Bethlehem Martijn S, Kramp Kelvin H, van Det Marc J, ten Cate Hoedemaker Henk O, Veeger Nicolaas J G M, Pierie Jean Pierre E N
Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands; Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
J Surg Educ. 2014 Nov-Dec;71(6):810-6. doi: 10.1016/j.jsurg.2014.04.009. Epub 2014 Jun 7.
Content, evaluation, and certification of laparoscopic skills and procedure training lack uniformity among different hospitals in The Netherlands. Within the process of developing a new regional laparoscopic training curriculum, a uniform and transferrable curriculum was constructed for a series of laparoscopic procedures. The aim of this study was to determine regional expert consensus regarding the key steps for laparoscopic appendectomy and cholecystectomy using Delphi methodology.
Lists of suggested key steps for laparoscopic appendectomy and cholecystectomy were created using surgical textbooks, available guidelines, and local practice. A total of 22 experts, working for teaching hospitals throughout the region, were asked to rate the suggested key steps for both procedures on a Likert scale from 1-5. Consensus was reached with Crohnbach's α ≥ 0.90.
Of the 22 experts, 21 completed and returned the survey (95%). Data analysis already showed consensus after the first round of Delphi on the key steps for laparoscopic appendectomy (Crohnbach's α = 0.92) and laparoscopic cholecystectomy (Crohnbach's α = 0.90). After the second round, 15 proposed key steps for laparoscopic appendectomy and 30 proposed key steps for laparoscopic cholecystectomy were rated as important (≥4 by at least 80% of the expert panel). These key steps were used for the further development of the training curriculum.
By using the Delphi methodology, regional consensus was reached on the key steps for laparoscopic appendectomy and cholecystectomy. These key steps are going to be used for standardized training and evaluation purposes in a new regional laparoscopic curriculum.
荷兰不同医院之间腹腔镜技能及手术培训的内容、评估和认证缺乏统一性。在制定新的区域腹腔镜培训课程的过程中，针对一系列腹腔镜手术构建了一个统一且可转换的课程。本研究的目的是使用德尔菲法确定关于腹腔镜阑尾切除术和胆囊切除术关键步骤的区域专家共识。
利用外科教科书、现有指南和当地实践，制定了腹腔镜阑尾切除术和胆囊切除术建议关键步骤清单。邀请了该地区教学医院的22名专家，要求他们对这两种手术的建议关键步骤按照1至5的李克特量表进行评分。当克隆巴赫α系数≥0.90时达成共识。
22名专家中有21名完成并返回了调查问卷（95%）。第一轮德尔菲法后，数据分析已显示在腹腔镜阑尾切除术（克隆巴赫α系数=0.92）和腹腔镜胆囊切除术（克隆巴赫α系数=0.90）的关键步骤上达成了共识。第二轮后，15项腹腔镜阑尾切除术的建议关键步骤和30项腹腔镜胆囊切除术的建议关键步骤被评为重要（专家小组中至少80%的人评分为≥4）。这些关键步骤用于培训课程的进一步开发。
通过使用德尔菲法，在腹腔镜阑尾切除术和胆囊切除术的关键步骤上达成了区域共识。这些关键步骤将用于新的区域腹腔镜课程中的标准化培训和评估。
