A simple model for a complex procedure: broadening access to endoscopic retrograde cholangiopancreatography simulation.

Key Takeaways for GI Nurses

• A newly described low-cost, simplified simulation model aims to make ERCP training more widely accessible, which has direct implications for how endoscopy units structure staff competency programs.
• Because ERCP is a high-complexity, high-risk procedure, simulation-based training allows nurses and other members of the endoscopy team to build familiarity with equipment, workflow, and potential complications in a zero-risk environment before encountering them with live patients.
• Broader access to simulation tools means smaller or resource-limited endoscopy units—not just large academic tertiary centers—may now be able to offer hands-on ERCP education to nursing and technician staff.
• Nurses involved in training, orientation, or competency validation should be aware of emerging simulation options as a potential addition to existing education pathways, particularly for staff new to advanced endoscopy support roles.

Clinical Relevance

ERCP remains one of the most technically demanding procedures performed in the endoscopy suite, requiring tight coordination between the physician, sedation team, and supporting nursing staff. For endoscopy nurses and technicians, true competency extends beyond understanding the clinical indications—it requires fluency with fluoroscopy positioning, accessory selection and handling (sphincterotomes, stents, baskets, balloons), rapid troubleshooting, and anticipation of complications such as pancreatitis, bleeding, or perforation. Traditional training for these skills has largely depended on live-case exposure, which is inherently variable, dependent on institutional case volume, and limited by patient safety considerations. A simplified simulation model addresses this gap by offering a reproducible, standardized way to introduce or reinforce ERCP workflow and technical concepts outside of direct patient care.

The significance of a "simple" model, as opposed to high-fidelity, high-cost mannequin or virtual-reality systems, is that it lowers the barrier to entry for institutions with limited education budgets or lower ERCP volumes. This matters for nursing practice because competency in assisting with advanced procedures is often a documentation and credentialing requirement, yet opportunities to practice are not evenly distributed across facilities. A more accessible simulation tool could support more consistent onboarding for new endoscopy nurses, refresher training for staff who support ERCP infrequently, and interdisciplinary team training that includes nursing, technologist, and physician trainees practicing together in a lower-stakes setting.

From a unit operations perspective, incorporating simulation into staff development may also support safety culture and procedural efficiency. Teams that have rehearsed equipment setup, troubleshooting, and communication patterns in simulation may demonstrate smoother room turnover, fewer delays related to equipment unfamiliarity, and improved confidence when assisting with urgent or complex cases. For nursing professional development leaders, this type of innovation is worth monitoring as a potential low-cost addition to existing competency validation programs, particularly as endoscopy units continue to face staffing turnover and the ongoing need to train new team members efficiently.

Bottom Line

This publication highlights a simplified, more accessible ERCP simulation model that could help endoscopy units of all sizes strengthen staff training and competency for one of the most complex procedures nurses support—offering a practical, low-cost pathway to building confidence and skill before stepping into live, high-stakes cases.