Abstract
Background and study aims Colonoscopy is a technically challenging procedure that requires extensive training
to minimize discomfort and avoid trauma due to its drive mechanism. Our academic team
developed a magnetic flexible endoscope (MFE) actuated by magnetic coupling under
supervisory robotic control to enable a front-pull maneuvering mechanism, with a motion
controller user interface, to minimize colon wall stress and potentially reduce the
learning curve. We aimed to evaluate this learning curve and understand the user experience.
Methods Five novices (no endoscopy experience), five experienced endoscopists, and five experienced
MFE users each performed 40 trials on a model colon using 1:1 block randomization
between a pediatric colonoscope (PCF) and the MFE. Cecal intubation (CI) success,
time to cecum, and user experience (NASA task load index) were measured. Learning
curves were determined by the number of trials needed to reach minimum and average
proficiency—defined as the slowest average CI time by an experienced user and the
average CI time by all experienced users, respectively.
Results MFE minimum proficiency was achieved by all five novices (median 3.92 trials) and
five experienced endoscopists (median 2.65 trials). MFE average proficiency was achieved
by four novices (median 14.21 trials) and four experienced endoscopists (median 7.00
trials). PCF minimum and average proficiency levels were achieved by only one novice.
Novices’ perceived workload with the MFE significantly improved after obtaining minimum
proficiency.
Conclusions The MFE has a short learning curve for users with no prior experience—requiring relatively
few attempts to reach proficiency and at a reduced perceived workload.
