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The Erlanger Endo-Trainer offers a large spectrum of training possibilities in endoscopic techniques using life-like biological specimens. We organised the first pilot study of interventions at the papilla and the bile duct under x-ray control. Specially prepared upper visceral porcine organ packages including the esophagus, stomach, duodenum, liver, gallbladder and bile ducts were implanted into the Endo-Trainer. Furthermore, small stones were introduced into the bile duct. The test study was carried out by a senior endoscopist assisted by his endoscopy nurse. The following steps could therefore be carried out as a structured team-training scheme: Introduction of the side-viewing endoscope and passage into the duodenum; identification and adjustment at the papilla; cannulation of the papilla; selective bile duct imaging with contrast application under x-ray vision; placement of a guidewire; papillotomy; stone extraction and finally placement of a plastic stent. The special value of this type of simulation is the fact that endoscopic techniques can be trained in the usual manner with real tissue-feeling using regular commercial instruments. Although there is general consent that individual practice on the patient cannot be completely replaced by simulator training, a suitable and realistic simulation model can be of great value, for initial steps prior to "real" patient contact as well as for refining techniques and tactics.

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There is a long-lasting debate on whether subliminal advertising actually works. In this context there are some studies suggesting that subjects’ motivation is a crucial point. Karremans et al. [Karremans, J. C., Stroebe, W., & Claus, J. (2006). Beyond Vicary’s fantasies: The impact of subliminal priming and brand choice. Journal of Experimental Social Psychology, 42, 792–798] showed that subjects were influenced in their intention to drink a specific brand of soft drink by a subliminally presented brand prime, but only if they were thirsty. In the present study, we adapted their paradigm to the concept of ‘concentration’ and embedded the subliminal presentation of a brand logo into a computer game. Actual subsequent consumption of dextrose pills (of the presented or a not presented brand) was measured dependent on the level of participants’ tiredness and the subliminally presented logo. We found the same pattern as Karremans et al. (2006): only tired participants consumed more of the subliminally presented than the not presented brand. Therefore, the findings confirm that subjects are influenced by subliminally presented stimuli if these stimuli are need-related and if subjects are in the matching motivational state

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