Digestive endoscopy is a rapidly expanding specialty, essential for the diagnosis and treatment of gastrointestinal diseases. It occupies a central place in the daily practice of gastroenterologists. The need for high-quality training has increased due to the growing complexity of techniques and the volume of patients requiring endoscopic interventions. Therefore, the need to standardize and improve digestive endoscopy training is crucial to meet increasing clinical demands. A simulation center represents an opportunity to provide structured and progressive training for young gastroenterologists.

The main challenges include the absence of animal models and reliance on simulators for practical training, heterogeneous exposure of residents to clinical cases during intensive rotations, and difficulty for residents to acquire standardized practical skills in a structured setting.

The objectives were to evaluate the effectiveness of an optimized educational program on residents’ skills, identify weaknesses and opportunities for improvement in the current curriculum, and propose recommendations to strengthen the quality of training.

This is a prospective single-center study including 18 residents in training who underwent two evaluations three months apart using a competency assessment grid based on direct observation with immediate feedback. The assessment grid was developed based on previously validated grids created by experts in digestive endoscopy. It is composed of five parts subdivided into multiple items allowing evaluation of cognitive, integrative, and technical skills.

The educational program included theoretical training with interactive courses, video analysis of diagnostic and interventional endoscopy, endoscopy staff meetings on various topics such as tumors, inflammatory diseases, polypectomy, hemostasis, APC, and foreign body extraction, and case studies focused on multiple pathologies. Practical training in the simulation center used high-fidelity simulators to learn basic techniques and manage simulated complications, with realistic scenarios for colonoscopy and upper endoscopy and real-time feedback from instructors. Intensive supervised clinical rotations allowed participation in real procedures to reinforce skills acquired in simulation, with post-procedure feedback sessions using the assessment grid.

Evaluation included an initial test to assess baseline competence, practical simulator tests after each session to measure progression, and satisfaction surveys among residents and instructors.

Results showed improvement in all evaluated items. Residents in the first year progressed from maximal to significant supervision, while third- and fourth-year residents progressed from significant supervision to minimal supervision and competence. Improvement was less marked in integrative skills. Technical skills showed a 35% average increase in practical scores after simulation training, with significant improvement in recognizing anomalies and manipulating endoscopic equipment. Resident satisfaction was high: 50% found simulators effective for learning basic techniques, 90% considered intensive rotations essential, and 80% emphasized the need to introduce animal-model simulation. Instructors observed that residents were more confident and precise in their technical skills and highlighted the need to expand simulator access for advanced scenarios and to integrate animal-model simulation into training.

In conclusion, a training program combining simulation and intensive supervised clinical rotations significantly improves technical and theoretical skills in young endoscopists. This single-center model can serve as a reference for other training centers.