title: Development of a novel ERCP mechanical simulator.
abstract: BACKGROUND
  There is a paucity of objective methods for evaluating trainee performance and comparing ERCP accessories.
  
  
  OBJECTIVE
  Use of a mechanical ERCP simulator to evaluate trainee performance and to compare ERCP accessories via procedure time.
  
  
  METHODS
  Pilot study using a mechanical simulator.
  
  
  METHODS
  Hands-on ERCP practice workshops.
  
  
  METHODS
  Endoscopists at various levels of ERCP experience.
  
  
  METHODS
  Validation studies are described to show that the simulator permits participants with varying ERCP experience to demonstrate their skill levels and offers novel training applications in ERCP courses. The time required for completing a simulated stent placement procedure, simulated fluoroscopy time, and participant expectations were recorded in different settings. Participants' expectations were compared before and after training to determine whether the simulator was a credible adjunct to ERCP training.
  
  
  RESULTS
  Significantly shorter procedure times were recorded for the same accessories used by participants with more ERCP experience than those with less experience and for the same group of participants when using accessories with 1 design compared with another. The mean total credibility score showed a significant increase after simulator practice.
  
  
  CONCLUSIONS
  In vitro practice by using a mechanical simulator; results may not translate directly to the clinical setting. How the objective procedure times measured during practice can complement assessment of trainee competence or define usefulness of different accessories is unknown but deserves to be explored in future studies.
  
  
  CONCLUSIONS
  The procedure times can categorize participants according to their ERCP experience and separate accessories according to their ease of use. An increase in credibility score validates participants' endorsement of such practice as a credible adjunct to ERCP training.
authors.affiliation: Section of Gastroenterology, Sacramento Veterans Affairs Medical Center, Veterans Affairs Northern California Healthcare System, Mather 95655, and Division of Gastroenterology, Davis Medical Center, University of California, Sacramento, USA.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Leung
authors.forename: John G
authors.initials: JG
authors.lastname: Lee
authors.forename: Micha
authors.initials: M
authors.lastname: Rojany
authors.forename: Robert
authors.initials: R
authors.lastname: Wilson
authors.forename: Felix W
authors.initials: FW
authors.lastname: Leung
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation*; D003135:Common Bile Duct / Q000601:surgery; D004502:Education, Medical, Continuing / Q000379:methods*; D019723:Endoscopes; D004867:Equipment Design; D005762:Gastroenterology; D006801:Humans; D010865:Pilot Projects; D019919:Prosthesis Implantation / Q000295:instrumentation; D015607:Stents; D011795:Surveys and Questionnaires