Design and validation of a therapeutic EUS training program using a live animal model: Taking training to the next level

Leonardo Sosa-Valencia, Jerôme Huppertz, Fanélie Wanert, Francois Haberzetser, Lee Swanström, Benedetto Mangiavillano, Pierre Eisendrath, Pierre Deprez, Carlos Robles-Medranda, Silvia Carrara, Mohammad A. Al-Haddad, Peter Vilmann, Stephane Koch, Alberto Larghi, Mouen Khashab

Research output: Contribution to journalArticlepeer-review


Background and Objectives: EUS has evolved into a therapeutic modality for gastrointestinal disorders. Simulators, ex vivo models, and phantoms are the current teaching methods for therapeutic EUS (TEUS). We create and evaluate a high-fidelity simulated live animal model (HiFi SAM) for teaching endoscopists TEUS. Materials and Methods: Designing a curriculum that uses HiFi SAM and enables trainees to perform realistic procedures with expert mentors. Results: Twenty-seven trainees participated in a 3-day program with 6 h of theoretical and 14 h of hands using life HiFi SAM. Eighteen experts participated. Twenty-two (20-25) TEUS were defined for each HiFi SAM, and 616 were performed in all. Of 616/264 (43%) were evaluated with a mean of 88 per course (ranging between 80 and 95). Ninety-one percent (240/264) of the procedures were completed successfully. In 24, success was not achieved due to technical and/or model problems. Student rating of HiFi SAM was: 71% excellent rating (scale 8-10) and 95% excellent/good. The HiFi SAM procedure evaluation was (scale 1-5): fine-needle biopsy: 4.79, radiofrequency: 4.76, common bile duct and gallbladder drainage: 4.75, cystic drainages: 4.72, neurolysis: 4.55, microbiopsy: 4.50, and hepatogastric drainage: 4.04, with an overall satisfaction rate of 4.56 (91%). A short survey showed: 83% would recommend absolutely (17% most likely), 33% think that ITEC training was sufficient for their practice, and 66% would like additional training, especially more practice in specific techniques rather than more clinical case discussion. Regarding impact on their practice, 66% of the trainees started a new procedure and/or noted improvement in previous ones. Conclusion: HiFi SAM is a complex model; however, experts and trainees are satisfied with the training this new curriculum provided.

Original languageEnglish (US)
Pages (from-to)112-121
Number of pages10
JournalEndoscopic Ultrasound
Issue number2
StatePublished - Mar 1 2022


  • EUS
  • FNA
  • education
  • fine-needle biopsy
  • radiofrequency
  • teaching
  • training

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging
  • Hepatology


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