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内镜黏膜切除术和内镜黏膜下剥离术培训:活体猪模型的表面、内容及专家效度

Training in endoscopic mucosal resection and endoscopic submucosal dissection: Face, content and expert validity of the live porcine model.

作者信息

Küttner-Magalhães Ricardo, Dinis-Ribeiro Mário, Bruno Marco J, Marcos-Pinto Ricardo, Rolanda Carla, Koch Arjun D

机构信息

Department of Gastroenterology, Santo António Hospital, Porto Hospital Centre, Portugal.

Department of Gastroenterology, Oncology Portuguese Institute of Porto, Porto, Portugal.

出版信息

United European Gastroenterol J. 2018 May;6(4):547-557. doi: 10.1177/2050640617742484. Epub 2017 Nov 10.

Abstract

INTRODUCTION

Endoscopic mucosal resection and endoscopic submucosal dissection are demanding procedures. This study aims to establish face, content and expert validity of the live porcine model in performing endoscopic mucosal resection, endoscopic submucosal dissection, complication management and to assess it as a training tool.

MATERIAL AND METHODS

Tutors and trainees participating in live porcine model endoscopic mucosal resection and endoscopic submucosal dissection workshops filled out a questionnaire regarding the realism of the model compared to human setting and its role as a learning tool. A 10-point Likert scale was used.

RESULTS

Ninety-one endoscopists (13 tutors; 78 trainees) were involved in four workshops. Median global classifications for the realism of the life porcine model ranged between 7.0-8.0 (interquartile range 5.0-9.0). Procedures resembled human cases with a median of 9.0 (8.0-9.0) for oesophageal multiband endoscopic mucosal resection; 8.5 (8.0-9.0) for oesophageal endoscopic submucosal dissection; 9.0 (8.0-10.0) for gastric endoscopic submucosal dissection; and 9.0 (8.5-9.75 and 8.0-9.69) for complication detection and management. The animal model as a learning tool had median scores of 9.0 (7.0-10.0) considering how procedures are performed; 9.0-9.5 (8.0-10.0) for usefulness for beginners; and 9.0-10.0 (5.0-10.0) regarding it a prerequisite.

CONCLUSIONS

Training in a live porcine model was considered very realistic compared to the human setting and was highly appreciated as a learning tool. This is the first study to establish face, content and expert validity of the live porcine model in performing multiband endoscopic mucosal resection, oesophageal and gastric endoscopic submucosal dissection. The validation of this model provides the rationale to incorporate it into formal teaching programmes.

摘要

引言

内镜黏膜切除术和内镜黏膜下剥离术是要求较高的操作。本研究旨在确立活猪模型在进行内镜黏膜切除术、内镜黏膜下剥离术及并发症处理方面的表面效度、内容效度和专家效度,并将其评估为一种培训工具。

材料与方法

参与活猪模型内镜黏膜切除术和内镜黏膜下剥离术工作坊的带教老师和学员填写了一份关于该模型与人体情况相比的逼真程度及其作为学习工具的作用的问卷。采用10分制李克特量表。

结果

91名内镜医师(13名带教老师;78名学员)参与了4个工作坊。活猪模型逼真程度的总体分类中位数在7.0 - 8.0之间(四分位间距为5.0 - 9.0)。操作与人体病例相似,食管多环内镜黏膜切除术的中位数为9.0(8.0 - 9.0);食管内镜黏膜下剥离术为8.5(8.0 - 9.0);胃内镜黏膜下剥离术为9.0(8.0 - 10.0);并发症检测与处理为9.0(8.5 - 9.75和8.0 - 9.69)。考虑到操作的执行方式,动物模型作为学习工具的中位数分数为9.0(7.0 - 10.0);对初学者的有用性为9.0 - 9.5(8.0 - 10.0);作为先决条件的认可度为9.0 - 10.0(5.0 - 10.0)。

结论

与人体情况相比,活猪模型培训被认为非常逼真,且作为学习工具受到高度评价。这是第一项确立活猪模型在进行多环内镜黏膜切除术、食管和胃内镜黏膜下剥离术方面的表面效度、内容效度和专家效度的研究。该模型的验证为将其纳入正规教学计划提供了理论依据。

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