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英格兰国家腹腔镜结直肠培训项目培训课程的设计、交付与验证

Design, delivery, and validation of a trainer curriculum for the national laparoscopic colorectal training program in England.

作者信息

Mackenzie Hugh, Cuming Tamzin, Miskovic Danilo, Wyles Susannah M, Langsford Laura, Anderson John, Thomas-Gibson Siwan, Valori Roland, Hanna George B, Coleman Mark G, Francis Nader

机构信息

*Department of Surgery and Cancer, Imperial College, London, United Kingdom †Department of Surgery, Princess Alexandra Hospital, Harlow, United Kingdom ‡John Goligher Colorectal Unit, The Leeds Teaching Hospitals, Leeds, United Kingdom §National Training Programme for Laparoscopic Surgery, Plymouth, United Kingdom ¶Department of Gastroenterology, Gloucestershire Hospitals, Gloucester, United Kingdom ∥Wolfson Unit for Endoscopy, St Mark's Hospital, London, United Kingdom **Colorectal Unit, Derriford Hospital, Plymouth, United Kingdom ††Department of Surgery, Yeovil District Hospital Foundation Trust, Yeovil, United Kingdom.

出版信息

Ann Surg. 2015 Jan;261(1):149-56. doi: 10.1097/SLA.0000000000000437.

Abstract

OBJECTIVE

To validate the delivery and efficacy of the national laparoscopic colorectal surgery "training the trainer" (Lapco TT) curriculum.

BACKGROUND

The National Training Programme in Laparoscopic Colorectal Surgery designed the Lapco TT curriculum to improve, standardize, and benchmark the quality of training. Evidence for such courses rarely extends beyond subjective feedback.

METHODS

The Lapco TT curriculum tailors key teaching skills for laparoscopic colorectal surgery: training structure, skills deconstruction, trainer intervention, and performance enhancing feedback. Ten Lapco TT courses were delivered to 65 national Lapco trainers since 2010. The course was validated at Kirkpatrick's 4 levels of evaluation: (i) pre- and post-course interviews reflecting initial reaction; (ii) training quality assessment on simulated scenarios using the Structured Training Trainer Assessment Report (STTAR) tool; (iii) follow-up interviews at 4 to 6 months; and (iv) delegate performance ratings, by their trainees, using the mini-STTAR and the delegates' trainees learning curves before and after the course.

RESULTS

There were significant improvements in training in the post-course simulated scenario, especially in the "set" (P < 0.001). Delegates described improved framework and structure in their native training environment, which aided difficult training situations. Findings mirrored in performance ratings by their trainees: overall (4.37 vs 4.46, P = 0.040), agreed learning points (3.65 vs 4.00, P = 0.042), encouraged self-reflection (3.67 vs 3.94, P = 0.046), and encouraged team awareness (3.53 vs 4.05, P = 0.045). The learning curve of delegates' trainees improved after the course.

CONCLUSIONS

The Lapco TT curriculum improved training performance in the short- and long-term, provided a structured training framework, and enhanced the learning curve of delegates' trainees.

摘要

目的

验证国家腹腔镜结直肠手术“培训培训师”(Lapco TT)课程的交付情况及效果。

背景

国家腹腔镜结直肠手术培训计划设计了Lapco TT课程,以提高、规范和衡量培训质量。此类课程的证据很少超出主观反馈。

方法

Lapco TT课程针对腹腔镜结直肠手术量身定制关键教学技能:培训结构、技能解构、培训师干预和绩效提升反馈。自2010年以来,已为65名国家Lapco培训师提供了10期Lapco TT课程。该课程在柯克帕特里克的四个评估层面得到验证:(i)课程前后的访谈以反映初始反应;(ii)使用结构化培训培训师评估报告(STTAR)工具对模拟场景进行培训质量评估;(iii)4至6个月后的随访访谈;(iv)由学员对代表进行绩效评级,使用小型STTAR以及课程前后代表学员的学习曲线。

结果

课程后的模拟场景培训有显著改进,尤其是在“准备”方面(P < 0.001)。代表们表示,在其本土培训环境中,框架和结构得到改善,这有助于应对困难的培训情况。学员对代表的绩效评级也反映了这些结果:总体(4.37对4.46,P = 0.040)、认可的学习要点(3.65对4.00,P = 0.042)、鼓励自我反思(3.67对3.94,P = 0.046)以及鼓励团队意识(3.53对4.05,P = 0.045)。课程结束后,代表学员的学习曲线有所改善。

结论

Lapco TT课程在短期和长期内均提高了培训绩效,提供了结构化的培训框架,并改善了代表学员的学习曲线。

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