Acquisition of cognitive and technical competence in ERCP: A prospective multicenter study

Marcia Canto, A. Chak, M. V. Sivak, B. J. Pollack, G. Elta, J. Barnett, M. Kochman, W. Long, G. Ginsberg, R. Bedford, M. Khandelwal, T. McGarrity, A. Damianos, W. Wassef, A. Zfass, A. Foxx-Orrenstein, M. Dabezies

Research output: Contribution to journalArticle

Abstract

Very little is known about the process of acquisition of cognitive and technical skills in ERCP. AIM: To describe the learning curve for cognitive and technical skills in diagnostic and therapeutic ERCP in a variety of GI fellowship training programs. METHODS: Over a 2-year period, 16 attendings skilled in ERCP supervised and graded 38 GI trainees (6 advanced or ADV, 32 regular or REG) from 7 university medical centers. 4 centers had formal ADV training programs. Cognitive and technical skills for each component of diagnostic ERCP (precannulation, CBD and PD cannulation) and each therapeutic maneuver were graded immediately following ERCP using pretested standardized scales. To adjust the learning curves, the difficulty of each ERCP component was estimated using a standardized scale pretested against procedure time. Cognitive skills were also evaluated before and after the training period with a pretested written test. RESULTS: Mean difficulty scores for ERCP were highly correlated with actual times for precannulation and cannulation (Spearman corr coeff=.45-.57, p=.0001). All REG trainees and 1 ADV trainee had no prior ERCP experience. After adjusting for procedure difficulty, the CBD and PD cannulation learning curves for REG trainees had initial steep slopes and continued rise without a plateau at competent score levels. In contrast, those for ADV trainees showed early gradual rise then plateau at competent levels. Mean CBD cannulation scores were significantly higher for ADV trainees than for REG trainees(p

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume45
Issue number4
StatePublished - 1997
Externally publishedYes

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Endoscopic Retrograde Cholangiopancreatography
Mental Competency
Multicenter Studies
Prospective Studies
Catheterization
Learning Curve
Education
Therapeutics

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Canto, M., Chak, A., Sivak, M. V., Pollack, B. J., Elta, G., Barnett, J., ... Dabezies, M. (1997). Acquisition of cognitive and technical competence in ERCP: A prospective multicenter study. Gastrointestinal Endoscopy, 45(4).

Acquisition of cognitive and technical competence in ERCP : A prospective multicenter study. / Canto, Marcia; Chak, A.; Sivak, M. V.; Pollack, B. J.; Elta, G.; Barnett, J.; Kochman, M.; Long, W.; Ginsberg, G.; Bedford, R.; Khandelwal, M.; McGarrity, T.; Damianos, A.; Wassef, W.; Zfass, A.; Foxx-Orrenstein, A.; Dabezies, M.

In: Gastrointestinal Endoscopy, Vol. 45, No. 4, 1997.

Research output: Contribution to journalArticle

Canto, M, Chak, A, Sivak, MV, Pollack, BJ, Elta, G, Barnett, J, Kochman, M, Long, W, Ginsberg, G, Bedford, R, Khandelwal, M, McGarrity, T, Damianos, A, Wassef, W, Zfass, A, Foxx-Orrenstein, A & Dabezies, M 1997, 'Acquisition of cognitive and technical competence in ERCP: A prospective multicenter study', Gastrointestinal Endoscopy, vol. 45, no. 4.
Canto, Marcia ; Chak, A. ; Sivak, M. V. ; Pollack, B. J. ; Elta, G. ; Barnett, J. ; Kochman, M. ; Long, W. ; Ginsberg, G. ; Bedford, R. ; Khandelwal, M. ; McGarrity, T. ; Damianos, A. ; Wassef, W. ; Zfass, A. ; Foxx-Orrenstein, A. ; Dabezies, M. / Acquisition of cognitive and technical competence in ERCP : A prospective multicenter study. In: Gastrointestinal Endoscopy. 1997 ; Vol. 45, No. 4.
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AU - Canto, Marcia

AU - Chak, A.

AU - Sivak, M. V.

AU - Pollack, B. J.

AU - Elta, G.

AU - Barnett, J.

AU - Kochman, M.

AU - Long, W.

AU - Ginsberg, G.

AU - Bedford, R.

AU - Khandelwal, M.

AU - McGarrity, T.

AU - Damianos, A.

AU - Wassef, W.

AU - Zfass, A.

AU - Foxx-Orrenstein, A.

AU - Dabezies, M.

PY - 1997

Y1 - 1997

N2 - Very little is known about the process of acquisition of cognitive and technical skills in ERCP. AIM: To describe the learning curve for cognitive and technical skills in diagnostic and therapeutic ERCP in a variety of GI fellowship training programs. METHODS: Over a 2-year period, 16 attendings skilled in ERCP supervised and graded 38 GI trainees (6 advanced or ADV, 32 regular or REG) from 7 university medical centers. 4 centers had formal ADV training programs. Cognitive and technical skills for each component of diagnostic ERCP (precannulation, CBD and PD cannulation) and each therapeutic maneuver were graded immediately following ERCP using pretested standardized scales. To adjust the learning curves, the difficulty of each ERCP component was estimated using a standardized scale pretested against procedure time. Cognitive skills were also evaluated before and after the training period with a pretested written test. RESULTS: Mean difficulty scores for ERCP were highly correlated with actual times for precannulation and cannulation (Spearman corr coeff=.45-.57, p=.0001). All REG trainees and 1 ADV trainee had no prior ERCP experience. After adjusting for procedure difficulty, the CBD and PD cannulation learning curves for REG trainees had initial steep slopes and continued rise without a plateau at competent score levels. In contrast, those for ADV trainees showed early gradual rise then plateau at competent levels. Mean CBD cannulation scores were significantly higher for ADV trainees than for REG trainees(p

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