Sidhu R, Sakellariou P, McAlindon M E, Leeds J S, Shafiq K, Hoeroldt B S, Hopper A D, Karmo M, Salmon C, Elphick D, Ali A, Sanders D S
Gastroenterology and Liver Unit, P Floor, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, United Kingdom.
Dig Liver Dis. 2008 Apr;40(4):298-302. doi: 10.1016/j.dld.2007.11.022. Epub 2008 Feb 20.
Little is known about the infrastructure to train gastroenterologists in capsule endoscopy. The level of capsule endoscopy exposure among trainees in the United Kingdom or Europe has also not been quantified.
To assess the ability of 10 gastroenterology trainees with endoscopy experience to interpret 10 capsule endoscopy videos against five medical students, with an expert in capsule endoscopy as the gold standard. Parameters assessed included gastric emptying time, small bowel transit and the diagnosis made. A questionnaire survey assessed the level of capsule endoscopy exposure among United Kingdom trainees.
Trainees were better at determining the gastric emptying time (p=0.013) and more likely to record true positives compared to the students (p=0.037). They were also less likely to record false positives (p=0.005) and more likely to reach the correct diagnosis (p=0.001, OR 3.6, CI 1.8-7.4). Our survey found that, 65% of trainees had prior exposure to capsule endoscopy but only 13% had done capsule endoscopy reporting. Sixty seven percent felt capsule endoscopy should be incorporated into their training.
This study has shown that prior endoscopic experience enables trainees to interpret capsule endoscopy more accurately than medical students. However, there is a demand for focussed training which would enable trainees to reliably interpret pathology on capsule endoscopy.
关于培训胃肠病学医生进行胶囊内镜检查的基础设施知之甚少。英国或欧洲实习医生接触胶囊内镜检查的程度也尚未得到量化。
以一名胶囊内镜专家作为金标准,评估10名有内镜检查经验的胃肠病学实习医生与5名医学生解读10段胶囊内镜视频的能力。评估的参数包括胃排空时间、小肠通过时间以及做出的诊断。一项问卷调查评估了英国实习医生接触胶囊内镜检查的程度。
与学生相比,实习医生在确定胃排空时间方面表现更好(p = 0.013),记录真阳性的可能性更高(p = 0.037)。他们记录假阳性的可能性也更低(p = 0.005),做出正确诊断的可能性更高(p = 0.001,比值比3.6,可信区间1.8 - 7.4)。我们的调查发现,65%的实习医生此前接触过胶囊内镜检查,但只有13%进行过胶囊内镜检查报告。67%的人认为胶囊内镜检查应纳入他们的培训。
这项研究表明,有内镜检查经验的实习医生比医学生能更准确地解读胶囊内镜检查结果。然而,需要有针对性的培训,使实习医生能够可靠地解读胶囊内镜检查中的病理情况。