在高级内镜培训期间对胰腺ERCP的有限暴露会影响独立实践中的能力和表现
Samuel Han1, Rajesh N Keswani2, Matt Hall3
1Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
概括
先进的内镜培训提供了不足的胰腺ERCP暴露,影响学员的能力. 目前的培训方法需要新的策略来提高胰腺ERCP技能,以获得更好的患者结果.
科学领域:
- 胃肠病学 胃肠病学
- 先进的内镜培训 培训
- 外科教育的外科教育
背景情况:
- 基于能力的培训计划对胰腺内镜逆行胆血管瘤学 (ERCP) 性能的影响还不清楚.
- 胰腺ERCP是一种复杂的程序,需要专门的技能.
- 目前的高级内镜培训可能无法充分为胰腺ERCP准备学员.
研究的目的:
- 在高级内镜学员 (AETs) 中描述胰腺ERCP的学习曲线.
- 在独立实践期间评估AET在胰腺ERCP中的表现.
- 确定当前ERCP培训课程中的潜在缺口.
主要方法:
- 一项多中心前性队列研究,涉及20个培训计划的24名AET.
- 使用脏ERCP评估 (TEESAT) 的累积和 (CUSUM) 分析来建立学习曲线.
- 在培训期间 (第一阶段) 和独立实践的第一年 (第二阶段) 监测了学员的表现.
主要成果:
- 只有16.7%的AET进行了足够的胰腺ERCP来产生有意义的学习曲线.
- 没有AET在培训期间获得了胰腺ERCP关键技能的能力.
- 在独立实践中,本地乳头胰腺管管道化率 (85.7%) 低于推的90%门.
结论:
- 先进的内镜培训提供了有限的胰腺ERCP暴露,这在独立实践中仍然存在.
- 目前的培训不足以为胰腺ERCP的复杂性准备内镜医生.
- 新的培训策略对于提高胰腺ERCP能力至关重要.
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