased in the control group.Conclusion
Structured SBT with a high-fidelity bleeding simulator improved technical performance, efficiency, and self-efficacy in coagulation hemostasis, representing a scalable framework for competency-based education.
Related
- A Dual-Pump Switchable Irrigation System for Hemostasis under Gel Immersion during Water Pressure Duodenal Endoscopic Submucosal Dissection.
- Endoscopic hemostasis using a narrow-caliber endoscope for a bleeding duodenal ulcer in a 7-month-old infant: A case report.
- Continuous Infusion Versus Intermittent Bolus Proton Pump Inhibitor Therapy Following Endoscopic Hemostasis for Bleeding Peptic Ulcers: A Systematic Review and Meta-Analysis
- Association Between Structured Obstetric Simulation and OSCE Performance in Undergraduate Medical Students
- Changes in Nursing Students' Clinical Handover Performance Following ISBAR‐Structured Handover Simulation Teaching: A Mixed‐Methods Study
BibTeX
@article{suzuki2026structured,
title = {{A Structured, Repetitive Simulation Program for Endoscopic Coagulation Hemostasis with Hemostatic Forceps: An Assessor-Blinded Randomized Controlled Trial Using a Bleeding Ulcer Model.}},
author = {Suguo Suzuki and Takeshi Kanno and Yutaka Hatayama and Yutaro Arata and Yohei Ogata and Masahiro Saito and Xiaoyi Jin and Waku Hatta and Kaname Uno and Akira Imatani and Tomoyuki Koike and Atsushi Masamune},
journal = {Digestion},
year = {2026},
month = oct,
doi = {10.1159/dig/acmag013},
url = {https://europepmc.org/article/MED/42879351},
note = {CC BY},
}
RIS
TY - JOUR
TI - A Structured, Repetitive Simulation Program for Endoscopic Coagulation Hemostasis with Hemostatic Forceps: An Assessor-Blinded Randomized Controlled Trial Using a Bleeding Ulcer Model.
AU - Suguo Suzuki
AU - Takeshi Kanno
AU - Yutaka Hatayama
AU - Yutaro Arata
AU - Yohei Ogata
AU - Masahiro Saito
AU - Xiaoyi Jin
AU - Waku Hatta
AU - Kaname Uno
AU - Akira Imatani
AU - Tomoyuki Koike
AU - Atsushi Masamune
PY - 2026
DA - 2026/10/15
JO - Digestion
DO - 10.1159/dig/acmag013
UR - https://europepmc.org/article/MED/42879351
AB - Introduction Prompt endoscopic hemostasis is required to control upper gastrointestinal bleeding. Current training relies on on-the-job exposure, with limited evidence supporting the use of dry-lab simulators. This study aimed to develop a structured, repeatable simulation-based training (SBT) program for thermal coagulation hemostasis and evaluate its efficacy.Methods This single-center, assessor-blinded, randomized controlled trial was conducted at Tohoku University Hospital from December 2023 to June 2025. Nonexpert endoscopists were randomized into either an intervention group (five SBT sessions, including basic and hemostasis tasks, over 2 months) or a control group. Co-primary outcomes were procedure time and blinded video-based rubric scores for hemostasis at both low- and high-difficulty sites. Changes in self-efficacy were assessed using a visual analog scale (VAS). The analysis followed intention-to-treat principles.Results Twenty participants were enrolled, with nine in the intervention group and 11 in the control group. At the final assessment, the intervention group demonstrated shorter procedure times at both the antrum (43.6 vs. 51.3 s, p = 0.02) and the upper gastric body (32.6 vs. 59.7 s, p < 0.01). Significant within-group reductions were observed only in the intervention group (effect sizes of 0.62 in the antrum and 0.80 in the upper body). Rubric-based scores improved at high-difficulty sites (p = 0.03). All five VAS domains improved significantly in the intervention group, whereas two domains increased in the control group.Conclusion Structured SBT with a high-fidelity bleeding simulator improved technical performance, efficiency, and self-efficacy in coagulation hemostasis, representing a scalable framework for competency-based education.
SN - 0012-2823
SN - 1421-9867
ER -