The impact of a hands-on ERCP workshop on clinical practice

Hands-on endoscopy workshops are increasingly common venues for procedure training. However, the effect of this type of training on the practices of participants is unknown. The goal of this study was to examine the changes in individual clinical practices subsequent to participation in an ERCP hands-on course. Forty-eight practicing pancreatobiliary endoscopists participating in a 2-day hands-on advanced ERCP course were asked to complete a 24-item survey evaluating their endoscopic practices both before and 3 months after workshop participation. The surveys evaluated monthly volume and self-confidence in performing the following procedures: diagnostic ERCP, standard sphincterotomy, needle-knife pre-cut sphincterotomy, biliary stone extraction, mechanical lithotripsy, plastic stent placement, metal stent placement, and biliary brushing for cytologic specimens. Thirty-one of the 48 participants (65%) who completed both pre- and postcourse surveys form the study cohort. After the workshop, there was a significant increase in use of needle-knife pre-cut sphincterotomy in clinical practices. In addition, the post-workshop survey indicated a significant increase in confidence for procedures such standard sphincterotomy, needle-knife pre-cut sphincterotomy, stone extraction, mechanical lithotripsy, placement of metal stents, and cytology brushing. Confidence in basic diagnostic ERCP and plastic stent placement did not increase because of high initial confidence levels. Participation in a hands-on course appears to increase the confidence of endoscopists in the performance of more complex interventions. However, this was only associated with increased clinical application for one technique.