Efficacy of e-learning using video content in improving trainees’ biliary cannulation skills and understanding (with video)

Abstract

Objectives

E-learning with video content was created to improve trainees’ biliary cannulation techniques; this study aimed to evaluate its educational effect prospectively.

Methods

E-learning program was conducted using videos demonstrating biliary cannulation for 24 papillae, targeting trainees with 2–6 years of experience in endoscopic retrograde cholangiopancreatography. Ten consecutive cases of biliary cannulation for native papillae performed by trainees were prospectively assessed before and after the e-learning, respectively. The primary outcome was the difficult biliary cannulation rate; the secondary outcomes included a comprehension score assigned by the trainer for each biliary cannulation (maximum of 6 points), trainee failure rate, and adverse events incidence.

Results

Eleven trainees participated in the e-learning program. The overall and per-trainee analyses showed no significant differences in the difficult biliary cannulation rate, trainee failure rate, and adverse event incidence before and after e-learning. However, the overall analysis showed a significant increase in comprehension scores after e-learning (median 4 vs. 5, p < 0.01) and the per-trainee analysis revealed that the rate of comprehension score ≥5 increased significantly after e-learning (p = 0.02). Comprehension score <5 (odds ratio: 4.31, p < 0.01) and endoscopic retrograde cholangiopancreatography experience <3 years (odds ratio: 2.15, p = 0.01) were independent risk factors for difficult biliary cannulation. Additionally, the difficult biliary cannulation incidence showed a negative correlation with the comprehension score (p < 0.01).

Conclusions

E-learning using video content did not result in a reduction in the difficult biliary cannulation rate. However, it significantly enhanced procedural understanding, indicating its potential to support future acquisition of biliary cannulation skills.