Trial reportJournal of gastroenterology and hepatology2026
Self-Directed Mikoto Simulator Training for Colonoscopy in Gastroenterology Trainees: An International Multicenter Randomized Trial.
Trial report in Journal of gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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24 authors.
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Abstract
objectivesSimulation-based colonoscopy training may support early acquisition of insertion skills, but its clinical effect remains uncertain. We evaluated whether a self-directed curriculum using the mikoto colonoscopy simulator improved insertion performance in gastroenterology trainees.
methodsIn this multicenter cluster-randomized trial, 12 gastroenterology trainees from 11 institutions in Japan and Taiwan were assigned 1:1 to mikoto simulator training or standard training, with the trainee as the unit of randomization. Each trainee performed 35 colonoscopies; intervention-arm trainees additionally completed 100 self-directed simulator sessions over 2 weeks. The primary endpoint was post-training cecal intubation rate (CIR), compared using mixed-effects logistic regression with trainee as a random intercept and pre-training CIR as a covariate.
resultsA total of 420 colonoscopies were analyzed. Post-training CIR was 80.0% (72/90) in the mikoto group versus 77.8% (70/90) in controls (adjusted OR, 1.34; 95% confidence interval, 0.37-4.84; p = 0.606). Within the mikoto group, CIR increased from 60.0% to 80.0% (p = 0.003) and cecal intubation time decreased, but the group-by-period interaction was not significant. Detection outcomes were unchanged.
conclusionsAlthough the between-group difference in post-training CIR did not reach statistical significance, self-directed mikoto simulator training produced a significant within-group improvement in CIR and a parallel reduction in cecal intubation time, supporting it as a feasible and educationally meaningful adjunct to conventional colonoscopy training for gastroenterology trainees.
trial registrationUMIN Clinical Trials Registry: UMIN000054647.
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