Abstract:

Objective To explore the application effect of the combination of four-quadrant localization and mechanical quantitative method in nursing education for advanced training nurses in endoscopic retrograde cholangiopancreatography（ERCP）. Methods A historical control study design was adopted，with ERCP advanced training nurses from the digestive endoscopy center of a hospital as the research objects. Those from January 2022 to December 2023（n=57） were assigned to the control group，and those from January 2024 to June 2025（n=59） to the experimental group. The control group adopted phased teaching method，while the experimental group integrated four-quadrant localization and mechanical quantitative method in addition to the phased teaching. Theoretical assessment scores，operational assessment scores and teaching effect evaluation were compared between the two groups，and semi-structured interviews were conducted with the experimental group. Results The operational assessment scores of the experimental group was significantly higher than those of the control group，and the difference was statistically significant（P<0.05）. This difference was mainly reflected in individual skills such as biliary-pancreatic duct axial judgment，direction adjustment of incision knife and coordination of deep guidewire intubation. Comparison of teaching method evaluations between the two groups showed statistically significant differences in five aspects：facilitating the understanding of knowledge and theory，enhancing movement accuracy，improving critical thinking ability，improving problem-analysis ability，and enhancing self-confidence and sense of professional value（all P<0.001）. Five themes were extracted from qualitative interviews：four-quadrant positioning improves judgment proactivity and accuracy；graded force quantification aids in force control；nursephysician cooperation shifts from “passive waiting” to “active coordination”；the teaching method is concrete and structured，reducing the learning curve and anxiety；and expectations for a standardized and systematic training system. Conclusion The combination of four-quadrant localization and mechanical quantitative method can effectively improve the operational skill level and comprehensive teaching effect of ERCP advanced training nurses，and promote the coordinated development of theoretical cognition，practical ability and professional confidence.

Key words: Cholangiopancreatography, Endoscopic Retrograde, Advanced Training Nurses, In-service Training