Validation of a Novel Endoscopic Retrograde Cholangiopancreatography Cannulation Simulator
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Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) requires a unique skill set. Currently, there is noobjective methodology to assess and train a professional to perform ERCP. This study aimed to develop and validate a novel ERCPsimulator. Methods: The simulator consists of papillae presenting different anatomy and positioned in varied locations. Deep cannulation of thepancreatic duct, followed by the bile duct, was performed. The time allotted was 5 minutes. The content validity indexes (CVIs) forrealism, relevance, and representativeness were calculated. Correlation between ERCP experience and simulator score was determined. Results: Twenty-three participants completed the simulation. The CVIs for realism were orientation of duodenoscope to papilla (1.00),angulation of papillotome to achieve cannulation (0.71), and haptic feedback during cannulation (0.80). The CVIs for relevance wereuse of elevator (1.00), wheels to achieve en face orientation (1.00), and papillotome for selective cannulation (1.00). Regarding CVI forrepresentativeness, the results were as follows: basic cannulation (0.83), papilla locations (0.83), and papilla anatomies (0.80). The novice,intermediate, and experienced groups scored 6.7±8.7, 30.0±16.3, and 74.4±43.9, respectively (p<0.0001). There was a strong correlationbetween the ERCP experience level and the individual’s simulator score (Pearson value of 0.77, R2 of 0.60). Conclusions: This simulator appears to be realistic, relevant, and representative of ERCP cannulation techniques. Additionally, it iseffective at objectively assessing basic ERCP skills by differentiating scores based on clinical experience.
Abstract
Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) requires a unique skill set. Currently, there is noobjective methodology to assess and train a professional to perform ERCP. This study aimed to develop and validate a novel ERCPsimulator. Methods: The simulator consists of papillae presenting different anatomy and positioned in varied locations. Deep cannulation of thepancreatic duct, followed by the bile duct, was performed. The time allotted was 5 minutes. The content validity indexes (CVIs) forrealism, relevance, and representativeness were calculated. Correlation between ERCP experience and simulator score was determined. Results: Twenty-three participants completed the simulation. The CVIs for realism were orientation of duodenoscope to papilla (1.00),angulation of papillotome to achieve cannulation (0.71), and haptic feedback during cannulation (0.80). The CVIs for relevance wereuse of elevator (1.00), wheels to achieve en face orientation (1.00), and papillotome for selective cannulation (1.00). Regarding CVI forrepresentativeness, the results were as follows: basic cannulation (0.83), papilla locations (0.83), and papilla anatomies (0.80). The novice,intermediate, and experienced groups scored 6.7±8.7, 30.0±16.3, and 74.4±43.9, respectively (p<0.0001). There was a strong correlationbetween the ERCP experience level and the individual’s simulator score (Pearson value of 0.77, R2 of 0.60). Conclusions: This simulator appears to be realistic, relevant, and representative of ERCP cannulation techniques. Additionally, it iseffective at objectively assessing basic ERCP skills by differentiating scores based on clinical experience.
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