Simulation-Based Training for Endoscopy Nurses Improves Device-to-Field Time: A Prospective Study

Background: Assistant performance is important for endoscopy workflow, yet nurse training is often informal. We evaluated whether a structured simulation-and-theory program improves nurse-dependent workflow during live endoscopy. Methods: In this prospective parallel-group study, 20 endoscopy nurses were grouped 1:1 into Simulation+Theory or Control. Each nurse assisted 10 recorded live procedures performed by the same endoscopist (5 gastroscopies and 5 colonoscopies; 200 nurse–procedure observations). The prespecified procedure mix included diagnostic biopsies, dilation, cold-snare polypectomy, hot-snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection. The primary endpoint was device-to-field time, defined at the procedure level using one predefined index request per procedure. The primary analysis was performed at the nurse level, comparing within-nurse change from baseline (cases 1–3) to post-training (cases 4–10). Results: Groups performed similarly at baseline. From case 4 onward, the Simulation group showed shorter device-to-field times and maintained this advantage through case 10. In the primary nurse-level analysis, the between-group difference in change from baseline to post-training corresponded to a time ratio of 0.80 (95% confidence interval 0.76–0.85; p < 0.001), indicating approximately 20% faster device readiness after structured training. Supportive sensitivity analyses showed the same directional pattern. Conclusions: A brief structured simulation-and-theory program was associated with faster nurse device readiness during live endoscopy. These findings support ongoing structured nurse training as a practical strategy to improve workflow efficiency in endoscopy services.