Gould D A, Kessel D O, Healey A E, Johnson S J, Lewandowski W E
Department of Medical Imaging, University of Liverpool, Liverpool, UK.
Clin Radiol. 2006 Jul;61(7):556-61. doi: 10.1016/j.crad.2006.01.013.
Training in interventional radiology (IR) relies on a traditional apprenticeship; to protect patients, expert supervision is mandatory until knowledge, attitudes and practical skills have been certified as satisfactory. However, the current quality of IR training is threatened by reduced time for trainees to learn, as well as a loss of basic diagnostic, training cases to non-invasive imaging. At the same time, IR techniques are becoming a focus of interest to a range of other clinical specialities. To address this training shortfall there is a need to develop novel training alternatives such as simulator models. Few simulator models in any medical field have been successfully validated to show improved clinical skills in treating patients. To date no endovascular simulator has met this standard. A good simulator must be based around key performance measures (metrics) derived from careful analysis of the procedure to be replicated. Metrics can be determined by trained psychologists from a direct analysis of the content of the job or task to be tested. The identification of these critical measures of performance is a complex process which must be tailored to a training curriculum to be effective. Simulators based on flawed metrics will invariably lead to unsatisfactory assessment. It follows that simulator development must involve the statutory licensing authorities. Equally it is essential that we do not assume that training on a particular simulator will correlate with the ability to perform the task in the real world. This "transfer of training" must be rigorously proven by validation studies.
介入放射学(IR)培训依赖于传统的师徒制;为保护患者,在知识、态度和实践技能被证明令人满意之前,必须有专家监督。然而,IR培训的当前质量受到学员学习时间减少以及基础诊断培训病例被无创成像取代的威胁。与此同时,IR技术正成为一系列其他临床专业关注的焦点。为弥补这一培训缺口,需要开发新的培训方式,如模拟器模型。在任何医学领域,很少有模拟器模型经过成功验证以证明能提高治疗患者的临床技能。迄今为止,没有血管内模拟器达到这一标准。一个好的模拟器必须基于对要复制的操作进行仔细分析得出的关键性能指标(度量)。度量可由训练有素的心理学家通过直接分析要测试的工作或任务内容来确定。确定这些关键性能指标是一个复杂的过程,必须根据培训课程进行调整才能有效。基于有缺陷度量的模拟器必然会导致评估不满意。因此,模拟器开发必须涉及法定许可机构。同样重要的是,我们不能假定在特定模拟器上的培训将与在现实世界中执行任务的能力相关。这种“培训迁移”必须通过验证研究严格证明。