Endoscopic retrograde cholangiopancreatography (ERCP) has one of the highest complication rates of all gastrointestinal endoscopic procedures. Morbidity has been reported to be 7-10% and mortality as high as 1.2%. It is technically difficult to learn and requires a large number of procedures to become competent. During the proposed research HT Medical will develop a virtual reality ERCP simulation system that allows trainees to learn and practice this procedure prior to actual patient contact. This offers the potential to improve patient care, decrease costs, and provide objective measurement of procedural competence. During Phase I a prototype simulator that emphasizes diagnostic ERCP will be developed and evaluated by gastrointestinal endoscopists. In Phase II of this project, the prototype simulator will be advanced to included therapeutic ERCP procedures. Visual and tactile enhancements that are necessary for commercialization will be made based on the evaluation of the endoscopists. A more comprehensive study will be conducted to evaluate the training efficacy of the simulator. During Phase II we will target medical schools, physician training programs, medical device companies, and CME organizations. The market base will be expanded by other medical simulators, using technology developed for the ERCP simulator. PROPOSED COMMERCIAL APPLICATION: There is a significant need for improved endoscopic training and no products currently exist that meet this need. The virtual reality simulator would be used to train physicians to perform ERCP. The target market includes medical schools, physician training programs, medical device companies, and organizations and hospitals that teach Continuing Medical Education courses. We plan on capturing an even larger market by leveraging the technology developed for the ERCP simulator to produce other medical simulators.