The Benefit of an Intensive Training Course on ERCP Artificial Simulator on Decreasing the Cannulation Time Achieved by the Trainees

Abstract

Abstract Background Trainees learn to perform ERCP with hands-on training in a clinical setting on real patients under the supervision of a trained endoscopist: the so-called master apprentice model. This setting offers immediate feedback from an experienced endoscopist, but it also has certain drawbacks. Trainees learn by “trial and error,” which potentially increases patient discomfort and risk of complications and prolongs procedure time, which has additional economic consequences. Simulators offer the potential to train in a dedicated „learning environment, offering a less stressful situation with less potential risks and the opportunity to endlessly repeat specific tasks. Aim of the Work The aim of this study is to test the benefit of a two weeks intensive training course on ERCP artificial simulator on decreasing the cannulation time achieved by the trainees. Patients and Methods This is a prospective study including 20 trainees classified into 2 equal groups; group (1) included 10 trainees were enrolled in a clinical training program only, and group (2) included 10 trainees were enrolled in an intensive two weeks hands on training on BoskoskiCostamagna ERCP trainer followed by clinical training. Another group (3) included 10 expert endoscopist represent the control group. Results All steps for ERCP shows successful ERCP steps of the three studied groups, however group (2) showed better improvement than group (1) as compared to group (3). None had failed for the overall technique. All steps for ERCP in the current study shows statistically highly significant difference (p < 0.001) in comparison between the three studied groups. Group (2) with intensive training program had a highly significant difference than group (1) and group (3) had a highly significant difference than both groups (1) & (2). The total biliary and pancreatic cannulation times were statistically highly significant difference in comparison between the three studied groups. Conclusion ERCP is a skill demanding procedure, therefore trainees who will train in ERCP should be selected between those who are likely to achieve competence and will make good use of the valuable skills. Structured ERCP training programs are still not widely available, especially in developing countries. Scientific societies should promote training in endoscopy on all levels especially through scholarships for doctors from developing countries.