Simulation-Based Training Accelerates ERCP Learning Curve in Novice Trainees

Pancreatobiliary

Rajesh N. Keswani, MD, MS reviewing Teles de Campos S, et al. Endoscopy 2024 Nov 14.

Simulation-based training is an important mechanism for safely teaching novice physicians how to perform medical procedures. However, there is a paucity of data on how to incorporate simulation-based learning into ERCP and whether it can truly accelerate trainees’ attainment of competency.

The authors conducted a multicenter randomized controlled trial of 16 trainees without ERCP experience. Control and simulation groups received standard hands-on training under the supervision of their local ERCP trainers. The simulation group received concurrent simulation training during their first 3 months of ERCP training. Simulation training consisted of 2 days of training once a month utilizing an animal model (chicken heart fashioned to behave as a papilla) inside a training box. Trainee performance was assessed after each procedure using the validated TEESAT tool, which measures performance on various technical and cognitive ERCP skills over the first year of training.

There was no difference in global overall competence between the groups. However, the native biliary cannulation rate was significantly higher for the simulation group (52% vs 42%). Similarly, the simulation trainees had faster biliary cannulation time (6 minutes vs 8 minutes) and sphincterotomy competency.

Comment:

The authors must be commended for completing such a vital and complex study that identified a scalable method to accelerate the ERCP learning curve for new trainees. The big-picture finding in this trial is that trainees receiving simulation-based training at the beginning of their ERCP training achieved competency in cannulation and sphincterotomy significantly faster than their counterparts. As there are essentially no risks associated with simulation-based training, programs should understand how to operationalize this learning tool in ERCP training.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Rajesh N. Keswani, MD, MS

Bio and Disclosures

Citation(s):

Teles de Campos S, Boškoski I, Voiosu T, et al. Fast-tracking ERCP learning with the Boškoski-Costamagna Trainer: results of a multicenter randomized clinical trial. Endoscopy 2024 Nov 14. (Epub ahead of print) (https://doi.org/10.1055/a-2443-6582)