Soma Takako, Sakamoto Yuichi, Matsuoka Yasufumi, Nakano Tomoko, Kamiuttanai Masatoshi, Akiyama Masaki
Department of General Medicine, Sotogahama Central Hospital, Aomori, Japan ; Department of General Medicine, Aomori Prefectural Central Hospital, Aomori, Japan.
Adv Med Educ Pract. 2013 Jul 9;4:127-31. doi: 10.2147/AMEP.S43476. eCollection 2013.
It is essential for young physicians in municipal hospitals to be familiar with the technique of upper gastrointestinal (GI) endoscopy. Endoscopy is an exciting subspecialty in primary care medicine. Endoscopic procedures are primarily performed by general physicians in Japan. However, a standardized strategy for teaching diagnostic GI endoscopy is still lacking, and there is not sufficient time for young physicians to effectively learn the upper GI endoscopy technique. To elucidate how young physicians can be trained in the skills of GI endoscopy in a short time period, we initiated a 12-week training course. Two young physicians performed upper GI endoscopies for outpatients and inpatients 2 or 3 days a week from April 2010 to March 2012. The total number of cases undergoing GI endoscopy during the training course in each year was 117 and 111, respectively. The young physicians were trained in this technique by the attending physician. The short-term training course included four phases. During these phases, the young physicians learned how to insert the endoscope through the nasal cavity or oral cavity into the esophageal inlet, how to pass the endoscope from the esophageal inlet into the duodenum, how to take pictures with the endoscope, and how to stain the gastric and duodenal mucosa and take mucosal biopsy samples. The young physicians experienced 20-30 cases in each phase. In week five, they performed endoscope insertion into the duodenum along the folds of the greater curvature of the stomach. They viewed the entire stomach and took pictures until week ten of the course. The pictures taken in week ten were of a better quality for examining the disease lesions than those taken in week six. In the last 2 weeks of the training course, the young physicians stained the gastric and duodenal mucosa and took mucosal biopsy samples. The short-term training course of 100-120 cases in 12 weeks was effective for teaching young physicians how to perform GI endoscopies independently.
对于市级医院的年轻医生来说，熟悉上消化道（GI）内镜检查技术至关重要。内镜检查是初级保健医学中一个令人兴奋的亚专业。在日本，内镜检查程序主要由普通内科医生执行。然而，目前仍缺乏标准化的诊断性胃肠内镜教学策略，年轻医生也没有足够的时间有效地学习上消化道内镜检查技术。为了阐明如何在短时间内对年轻医生进行胃肠内镜技能培训，我们启动了一个为期12周的培训课程。从2010年4月至2012年3月，两名年轻医生每周2至3天为门诊和住院患者进行上消化道内镜检查。每年培训课程期间接受胃肠内镜检查的病例总数分别为117例和111例。年轻医生由主治医师进行该技术的培训。短期培训课程包括四个阶段。在这些阶段中，年轻医生学习如何将内镜通过鼻腔或口腔插入食管入口，如何将内镜从食管入口送入十二指肠，如何用内镜拍照，以及如何对胃和十二指肠黏膜进行染色并采集黏膜活检样本。年轻医生在每个阶段经历20 - 30个病例。在第五周，他们沿着胃大弯的褶皱将内镜插入十二指肠。他们观察整个胃部并拍照，直到课程的第十周。第十周拍摄的照片在检查疾病病变方面比第六周拍摄的质量更好。在培训课程的最后2周，年轻医生对胃和十二指肠黏膜进行染色并采集黏膜活检样本。为期12周、100 - 120例的短期培训课程对于教导年轻医生如何独立进行胃肠内镜检查是有效的。
