• James G Bittner, John D Mellinger, Toufic Imam, Robert R Schade, and Bruce V Macfadyen.
• Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia, USA. jbittner@mcg.edu
• Gastrointest. Endosc. 2010 Feb 1; 71 (2): 357-64.

BackgroundCurrently, little evidence supports computer-based simulation for ERCP training.ObjectiveTo determine face and construct validity of a computer-based simulator for ERCP and assess its perceived utility as a training tool.DesignNovice and expert endoscopists completed 2 simulated ERCP cases by using the GI Mentor II.SettingVirtual Education and Surgical Simulation Laboratory, Medical College of Georgia.Main Outcome MeasurementsOutcomes included times to complete the procedure, reach the papilla, and use fluoroscopy; attempts to cannulate the papilla, pancreatic duct, and common bile duct; and number of contrast injections and complications. Subjects assessed simulator graphics, procedural accuracy, difficulty, haptics, overall realism, and training potential.ResultsOnly when performance data from cases A and B were combined did the GI Mentor II differentiate novices and experts based on times to complete the procedure, reach the papilla, and use fluoroscopy. Across skill levels, overall opinions were similar regarding graphics (moderately realistic), accuracy (similar to clinical ERCP), difficulty (similar to clinical ERCP), overall realism (moderately realistic), and haptics. Most participants (92%) claimed that the simulator has definite training potential or should be required for training.LimitationsSmall sample size, single institution.ConclusionsThe GI Mentor II demonstrated construct validity for ERCP based on select metrics. Most subjects thought that the simulated graphics, procedural accuracy, and overall realism exhibit face validity. Subjects deemed it a useful training tool. Study repetition involving more participants and cases may help confirm results and establish the simulator's ability to differentiate skill levels based on ERCP-specific metrics.

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