Geffrier C, de Parades V, Abramowitz L, Benfredj P, Bonnaud G, Bord C, Bouchard D, Bouguen G, Devulder F, Didelot J M, Fathallah N, Higuero T, Lesage X, Nouts A, Petit P, Pigot F, Pommaret E, Roumeguere P, Siproudhis L, Staumont G, Zeitoun J D, Marteau P
Department of digestive diseases, CHU de Louis-Mourier, AP-HP, 92700 Colombes, France.
Department of proctology, groupe hospitalier Paris Saint Joseph, institut Léopold-Bellan, Paris, France.
Clin Res Hepatol Gastroenterol. 2019 Aug;43(4):483-496. doi: 10.1016/j.clinre.2018.12.003. Epub 2019 Mar 29.
Any gastroenterologist must be trained to properly diagnose anoperineal lesions in patients with Crohn's disease (APLOC). The aim of this study was to establish whether adding pictures would improve teaching effectiveness of the diagnosis of APLOC to French gastroenterology trainees.
Trainees were asked to answer a first web-based survey consisting of evaluating 12 pictures of APLOC with a closed answer questionnaire. They were then randomized in 2 groups. Group A received an online teaching with typical pictures and APLOC definitions and group B definitions only. Trainees were asked again seven days later to answer a second survey with 12 other pictures of APLOC and 14 experts also answered this survey. Diagnostic scores were expressed in %. The primary endpoint was the comparison of the score of survey 2 between the two groups of trainees. Secondary endpoints were to compare results of survey 2 between trainees of both groups and experts, and assess diagnosis of each lesion.
Two hundred fourty eight trainees among 465 answered survey 1, and 195 survey 2. The diagnostic score was 71.9% for groups A and B and 74.6% for experts (differences NS). After training diagnosis of ulceration was 72% for group A and 72.9% for group B, fistulae 85.2% versus 85.8%, erythema 44.1% vs. 55.6%, anoperineal scars 67.5% vs. 65.6%, and abscess 100% (differences NS).
There was no difference between the two teaching methods. Further research should be performed aiming at improving teaching material and quotation baremes.
任何胃肠病学家都必须接受培训,以便正确诊断克罗恩病患者的肛门会阴病变(APLOC)。本研究的目的是确定添加图片是否会提高向法国胃肠病学实习生传授APLOC诊断的教学效果。
要求实习生回答第一个基于网络的调查问卷,该问卷包括用封闭式答案问卷评估12张APLOC图片。然后将他们随机分为两组。A组接受带有典型图片和APLOC定义的在线教学,B组仅接受定义。七天后,再次要求实习生回答第二个调查问卷,其中包含另外12张APLOC图片,14名专家也回答了该调查问卷。诊断分数以百分比表示。主要终点是两组实习生第二次调查分数的比较。次要终点是比较两组实习生与专家第二次调查的结果,并评估每个病变的诊断。
465名实习生中有248名回答了第一次调查,195名回答了第二次调查。A组和B组的诊断分数为71.9%,专家为74.6%(差异无统计学意义)。训练后,A组溃疡诊断率为72%,B组为72.9%;瘘管诊断率分别为85.2%和85.8%;红斑诊断率分别为44.1%和55.6%;肛门会阴瘢痕诊断率分别为67.5%和65.6%;脓肿诊断率为100%(差异无统计学意义)。
两种教学方法之间没有差异。应进行进一步研究,以改进教材和评分标准。