Gil Parada Fabio Leonel
Facultad de Medicina. Universidades del Rosario y CES de Colombia; Pontifica Universidad Javeriana. Clínica Universitaria Colombia; Ex Presidente de la Asociación Colombiana de Endoscopía Digestiva; Ex Presidente de la Asociación Colombiana de Gastroenterología.
Rev Gastroenterol Peru. 2020 Jan-Mar;40(1):13-21.
To practice colonoscopy in a Latin American country it is required to certify the acquisition of specific competence, but there is no consensus regarding the criteria that define it. Lack of training in digestive endoscopy skills is associated with an increased risk of diagnostic and therapeutic error; late diagnosis of cancer, increased risk of complications and incomplete procedures with negative consequences for patients.
To establish the performance criteria of the specific competence required by a specialist to perform colonoscopy, in order to impact with better results on the quality of health.
Qualitative study of consensus of experts. With semi-structured personal interviews, the information is documented to carry out the questionnaires that are applied in successive rounds until reaching consensus of more than 70% with the participation of more than 80% of the experts, using the Delphi method.
Performance criteria are identified, which determine the specific competence required to perform colonoscopy with quality and safety. With significant findings due to the high percentage of agreement, they are presented grouped into 4 categories: general, before, during and after the procedure. Among the most important criteria that reached 100% agreement, are those related to cognitive, motor and integrative skills; quality, safety, screening, diagnostic and therapeutic techniques of this procedure.
The criteria standardized by consensus, constitute a very valuable tool in the Latin American countries for the formation and evaluation of competences.
在拉丁美洲国家进行结肠镜检查需要证明具备特定能力,但对于界定该能力的标准尚无共识。消化内镜技能培训的缺失与诊断和治疗错误风险增加、癌症诊断延迟、并发症风险增加以及操作不完整并给患者带来负面后果相关。
确定专科医生进行结肠镜检查所需特定能力的操作标准,以便对健康质量产生更好的效果。
专家共识的定性研究。采用半结构化个人访谈,记录信息以制定问卷,通过德尔菲法连续多轮应用问卷,直至超过80%的专家参与且达成超过70%的共识。
确定了操作标准,这些标准决定了高质量、安全地进行结肠镜检查所需的特定能力。由于达成一致的百分比很高,得出了重要结果,这些标准分为4类呈现:一般标准、操作前标准、操作期间标准和操作后标准。在达成100%一致的最重要标准中,有与认知、运动和综合技能相关的标准;该操作的质量、安全、筛查、诊断和治疗技术标准。
通过共识标准化的标准,在拉丁美洲国家对于能力的培养和评估是非常有价值的工具。