Simulator training in endoscopic hemostasis

Endoscopic management of acute gastrointestinal (GI) bleeding is an advanced procedure associated with high morbidity and mortality. The traditional apprentice model of training for such events is often inadequate because of their unpredictable frequency, common occurrence off hours, and high stakes for patient outcome. Hemostasis is the cessation of active bleeding and prevention of rebleeding with an endoscopic intervention. Proficiency in endoscopic management of GI hemorrhage includes proper preparation, a systematic categorization of both the source of bleeding and the technique used to control it, the necessary knowledge base, and technical skills to perform the endoscopic intervention. Various simulation platforms, including virtual reality simulators, in vivo models, and explanted tissue, can be helpful in gaining proficiency in endoscopic hemostasis, although validated criteria for obtaining and maintaining procedural competence in this area are still lacking.