van der Wiel Sophia E, Koch Arjun D, Bruno Marco J
Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Endosc Int Open. 2019 Jun;7(6):E757-E761. doi: 10.1055/a-0842-6369. Epub 2019 May 17.
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. 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. 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). 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.
内镜逆行胰胆管造影术（ERCP）被认为是技术要求最高的内镜操作之一。然而，关于ERCP培训模拟器的可用数据有限。最近，我们的研究小组验证了博什科夫斯基-科斯塔马尼亚ERCP训练器是一种逼真的训练模型。作为该模型的扩展，设计了一种新型合成乳头，用于训练胆管括约肌切开术。我们旨在确定这种合成乳头的表面效度及其在括约肌切开术训练中的教学价值。邀请了每位有超过2500例ERCP终身经验的专家参与者进行胆管括约肌切开术，并填写一份关于该操作的逼真程度和教学价值的问卷。总共纳入了40名ERCP专家，他们来自16个不同的国家。专家们对进行胆管括约肌切开术的逼真程度的评价在10分制李克特量表上的中位数为7分，所执行操作的相似度为8分，触觉反馈为7分。当被问及切割是否被认为逼真时，专家们给出的评分为6分，切割结果评分为8分。切割乳头作为新手训练工具的潜力在4分制量表上的评分为4分，专家们高度一致同意将该乳头纳入新手培训（评分为4分）。这是第一个可用于在博什科夫斯基-科斯塔马尼亚ERCP训练器上训练括约肌切开术的合成乳头，它显示出良好的表面效度。ERCP专家高度认同其在新手内镜医师培训课程中的教学价值和附加价值。
