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Dig Dis Sci. 2016 Mar;61(3):722-30. doi: 10.1007/s10620-015-3939-7. Epub 2015 Nov 14.

Can a Computerized Simulator Assess Skill Level and Improvement in Performance of ERCP?

Author information

1
Division of Gastrointestinal and Liver Diseases, University of Southern California School of Medicine, 1510 San Pablo St, Los Angeles, CA, 90033, USA. arasahak@med.usc.edu.
2
Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar Street-1080 LMP, New Haven, CT, 06520, USA. loren.laine@yale.edu.
3
Section of Digestive Diseases, V.A. Connecticut Healthcare System, 333 Cedar Street-1080 LMP, West Haven, CT, 06520, USA. loren.laine@yale.edu.
4
Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar Street-1080 LMP, New Haven, CT, 06520, USA. priya.jamidar@yale.edu.
5
Section of Gastroenterology, University of Chicago, 5700 S. Maryland Ave, Chicago, IL, 60637, USA. usiddiqui@bsd.uchicago.edu.
6
Department of Surgery, Yale University School of Medicine, PO Box 208062, New Haven, CT, 06510, USA. andrew.duffy@yale.edu.
7
Department of Biostatistics, Yale School of Public Health, 60 College St, Suite 209, New Haven, CT, 06510, USA. maria.ciarleglio@yale.edu.
8
Yale Center for Analytical Sciences, Yale School of Public Health, 300 George St, Suite 555, New Haven, CT, 06510, USA. yanhong.deng@yale.edu.
9
Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar Street-1080 LMP, New Haven, CT, 06520, USA. anil.nagar@yale.edu.
10
Section of Digestive Diseases, V.A. Connecticut Healthcare System, 333 Cedar Street-1080 LMP, West Haven, CT, 06520, USA. anil.nagar@yale.edu.
11
Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar Street-1080 LMP, New Haven, CT, 06520, USA. harry.aslanian@yale.edu.

Abstract

BACKGROUND:

Endoscopic retrograde cholangiography (ERCP) is a challenging procedure with considerable risk. Computerized simulators are valuable in training for flexible endoscopy, but little data exist for their use in ERCP training.

AIM:

To determine a simulator's ability to assess the level of ERCP skill and its responsiveness over time to increasing trainee experience.

MATERIALS AND METHODS:

In this prospective parallel-arm cohort study, six novice gastroenterology fellows and four gastroenterology faculty with expertise in ERCP completed four simulated baseline cases and the same four cases at a later date. This study took place at a surgical skills center at an academic tertiary referral center. The primary outcome was the total time to complete the ERCP procedure.

RESULTS:

For the baseline session, experts had a shorter total procedure time than novices (444.0 vs. 616.9 s; least squares mean; p = 0.026). There was no significant difference between experts and novices in the difference of total procedure time between session 1 and session 2 (-200.3 vs. -164.4; least squares mean; p = 0.402).

CONCLUSIONS:

The simulator was able to differentiate experts from novices for the primary outcome of total procedure time. The simulator was not responsive to an increase in trainee experience over time.

KEYWORDS:

ERCP; ERCP simulator; ERCP training; Endoscopy quality measures; Endoscopy simulators

PMID:
26572779
DOI:
10.1007/s10620-015-3939-7
[Indexed for MEDLINE]
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