ORIGINAL ARTICLE: Experimental Endoscopy The Welsh Institute for Minimal Access Therapy colonoscopy suitcase has construct and concurrent validity for colonoscopic polypectomy skills training: a prospective, cross-sectional study James Ansell, MBBCh, 1 Joanna J. Hurley, MBBCh, 2 James Horwood, MS, 3 Chantelle Rizan, BSc, 4 Konstantinos Arnaoutakis, MPhil, 1 Stuart Goddard, PGCE, 1 Neil Warren, PhD, 1 Jared Torkington, MS 3 Cardiff, United Kingdom Background: The Welsh Institute for Minimal Access Therapy (WIMAT) colonoscopy suitcase is an ex vivo porcine simulator for polypectomy training. Objective: To establish whether this model has construct and concurrent validity. Design: Prospective, cross-sectional study. Setting: Endoscopic training center. Participants: Twenty novice (N), 20 intermediate (I), 20 advanced (Ad), and 20 expert (E) colonoscopists. Intervention: A simulated polypectomy task aimed at removing 2 polyps; A (simple), B (complex). Main Outcome Measurements: Two accredited colonoscopists, blinded to group allocation, scored perfor- mances according to Direct Observation of Polypectomy Skills (DOPyS) assessment parameters. Group perfor- mances were compared. Real-life DOPyS scores were correlated to simulator DOPyS results. Results: Median overall DOPyS scores for novices were 1.00 (1.00-1.87) for A and 0.50 (0.00-1.00) for B (A vs B; P ! .01). Intermediates scored 2.50 (2.00-2.88) for A and 2.00 (1.13-2.50) for B (A vs B; P Z .03). The advanced group scored 3.00 (2.50-3.50) for A and 2.50 (2.00-3.00) for B (A vs B; P Z .01). Experts scored 3.00 (3.00-3.88) for A and 3.00 (2.50-3.50) for B (A vs B; P Z .47). Intergroup comparisons for A were, N vs I; P ! .01, N vs Ad; P ! .01, N vs E; P ! .01, I vs Ad; P ! .01, I vs E; P ! .01, and Ad vs E; P Z .46. Intergroup comparisons for B were, N vs I; P ! .01, N vs Ad; P ! .01, N vs E; P ! .01, I vs Ad; P Z .03, I vs E; P !.01, and Ad vs E; P Z .06. There was no difference between real-life DOPyS scores and simulator scores (0.07). Limitations: The model does not have inbuilt assessment parameters. Conclusion: This simulator demonstrates construct and concurrent validity for colon polypectomy training. (Gastrointest Endosc 2014;79:490-7.) Colonoscopy training in the United Kingdom is gov- erned by the Joint Advisory Group on Gastrointestinal Endoscopy (JAG). 1 Simulation forms an integral part of the JAG training process. There are several types of colo- noscopy simulators available, ranging from bench models to virtual reality platforms. 2-6 The focus of these simulators Abbreviations: DOPyS, Direct Observation of Polypectomy Skills; JAG, Joint Advisory Group on Gastrointestinal Endoscopy; WIMAT, Welsh Institute for Minimal Access Therapy. DISCLOSURE: J. Ansell was funded to conduct this research by the Royal College of Surgeons of England Research Fellowship scheme. All other authors disclosed no financial relationships relevant to this publication. Copyright ª 2014 by the American Society for Gastrointestinal Endoscopy 0016-5107/$36.00 http://dx.doi.org/10.1016/j.gie.2013.08.003 Received February 11, 2013. Accepted August 4, 2013. Current affiliations: Welsh Institute for Minimal Access Therapy (1), University Hospital Llandough, Cardiff (2), University Hospital of Wales, Wales (3), Cardiff University School of Medicine, Cardiff, Wales, United Kingdom (4). Reprint requests: Mr James Ansell, MBBCh, Royal College of Surgeons Clinical Research Fellow in Simulation, Welsh Institute for Minimal Access Therapy (WIMAT), Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, Wales, United Kingdom. If you would like to chat with an author of this article, you may contact Mr Ansell at ansellj@cf.ac.uk. 490 GASTROINTESTINAL ENDOSCOPY Volume 79, No. 3 : 2014 www.giejournal.org