EP584 - Simulator Training and Prior Experience as Predictors of Resident Colonoscopy Skill: A Validity Analysis Using GAGES Scores

Sunday, May 10, 2026

2:52 PM - 2:57 PM ET

ePoster Presenter(s)

HW

Hunter White, MD

Resident physician
University of Tennessee Memorial Hospital
Knoxville, Tennessee, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

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Senior Author(s)

GL

Gregory Low, MD

Assistant Professor
University of Tennessee Graduate School of Medicine
Knoxville, Tennessee, United States

Disclosure information not submitted.

Author(s)

MC

Mark A. Casillas, Jr., MD, FACS, FASCRS

Assistant Professor
UT Graduate School of Medicine
Knoxville, Tennessee, United States

Disclosure information not submitted.
AR

Andrew J. Russ, MD FACS FASCRS, MD

Professor Program Director, General Surgery Residency Chief, Division of Colorectal Surgery
University of Tennessee Graduate School of Medicine
Knoxville, Tennessee, United States

Disclosure information not submitted.

Purpose/Background: Competency-based surgical education increasingly relies on objective performance assessment and simulation-based training. The Global Assessment of Gastrointestinal Endoscopic Skills (GAGES) is a validated tool for evaluating technical proficiency in endoscopy; however, the relationship between simulator training, prior experience, and performance remains incompletely defined. This study aimed to determine whether simulator exposure and cumulative colonoscopy experience are associated with improved GAGES performance among surgical residents.

Methods/Interventions: Five general surgery residents (PGY 3-5) participated in a prospective assessment of colonoscopy performance. For each participant, total simulator training hours and baseline colonoscopy numbers at the start of the study were recorded. GAGES score served as the dependent variable representing procedural skill. Pearson and Spearman correlations and simple linear regression were used to evaluate the relationships between GAGES score and simulator training hours or colonoscopy numbers, with significance defined as p < 0.05.

Results/Outcomes: Mean (±SD) simulator time was 8.0 ± 7.1 hours, mean baseline colonoscopy number 63.9 ± 9.2, and mean GAGES score 17.6 ± 4.5. Simulator training demonstrated a moderate positive correlation with GAGES (r = 0.46, p = 0.10), with regression showing a 0.28-point increase in GAGES per additional simulator hour (R² = 0.21). Baseline colonoscopy experience correlated positively but nonsignificantly with GAGES (r = 0.37, p = 0.18), equating to a 0.17-point increase per prior case (R² = 0.14). Neither relationship reached statistical significance in this pilot cohort.

Conclusion/Discussion: Both simulator exposure and cumulative colonoscopy experience demonstrated positive associations with endoscopic skill as measured by GAGES, though not statistically significant in this small sample. These findings suggest that simulation-based training and procedural experience contribute meaningfully to colonoscopy proficiency, supporting the educational value of simulation within competency-based surgical curriculum whenever clinical colonoscopy access is limited.