Remote training in flexible gastrointestinal endoscopy

Post written by Jerome D. Waye, MD, from the Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York.


This is the first report of training doctors to adequately perform endoscopy using the internet. We used the internet to teach endoscopy with the trainee in Uganda and the instructor in New York. Following a 1-week session with 1-on-1 instruction on site in Uganda, showing how to hold an instrument, the manipulation of dials and valves as well as basic movements, close supervision via a proprietary video software program was continued via a high-speed internet connection. The instructor was able to see the hands of the operator alongside a split screen view of the image from the endoscope. The scope view was clear and both visual and auditory communication between operator and instructor had no lag.  

In the era of COVID, travel for training purposes has been suspended, and instructors cannot fly to distant lands to teach and train doctors in underserved areas. We have shown that remote training is not only possible but feasible as well. This experience has opened a new era for training in flexible endoscopy and will broaden the ability to expand the use of endoscopy to low-resource areas. We have shown that not only basic endoscopy can be taught but advanced therapeutic procedures can also be safely monitored and performed using this platform.   

The internet has affected everyone in the world, and the ability to use communication platforms to train has not been explored. We have shown that remote training is possible and rewarding. Once basic scope handling has been accomplished, the cognitive aspects of endoscopy need to be developed. These require the instructor’s close supervision because the remote trainee needs to be mentored when questions arise such as: What am I seeing? Is this normal? What should I do? Should this be biopsied? Is this a tumor? The instructor has to set aside dedicated time to interface with the student as if they were next to each other in the same endoscopy unit.  

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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