Original Articles
A direct comparison of ERCP teaching models,☆☆,

https://doi.org/10.1016/S0016-5107(03)70025-XGet rights and content

Abstract

Background: Several teaching models for ERCP are now available. Live, anesthetized porcine models have been used for many years, but harvested porcine organ preparations have recently been developed, and computer-based endoscopy simulators now incorporate ERCP modules. Each has proven to be a useful educational modality, but there is no direct comparison among these models. This study compared the performance of these 3 ERCP teaching models. Methods: Twenty endoscopists used each ERCP training model (computer simulator, harvested porcine organ, live anesthetized pig) and then completed a survey grading the realism and performance of each model compared with performance of ERCP in patients. A rank order was established for the models relative to their realism, educational utility, ease of use, and ease of incorporation into a training program. Results: The harvested porcine organ model scored highest on indices of realism, usefulness, and performance, although this reached statistical significance only for “ease of use” (p < 0.05). Conversely, the computer simulator scored significantly lower in most realism scores, although it was felt to be the one model most easily incorporated into a training program. Conclusions: Although each ERCP teaching model has proven to be a useful training modality, the harvested porcine organ model was felt to be the most realistic as well as the most favorable model for instruction in both basic and advanced ERCP. (Gastrointest Endosc 2003;57:886-90.)

Section snippets

Materials

The American Society for Gastrointestinal Endoscopy (ASGE) sponsored a “hands-on” advanced ERCP training course in February 2002. In a prospective descriptive study, 20 endoscopists (10 students, 10 faculty) drawn randomly from volunteers among the course participants were surveyed. The subjects included 48 “students” and 17 expert faculty. The subjects had varying levels of endoscopic experience, but each had prior training in ERCP, current hospital privileges to perform ERCP, and was

Results

All 20 subjects used each of the 3 models and completed the comparison survey. One faculty subject failed to complete a portion of the realism scores for the Erlangen model.

Median scores for realism in comparison to ERCP in patients are shown in Table 1.

. Scores for realism compared with a human ERCP

ModelTissue pliabilityPapillary anatomyVisual realismCannulation realismOverall experience
Combined group (all subjects)
 Erlangen (n = 19)6.0 (5.0-7.0)6.0 (4.0-7.0)6.0 (6.0-7.0)6.0 (4.0-7.0)5.0

Discussion

Training in procedures is coming under increasing scrutiny in all specialties, as attention is focused on errors, outcomes, and complications. Although experience and training in ERCP are closely associated with outcome of success versus failure, the participation of fellows and performance of ERCPs within a training environment have not been associated with increased complications.6 One result of the increased attention to training and outcomes is the growing interest in non-human training

Disclosure

The authors Bret Petersen and Kenneth Binmoeller served as the course director and co-director for the ASGE hands-on ERCP course where the data for this study was collected. None of the authors have any commercial association with the companies mentioned in this manuscript.

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    Citation Excerpt :

    It allows trainees to train with a real endoscope and accessories. The model has been extensively used in ERCP training workshops [51,52]. The Erlangen Endo Trainer, as well as the live animal model, scored high on realism and the model seems most useful in teaching basic ERCP skills [10,52].

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Funding for this project was provided by the ASGE.

☆☆

Reprint requests: Bret T. Petersen, MD, Eisenberg 8w-GI Endoscopy, Mayo Clinic, Rochester, MN 55905.

0016-5107/2003/$30.00 + 0

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