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. 2023 May;11(4):350-360.
doi: 10.1002/ueg2.12377. Epub 2023 Apr 6.

A portrait of Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound training programs in Europe: Current practices and opportunities for improvement

Sara Teles de Campos  1   2 , Marianna Arvanitakis  2   3 , Jacques Devière  2   3
Affiliations

A portrait of Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound training programs in Europe: Current practices and opportunities for improvement

Sara Teles de Campos et al. United European Gastroenterol J. 2023 May.

Erratum in

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) and EUS are challenging procedures requiring a high level of expertise to provide effective and safe patient care. Thus, high-quality training is needed to achieve competence. We aimed to evaluate the status of European ERCP/EUS training programs, to evaluate adherence to international recommendations, and to propose possible solutions for future improvements.

Methods: A web-based survey was developed and ERCP/EUS experts and trainees across Europe were invited to participate.

Results: Forty-one experts (out of 50; 82%) and 30 trainees (out of 70; 42.9%) from 18 countries answered the questionnaire. The training program application process is mainly driven by individual requests (87.8%). All surveyed departments offer combined ERCP/EUS training and the majority have adequate facilities and trainers. Although centers are high-volume and provide long-term fellowships, trainee hands-on exposure is not very high (43% expect to do (or did) 100-150 ERCPs and 69% up to 150 EUSs). A formal curriculum is in place in 53.7% centers, including simulation-training in 27.3%. Competence is assessed in 65.7% of centers, but validated tools are applied in only 33.3%.

Conclusions: This survey first provides an overview of ERCP/EUS training programs across Europe. It shows that there is adherence to international guidelines to a certain degree, but several gaps in the application process, use of simulators for training, training curriculum and assessment of performance have been recognized. Overcoming these shortcomings could serve as a basis for further improvement in ERCP/EUS training.

Keywords: Curriculum; ERCP; EUS; Europe; training.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Geographical distribution of respondents to Endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic ultrasound (EUS) training survey: Austria (n = 1), Croatia (n = 1), Czech Republic (n = 1), Denmark (n = 1), Northern Ireland (n = 1), Norway (n = 1), Poland (n = 1), Sweden (n = 1); Hungary (n = 2), Portugal (n = 2), Romania (n = 2), United Kingdom (n = 2); Belgium (n = 3), Italy (n = 3); Germany (n = 4), Spain (n = 4); The Netherlands (n = 5), France (n = 6).
FIGURE 2
FIGURE 2
Average number of procedures per year in each center: Endoscopic ultrasound (EUS) (a) and Endoscopic retrograde cholangiopancreatography (ERCP) (b).
FIGURE 3
FIGURE 3
Average number of endoscopic ultrasound (EUS)/ERCP expected to be done by trainees at the end of the training.
FIGURE 4
FIGURE 4
Trainer's characteristics considered to be “extremely important” according to the experts' opinion (left columns) and trainees' opinion (right columns)—exceptions: “keep good track record with prior trainees” and “being a connector” were mentioned only by experts.
See this image and copyright information in PMC

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