Face and construct validity of a novel mechanical ERCP simulator

Wiel, Sophia E. van der; Koch, Arjun D.; Bruno, Marco J.

doi:10.1055/s-0044-101754

Cited by 20 publications

(22 citation statements)

References 30 publications

(43 reference statements)

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“…23 Validation studies of these simulators revealed that operators with more clinical ERCP experience performed better on the simulators compared to those with less experience. [20][21][22][23][24] Considering previous models, our simulator contains multiple papillae that vary based on several factors, including: (1) angles or axes of the papilla, (2) common channel length, (3) angle between biliary and pancreatic ducts, and (4) location within the duodenum. Additionally, a papilla to simulate Billroth II and RYGB anatomy was included for assessment of advanced cannulation skill.…”

Section: Discussionmentioning

confidence: 99%

Validation of a Novel Endoscopic Retrograde Cholangiopancreatography Cannulation Simulator

et al. 2020

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Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) requires a unique skill set. Currently, there is no objective methodology to assess and train a professional to perform ERCP. This study aimed to develop and validate a novel ERCP simulator. Methods: The simulator consists of papillae presenting different anatomy and positioned in varied locations. Deep cannulation of the pancreatic duct, followed by the bile duct, was performed. The time allotted was 5 minutes. The content validity indexes (CVIs) for realism, 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 were use of elevator (1.00), wheels to achieve en face orientation (1.00), and papillotome for selective cannulation (1.00). Regarding CVI for representativeness, 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 correlation between the ERCP experience level and the individual's simulator score (Pearson value of 0.77, R 2 of 0.60). Conclusions: This simulator appears to be realistic, relevant, and representative of ERCP cannulation techniques. Additionally, it is effective at objectively assessing basic ERCP skills by differentiating scores based on clinical experience.

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Section: Discussionmentioning

confidence: 99%

Validation of a Novel Endoscopic Retrograde Cholangiopancreatography Cannulation Simulator

et al. 2020

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“…The synthetic papilla is a newly developed insertable component in the previously described mechanical ERCP simulator, the Boškoski-Costamagna ERCP Trainer (Cook Medical, Limerick, Ireland) 2 . It can be used to perform sphincterotomy.…”

Section: Methodsmentioning

confidence: 99%

“…Despite the fact that ERCP seems to be an ideal platform for simulation-based training, limited data are available on simulators in training ERCP. Recently, our study group has validated a novel mechanical ERCP simulator, the Boškoski-Costamagna ERCP Trainer 2 . This simulator allows novice trainees to practice cannulation, stent placement in both common bile duct (CBD) and pancreatic duct (PD), and CBD stone extraction.…”

Section: Introductionmentioning

confidence: 99%

Face validity of a synthetic papilla designed for biliary sphincterotomy training

2019

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Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is considered one of the most technically demanding endoscopic procedures. Still, limited data are available on simulators in ERCP training. Recently, the Boškoski-Costamagna ERCP Trainer was validated as a realistic training model by our study group. As an extension to this model, a novel synthetic papilla has been designed allowing to train biliary sphincterotomy. We aimed to determine the face validity of this synthetic papilla and its didactic value for training sphincterotomy. Methods Expert participants, each with more a than 2500 ERCPs lifetime experience, were invited to perform a biliary sphincterotomy and fill out a questionnaire on the realism of the procedure and the didactic value. Results A total of 40 ERCP experts were included, originating from 16 different countries. Experts’ opinion on realism of performing a biliary sphincterotomy was rated with a median of 7 on a 10-point Likert scale, resemblance of the performed maneuvers 8 and tactile feedback 7. When asked if the cutting was perceived as realistic, experts rated a 6 and the cutting result was rated 8. The potential of the cutting papilla as a training tool for novices was rated 4 on a 4-point scale and there was a high agreement among the experts to include the papilla in the training of novices (rating 4). Conclusion This is the first synthetic papilla available for training sphincterotomy on the Boškoski-Costamagna ERCP Trainer and it demonstrates good face validity. ERCP experts highly agree on its didactic value and added value in the training curriculum of novice endoscopists.

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“…2). It has recently been validated for cannulation as well as for sphincterotomy by the Rotterdam group in two different studies [10,11].…”

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confidence: 99%

Blind-eye cannulation as a new method for ERCP training: Can we do more than merely teach?

et al. 2020

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Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) requires extensive hands-on training. Currently in ERCP training there are two very important problems that need attention: lack of standardized commands for communication, and misunderstanding between the trainee and the trainer. Methods A method of “blind-eye” cannulation was developed with two paired trainees using the Boškoski-Costamagna ERCP Trainer. The trainee who was holding the duodenoscope was blind-folded and the other trainee gave instructions on what maneuvers were necessary to achieve cannulation, under the supervision of a trainer. Before starting cannulation, a standard list of commands was agreed by the operators. Results The blind-eye method of cannulation teaches the operator trainee to listen and the assistant trainee to teach. Trainees use standardized commands. During the training session the two trainees swapped roles. Conclusions Currently, we do not have proof that this type of training is useful, therefore, scientific studies are needed for confirmation. However, we believe that this ERCP model may provide an entirely safe means of improving communication and technical proficiency.

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Face and construct validity of a novel mechanical ERCP simulator

Cited by 20 publications

References 30 publications

Validation of a Novel Endoscopic Retrograde Cholangiopancreatography Cannulation Simulator

Validation of a Novel Endoscopic Retrograde Cholangiopancreatography Cannulation Simulator

Face validity of a synthetic papilla designed for biliary sphincterotomy training

Blind-eye cannulation as a new method for ERCP training: Can we do more than merely teach?

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