Kaneko Junichi, Kobayashi Yosuke, Takinami Masaki, Kimata Masaharu, Nishino Masafumi, Takahashi Yurimi, Yoshizawa Yashiro, Murohisa Go, Hosoda Yoshisuke, Yamada Takanori
Department of Gastroenterology Iwata City Hospital Shizuoka Japan.
Department of Gastroenterology Seirei Hamamatsu General Hospital Shizuoka Japan.
DEN Open. 2025 Jan 28;5(1):e70068. doi: 10.1002/deo2.70068. eCollection 2025 Apr.
E-learning with video content was created to improve trainees' biliary cannulation techniques; this study aimed to evaluate its educational effect prospectively.
E-learning program was conducted using videos demonstrating biliary cannulation for 24 papillae, targeting trainees with 2-6 years of experience in endoscopic retrograde cholangiopancreatography. Ten consecutive cases of biliary cannulation for native papillae performed by trainees were prospectively assessed before and after the e-learning, respectively. The primary outcome was the difficult biliary cannulation rate; the secondary outcomes included a comprehension score assigned by the trainer for each biliary cannulation (maximum of 6 points), trainee failure rate, and adverse events incidence.
Eleven trainees participated in the e-learning program. The overall and per-trainee analyses showed no significant differences in the difficult biliary cannulation rate, trainee failure rate, and adverse event incidence before and after e-learning. However, the overall analysis showed a significant increase in comprehension scores after e-learning (median 4 vs. 5, < 0.01) and the per-trainee analysis revealed that the rate of comprehension score ≥5 increased significantly after e-learning (= 0.02). Comprehension score <5 (odds ratio: 4.31, < 0.01) and endoscopic retrograde cholangiopancreatography experience <3 years (odds ratio: 2.15, 0.01) were independent risk factors for difficult biliary cannulation. Additionally, the difficult biliary cannulation incidence showed a negative correlation with the comprehension score (< 0.01).
E-learning using video content did not result in a reduction in the difficult biliary cannulation rate. However, it significantly enhanced procedural understanding, indicating its potential to support future acquisition of biliary cannulation skills.
创建包含视频内容的电子学习课程以提高学员的胆管插管技术；本研究旨在前瞻性评估其教育效果。
针对有2至6年内镜逆行胰胆管造影经验的学员，使用展示24个乳头胆管插管的视频开展电子学习课程。分别前瞻性评估学员在电子学习前后连续进行的10例天然乳头胆管插管病例。主要结局指标为困难胆管插管率；次要结局指标包括培训师为每次胆管插管评定的理解分数（最高6分）、学员失败率和不良事件发生率。
11名学员参与了电子学习课程。总体分析和学员个体分析均显示，电子学习前后在困难胆管插管率、学员失败率和不良事件发生率方面无显著差异。然而，总体分析显示电子学习后理解分数显著提高（中位数由4分升至5分，<0.01），学员个体分析显示电子学习后理解分数≥5分的比例显著增加（=0.02）。理解分数<5分（优势比：4.31，<0.01）和内镜逆行胰胆管造影经验<3年（优势比：2.15，0.01）是困难胆管插管的独立危险因素。此外，困难胆管插管发生率与理解分数呈负相关（<0.01）。
使用视频内容的电子学习并未降低困难胆管插管率。然而，它显著增强了对操作的理解，表明其在支持未来胆管插管技能掌握方面的潜力。
