Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Chest. 2013 Sep;144(3):935-939. doi: 10.1378/chest.12-3028.
Current interventional pulmonary (IP) procedural guidelines for competency are based on expert opinion. There are few objective data to support competency metrics for IP procedures. This survey reports procedural volume during IP fellowships to help define new standards in training and curriculum development.
A web-based survey was developed to evaluate IP training procedural volume. The survey was administered to all US and Canadian IP fellowship directors and graduates in training from 2006 to 2011. The survey inquired about all diagnostic and therapeutic procedures performed during the specialized year of IP training. Questions regarding the training program structure were collected and analyzed.
There was a 92.5% fellow response rate (37 of 40) and 77% fellowship director response rate (10 of 13) from programs in existence at the time of the survey. Procedural volume was consistent between fellowship directors and graduates (P = .64). Although there was a wide range of procedural volume and types of procedures between different programs, the procedural mean volumes were all significantly higher than the American College of Chest Physicians (ACCP) and American Thoracic Society/European Respiratory Society (ATS/ERS) guideline recommendations (P < .005).
US and Canadian IP fellowships produce fellows with variable procedural volumes; however, these are significantly higher than ACCP and ATS/ERS guidelines for most programs and procedures. With a uniform training curriculum being adopted by the majority of IP fellowship programs in the United States and Canada, as well as data showing improved core knowledge in IP fellows undergoing a dedicated year of additional training, further metrics examining the impact of advanced IP training on patient outcomes are needed.
目前介入性肺病（IP）程序能力的指南是基于专家意见。很少有客观数据支持 IP 程序的能力指标。这项调查报告了 IP 研究员的程序量，以帮助定义培训和课程开发的新标准。
开发了一个基于网络的调查来评估 IP 培训的程序量。该调查针对 2006 年至 2011 年期间的所有美国和加拿大 IP 研究员主任和研究员进行了调查。调查询问了在 IP 培训的专门年中进行的所有诊断和治疗程序。收集并分析了有关培训计划结构的问题。
调查时存在的计划中有 92.5%的研究员应答率（37/40）和 77%的研究员主任应答率（10/13）。研究员主任和研究员之间的程序量是一致的（P=0.64）。尽管不同计划之间的程序量和程序类型存在很大差异，但程序平均量均明显高于美国胸科学会（ACCP）和美国胸科学会/欧洲呼吸学会（ATS/ERS）指南建议（P <0.005）。
美国和加拿大的 IP 研究员完成的程序量各不相同；然而，与大多数程序和程序的 ACCP 和 ATS/ERS 指南相比，这些程序量明显更高。由于美国和加拿大的大多数 IP 研究员课程都采用了统一的培训课程，并且数据显示经过专门的一年额外培训后，IP 研究员的核心知识得到了提高，因此需要进一步的指标来检验高级 IP 培训对患者结果的影响。
