Int J Cardiol. 2012 Oct 4;160(2):79-81. doi: 10.1016/j.ijcard.2012.01.085. Epub 2012 Feb 20.
Higher specialist training in cardiology has undergone significant reform across numerous countries in recent years. A number of factors have driven these changes, from the legal requirement to reduce working hours (i.e., the European Working Time Directive) to the increasing sub-specialisation within cardiology and the need for appropriately focussed training within these sub-specialties. Cardiac imaging provides a neat framework in which to examine the effect of such changes. Technological advances in echocardiography, nuclear cardiology, computed tomography and magnetic resonance imaging have seen an unprecedented increase in the utilisation of all techniques. The need to deliver appropriate training is recognised and numerous accreditation schemes exist within cardiovascular imaging, with the aim of demonstrating that specified levels of experience and expertise have been attained. However, in the United Kingdom, there has been a change from the traditional experience-based training scheme to a new, competency-based training program, with regular use of workplace-based assessments to prove competence in a specified area or procedure. As this training model is implemented, it will produce a generation of trainees for whom individual accreditation schemes carry less value, given the competency assessment inherently present within their new training system. This article discusses the role of accreditation in the era of competency-based specialist training from a cardiac imaging perspective using the UK experience to highlight the challenges facing trainees and to encourage a debate around how best to ensure cardiac imaging specialists are fully competent at the end of their specific training programs.
近年来，许多国家的心脏病学高级专科培训都经历了重大改革。这些变化的驱动因素有很多，从减少工作时间的法律要求（即欧洲工作时间指令）到心脏病学内部的日益专业化以及这些亚专业领域内有针对性培训的需求。心脏影像学为研究这些变化的影响提供了一个很好的框架。超声心动图、核医学、计算机断层扫描和磁共振成像等技术的进步使得所有技术的应用都出现了前所未有的增长。人们认识到需要提供适当的培训，并且心血管影像学领域存在许多认证计划，旨在证明已经达到了规定的经验和专业水平。然而，在英国，传统的基于经验的培训计划已经转变为一种新的、基于能力的培训计划，经常使用基于工作场所的评估来证明在特定领域或程序中的能力。随着这种培训模式的实施，由于其新的培训系统中内在存在的能力评估，对于这一代受训者来说，个人认证计划的价值将会降低。本文从心脏影像学的角度讨论了认证在基于能力的专科培训时代的作用，以英国的经验为例，强调了受训者面临的挑战，并鼓励围绕如何最好地确保心脏影像学专家在完成特定培训计划时完全具备能力进行辩论。
