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Coached practice using ERCP mechanical simulator improves trainees' ERCP performance: a randomized controlled trial
Abstract
BACKGROUND AND STUDY AIMS: Preliminary data suggested that simulation practice using an endoscopic retrograde cholangiopancreatography (ERCP) mechanical simulator (EMS) improved trainees' skill. The aims of the current study were to confirm the impact of coached EMS practice at the beginning of ERCP training and to investigate whether subsequent uncoached EMS practice provides additional benefit. METHODS: Trainees entering ERCP training in 2008 (n = 8) and 2009 (n = 8) at two referral medical centers were randomized to receive a coached EMS practice either with (2009) or without (2008) subsequent uncoached practices or only routine training (controls). The outcome measures were successful deep biliary cannulation by the trainee and overall performance score as rated by blinded trainers, during the subsequent 3 months of clinical practice. RESULTS: Trainees undergoing single and multiple EMS practices were more likely than controls to achieve successful biliary cannulation (single: adjusted odds ratio [aOR] 2.89, 95 % confidence interval [CI] 2.21 - 3.80 [P < 0.001]; multiple: 3.09, 95 %CI 1.13 - 8.46 [P = 0.028]) and to have superior overall performance scores (aOR 3.29, 95 %CI 1.37 - 7.91 [P = 0.008] and 6.92, 95 %CI 3.77 - 12.69 [P < 0.001], respectively). The benefit of single and multiple EMS practices on overall performance score remained significant after adjustment for success or failure of deep biliary cannulation (aOR 2.98, 95 %CI 1.38 - 6.43 [P = 0.005] and 6.09, 95 %CI 2.40 - 15.45 [P < 0.001], respectively). The benefits of single vs. multiple EMS practices were not statistically different. CONCLUSIONS: Coached simulation using EMS improved novice trainees' success of biliary cannulation and overall ERCP performance. Additional uncoached practices did not appear to provide further benefit. Trainees should undergo a coached EMS practice at the beginning of ERCP training.
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“| Coaching process related | Session duration | >2 h | [72,78] |”
From Coaching in undergraduate and graduate medical education: a scoping review of success factors, barriers, and outcomes (2026) · cites this paper as [78]
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Metadata
- Authors
- Liao, W.-C., Leung, J., Wang, H.-P., Chang, W.-H., Chu, C.-H., Lin, J.-T., Wilson, R., Lim, B., & Leung, F.
- Affiliations
- National Taiwan University (TW)
- VA Northern California Health Care System (US)
- National Taiwan University Hospital (TW)
- Mackay Memorial Hospital (TW)
- Kaiser Permanente (US)
- University of California, Los Angeles (US)
- Corresponding author
- Leung, Joseph
- Venue
- Endoscopy
- Publisher
- Georg Thieme Verlag KG
- Published
- 2013-07-29
- Volume
- 45
- Issue
- 10
- Pages
- 799-805
- ISSN
- 0013-726X (ISSN-L)
- 1438-8812
- OpenAlex
- W2328634208
- Cited by
- 54
- References
- 0
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 1 · 2023: 7 · 2022: 7 · 2021: 3 · 2020: 7 · 2019: 2 · 2018: 6 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 3
- FWCI
- 2.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endoscopy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Surgical Simulation and Training
- Social Sciences › Education › Simulation-Based Education in Healthcare
- Social Sciences › Education › Innovations in Medical Education
- Keywords
- endoscopic retrograde cholangiopancreatography, mechanical simulator, simulation-based training, biliary cannulation, coaching, procedural skill acquisition, endoscopy education, trainee performance assessment, novice trainees, performance score
- MeSH terms
- Cholangiopancreatography, Endoscopic Retrograde, Clinical Competence, Education, Medical, Graduate, Humans, Models, Anatomic, Taiwan, Teaching, Single-Blind Method, Intention to Treat Analysis
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