Wolfson Unit for Endoscopy, St Mark's Hospital, Imperial College London, Watford Road, Harrow, UK.
Eur J Gastroenterol Hepatol. 2010 Mar;22(3):368-73. doi: 10.1097/MEG.0b013e32832adfac.
An audit in 2002 showed that colonoscopy training in a large London training region was poorly structured, with the quality of supervision below recommendations and high reported complication rates. In 2004, the UK National Endoscopy Training Programme introduced centrally funded, accredited courses and new assessment tools to standardize training and raise the quality of colonoscopy by improving the skills of practicing endoscopists.
To evaluate the changes in the standard of colonoscopy training over the last 5 years.
Questionnaires used in the earlier study were updated and e-mailed to all gastroenterology trainees in the region and those who participated in the earlier study. Trainees completed and returned the forms electronically.
Twenty-six out of 37 gastroenterology trainees responded (70.3%). Significantly more trainees said that they had been formally taught the principles of colonoscopy (91 vs. 65%; P = 0.02), polypectomy (81 vs. 52%; P = 0.02) and extubation (88 vs. 56%; P = 0.01) than in 2002, and reported that complication rates were lower. Trainers displayed more appropriate teaching strategies and course attendance had significantly increased (84 vs. 48%, P = 0.003). Eighty-seven percent of the trainees thought that their training had been adequate or better than adequate, compared with 25% in 2002.
In the 2007 survey, trainees reported a significant improvement both in colonoscopy training at base hospitals and in access to specialist courses compared with those in the 2002 survey. The centrally funded training programme has made a significantly positive impact in this large training region that is likely to be reflected elsewhere in England. The loss of such investment may have a detrimental effect on future colonoscopy training and the quality of service provision.
2002 年的一次审核显示，在伦敦一个大型培训区域，结肠镜检查培训结构不佳，监督质量未达到建议标准，且报告的并发症发生率较高。2004 年，英国国家内镜培训计划引入了中央资助、认证的课程和新的评估工具，以通过提高执业内镜医生的技能来规范培训并提高结肠镜检查的质量。
评估过去 5 年来结肠镜检查培训标准的变化。
使用早期研究中使用的问卷，并通过电子邮件发送给该区域的所有胃肠病学受训者和参与早期研究的受训者。受训者填写并以电子方式返回表格。
37 名胃肠病学受训者中有 26 名（70.3%）做出了回应。与 2002 年相比，现在有更多的受训者表示他们已经接受过结肠镜检查（91%比 65%；P = 0.02）、息肉切除术（81%比 52%；P = 0.02）和拔管（88%比 56%；P = 0.01）的正式教学，且报告的并发症发生率更低。培训师表现出更恰当的教学策略，且课程出勤率显著提高（84%比 48%，P = 0.003）。87%的受训者认为他们的培训是充分的或好于充分的，而在 2002 年这一比例为 25%。
在 2007 年的调查中，与 2002 年的调查相比，受训者报告称，基层医院的结肠镜检查培训以及获得专科课程的机会都有显著改善。中央资助的培训计划对这个大型培训区域产生了显著的积极影响，这可能在英格兰其他地方也有体现。失去这种投资可能会对未来的结肠镜检查培训和服务质量产生不利影响。
