Dickinson Karen J, Dunkin Brian J, Bass Barbara L, Ali Aman B, Nguyen-Lee J Joseph, Zajac Stephanie
Houston Methodist Institute for Technology, Innovation and Education (MITIE), Houston, Texas; Department of Surgery, Houston Methodist Hospital, Houston, Texas.
Houston Methodist Institute for Technology, Innovation and Education (MITIE), Houston, Texas; Department of Surgery, Houston Methodist Hospital, Houston, Texas.
J Surg Educ. 2020 Nov-Dec;77(6):1511-1521. doi: 10.1016/j.jsurg.2020.05.024. Epub 2020 Jul 21.
The current, unprecedented pace of change in medicine challenges healthcare professionals to stay up-to-date. To more effectively disseminate new surgical or endoscopic techniques a modern paradigm of training is required. Our aim was to develop a curricular framework for complex techniques that provide logistical challenges to training in order to increase safe, effective use. We use colonic endoscopic submucosal dissection (cESD) as an example.
Curriculum development followed a multistep process representing best practice in training and education. First, a Clinical Needs Assessment established the demand for/sustainability of training. A Training Needs Analysis then identified the knowledge, skills, and attitudes required to perform cESD. A modified Delphi process defined desired learner characteristics, identified indications/contraindications to cESD, and developed a procedural task list. A pilot simulation program gathered feedback from cESD faculty experts and learners. Finally, a Behavioral Observation Scale was developed as a clinical assessment tool to assess procedural performance.
The Houston Methodist Institute for Technology, Innovation and Education.
The first Curriculum Design Summit engaged 11 clinical SMEs, 4 education and training SMEs, 3 market development SMEs, and 1 medical device research and design engineer. The second Curriculum Design Summit engaged 10 clinical SMEs, 4 education and training SMEs, and 4 market development SMEs. We also engaged 12 Learner SMEs at both hands-on pilot courses who currently are training to perform cESD.
Desired learner criteria were defined (e.g., in practice >2 years, available case volume ≥25/year) to ensure ability and motivation of learners. Lesions were classified by (1) suitability for cESD (Clinical T1N0M0, Paris 0-IIa +1s > 2 cm, 0-IIc + IIa, 0-IIc), and (2) suitability for trainee experience level. A comprehensive cESD task list was constructed and an assessment tool created based on SME review of key characteristics (e.g., comprehensiveness and usability).
We describe a comprehensive framework to develop educational curricula for complex surgical/endoscopic techniques with logistical challenges. To illustrate the sustainability of this training model and impact on patient outcomes, we plan to further develop and implement this program nationally.
当前医学领域前所未有的变革速度对医疗保健专业人员不断更新知识提出了挑战。为了更有效地传播新的外科或内镜技术，需要一种现代的培训模式。我们的目标是为复杂技术开发一个课程框架，这些技术在培训方面存在后勤保障方面的挑战，以提高其安全、有效使用。我们以结肠内镜黏膜下剥离术（cESD）为例。
课程开发遵循一个多步骤过程，代表了培训和教育中的最佳实践。首先，进行临床需求评估，确定培训的需求/可持续性。然后进行培训需求分析，确定进行cESD所需的知识、技能和态度。一个经过改进的德尔菲过程确定了期望的学习者特征，确定了cESD的适应证/禁忌证，并制定了一份操作任务清单。一个试点模拟项目收集了cESD教员专家和学习者的反馈。最后，开发了一个行为观察量表作为临床评估工具，以评估操作表现。
休斯顿卫理公会技术、创新与教育研究所。
第一次课程设计峰会有11名临床主题专家、4名教育培训主题专家（SMEs）、3名市场开发主题专家和1名医疗器械研究与设计工程师参与。第二次课程设计峰会有10名临床主题专家、4名教育培训主题专家和4名市场开发主题专家参与。我们还在两个实践试点课程中邀请了12名学习者主题专家，他们目前正在接受cESD操作培训。
确定了期望的学习者标准（例如，实际工作超过2年，每年可用病例数≥25例），以确保学习者的能力和积极性。病变按以下方式分类：（1）适合cESD的情况（临床T1N0M0，巴黎分类0-IIa +1s > 2 cm，0-IIc + IIa，0-IIc），以及（2）适合学员经验水平的情况。构建了一份全面的cESD任务清单，并根据主题专家对关键特征（如全面性和可用性）的审查创建了一个评估工具。
我们描述了一个为具有后勤保障挑战的复杂外科/内镜技术开发教育课程的综合框架。为了说明这种培训模式的可持续性以及对患者预后的影响，我们计划在全国范围内进一步开发和实施该项目。
