Efficacy and determinants of success in a structured ERCP training program: a retrospective cohort study from a national training center in China

Key Takeaways for GI Nurses

• Structured, mentorship-based ERCP training programs—like the national center model described in this study—provide a framework for evaluating whether new endoscopists and trainees are meeting competency benchmarks, which directly affects staffing and scheduling decisions in the ERCP suite.
• Competency in ERCP is defined not just by procedure volume but by cannulation success rates, reinforcing that GI nurses supporting trainees should be attentive to both case counts and quality metrics when assisting with credentialing or quality assurance documentation.
• Understanding the factors that predict a trainee's success (such as case volume, mentorship structure, and prior endoscopic experience) can help nursing staff anticipate which team members may need additional procedural support, longer case times, or closer monitoring during the learning curve.
• As ERCP training becomes more formalized globally, nurses play a critical role in the training ecosystem—from instrument readiness and patient positioning to real-time communication during complex cannulation attempts—making awareness of training benchmarks relevant to daily practice.

Clinical Relevance

ERCP is one of the most technically demanding procedures in the endoscopy suite, and the learning curve for achieving safe, independent competence is long and variable. This study's focus on a structured training program—and its attempt to define competence using both an entry-level threshold (>10 ERCPs annually with ≥70% cannulation success) and an advanced mastery benchmark (>90% cannulation success)—offers GI nursing teams a clearer picture of what "competent" actually looks like in practical, measurable terms. For nurses working alongside trainees or newly independent endoscopists, this translates into better-informed expectations about procedure duration, complication vigilance, and the level of assistance that may be required during cannulation attempts, sphincterotomy, and stent placement.

From an operational standpoint, findings on determinants of training success can help endoscopy unit leadership and nurse managers make the case for dedicated training rotations, protected case volumes, and mentorship pairing when developing or hosting their own ERCP training initiatives. Nurses often serve as the continuity link across multiple trainees and attending physicians, and insight into what separates successful graduates from those who struggle to reach competency can inform how pre-procedure briefings, room setup, and escalation protocols are structured to best support the learning process without compromising patient safety.

This research also underscores the global relevance of standardized ERCP training, particularly in regions facing workforce shortages. Nurses in training centers, whether in China or elsewhere, are uniquely positioned to observe real-time performance trends—difficulty with wire-guided cannulation, fluoroscopy interpretation, or sphincterotome control—that may not be fully captured in self-reported post-training questionnaires. Advocating for nursing input in competency assessment and training program design could strengthen the overall rigor and safety of ERCP education pathways.

Bottom Line

This study highlights that ERCP competency is a measurable, multifactorial outcome shaped by structured training, procedure volume, and cannulation success rates—information that GI nurses can use to better anticipate trainee support needs, contribute to competency assessment discussions, and advocate for the institutional resources necessary to sustain high-quality ERCP training programs.