Assessment of technical competence during ERCP training.
Successful performance of diagnostic and therapeutic ERCP requires skillful manipulation of the duodenoscope and accessories.
The evaluation process for assessing competency is still in evolution.
Recommendations for the number of examinations has ranged from 35 to 200, made without the benefit of prospective data.
Pancreatic and common bile duct cannulation rates were prospectively recorded for 21 trainees and 9 proctors over 6 years in a large university-based training program.
Trainee success rates were compared to those of the proctor and learning curves were constructed.
Trainees performed 641 examinations over 6 years.
Each did an average of 31 examinations (range, 10 to 96).
For both pancreatic duct and common bile duct cannulation, there was a rapid linear rise of the success curve extending up to the fortieth procedure.
Pancreatic duct cannulation rates exceeded those of the common bile duct.
This is the first prospective evaluation of acquisition of skills in ERCP.
Although the rapid rise of the learning curve ends at the fortieth examination, the 85% level of selective cannulation is not reached for the pancreas duct until the seventieth procedure and is not reached for the common bile duct even at 100 procedures.
These data suggest a threshold of at least 100 procedures.
Mots-clés Pascal : Cholangiopancréatographie, Endoscopie, Rétrograde, Diagnostic, Traitement, Formation professionnelle, Technique, Entraînement, Competency Screening Test, Médecin, Evaluation performance, Homme, Radiodiagnostic, Appareil digestif pathologie, Pancréas pathologie, Voie biliaire pathologie
Mots-clés Pascal anglais : Cholangiopancreatography, Endoscopy, Retrograde, Diagnosis, Treatment, Occupational training, Technique, Dragging, Competency Screening Test, Physician, Performance evaluation, Human, Radiodiagnosis, Digestive diseases, Pancreatic disease, Biliary tract disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0493590
Code Inist : 002B24E06. Création : 10/04/1997.