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[腔内泌尿外科手术培训项目。未来展望。]

[Training program in endourological surgery. Future perspectives.].

作者信息

Soria Federico, Villacampa Felipe, Serrano Alvaro, Moreno Jesús, Rioja Jorge, Sánchez Francisco Miguel

机构信息

Unidad de Endoscopia de la Fundación Centro de Cirugía de Mínima Invasión Jesús Usón. Cáceres. España.

Servicio de Urología. Hospital Universitario 12 de Octubre. Madrid. España.

出版信息

Arch Esp Urol. 2018 Jan;71(1):89-96.

Abstract

Current training in urological endoscopy lacks a specific training program. However, there is a clear need for a specific and uniform program, which will ensure the training, regardless of the unit where it is carried out. So, the goal is to first evaluate the current model and then bring improvements for update. The hospital training accreditation programme are only the adjustment of the official program of the urology specialty to the specific circumstances of each center, which causes variability in training of residents. After reviewing 19 training programs belonging to 12 Spanish regions. The current outlook shows that scarcely 10% of hospitals quantify the number of procedures/ year, although the Spanish program emphasizes that the achievement of the residents should be quantified. Urology residents, sense their training as inadequate and therefore their level of satisfaction is moderate. The three main problems detected by residents as an obstacle on their training are: the lack of supervision, tutors completing their own learning. Finally, the lack of quantification in surgical activities is described as a threat. This has no easy solution, since the learning curve of the most common techniques in endourology is not correctly established. Regarding aspects that can improve the current model, they highlight the need to design a specific program. The need to customize the training, the ineludible accreditation of tutors and obviously dignify the tutor's teaching activity. Another basic aspect is the inclusion of new technologies as training tools, e-learning. As well as the implementation of an adequate competency assessment plan and the possibility of relying on simulation systems. Finally, they highlight the need to attend monographic meetings and external clinic rotations to promote critical training.

摘要

目前泌尿外科内镜培训缺乏特定的培训项目。然而,显然需要一个具体且统一的项目,以确保培训可在任何单位开展。因此,目标是首先评估当前模式,然后加以改进和更新。医院培训认证项目只是将泌尿外科专业的官方项目根据每个中心的具体情况进行调整,这导致住院医师培训存在差异。在审查了西班牙12个地区的19个培训项目后。目前的情况表明,尽管西班牙的项目强调应对住院医师的成绩进行量化,但只有不到10%的医院对每年的手术数量进行量化。泌尿外科住院医师认为他们的培训不充分,因此满意度一般。住院医师认为阻碍他们培训的三个主要问题是:缺乏监督、导师自身学习任务繁重。最后,手术活动缺乏量化被描述为一种威胁。这没有简单的解决办法,因为腔内泌尿外科最常见技术的学习曲线尚未正确确立。关于可以改进当前模式的方面,他们强调需要设计一个具体的项目。需要定制培训、对导师进行必要的认证并切实提高导师的教学活动质量。另一个基本方面是将新技术作为培训工具纳入,即电子学习。以及实施适当的能力评估计划和依靠模拟系统的可能性。最后,他们强调需要参加专题会议和外部临床轮转以促进批判性培训。

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