Simulation and training of procedural sedation

Simulation offers a unique and possibly essential tool to train endoscopists in safe and successful gastrointestinal endoscopy using procedural sedation. In turn, it is becoming more common to integrate procedural trainers into full-scale environments to allow simulation of both technical and behavioral skills required to perform sedated procedures, as well as communication skills that are fundamental in effective and high-quality endoscopy teams. Generally speaking, simulation can be used to “animate the textbook” by creating simulated encounters around a myriad of sedation regimens to teach and reinforce safe practice through a deepened understanding of pharmacology and patient–drug interactions. In this chapter, we present our experience designing full-scale simulated endoscopy scenarios around actual patient events that are generally rare, but always clinically significant. We also explain our position that simulation-based team training should balance both clinical (drug administration, active airway management) and behavioral (communication and decision making) objectives. Finally, we discuss the likelihood that use of simulation to teach sedation for endoscopy will yield a positive impact on the practice of procedural gastroenterology and ultimately patient outcomes.