Sabrina Forsell, Ilkka Kalliala, Mervi Halttunen-Nieminen, Charles Redman, Simon Leeson, Ameli Tropé, Esther Moss, Maria Kyrgiou, Eeva Pyörälä, Pekka Nieminen
Department of Obstetrics and Gynaecology, Helsinki University Hospital and Helsinki University, 00290 Helsinki, Finland.
Department of Metabolism, Digestion and Reproduction & Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Department of Surgery and Cancer, IRDB, Faculty of Medicine, Imperial College, London W12 0NN, UK.
Cancers (Basel). 2020 Oct 30;12(11):3201. doi: 10.3390/cancers12113201.
High-quality colposcopy is essential in cervical cancer prevention. We performed a multicentre prospective interventional pilot-study, evaluating the effect of a six-hour case-based colposcopy course on short- and long-term learning of colposcopy-related knowledge, diagnostic accuracy levels and confidence. We recruited 213 colposcopists participating in three European Federation of Colposcopy (EFC) basic colposcopy courses (Finland, Norway, UK). The study consisted of three tests with identical content performed before, after and 2 months after the course, including ten colposcopic images, ten patient cases and scales for marking confidence in the answers. Outcome measures where mean scores in correct case-management, diagnosis (including high-grade lesion recognition), transformation-zone recognition and confidence in answers. Results were compared between the three tests and stratified according to experience. Mean test scores improved after the course for all participants. The increase was highest for beginners. Confidence in answers improved and the number of colposcopists showing high confidence with low scores decreased. A structured case-based course improves skills and confidence especially for inexperienced colposcopists; however, trainers should be aware of the risk of overconfidence. To complement theoretical training, further hands-on training including high-quality feedback is recommended. Conclusions drawn from long-term learning are limited due to the low participation in the follow-up test.
高质量的阴道镜检查对于宫颈癌预防至关重要。我们开展了一项多中心前瞻性干预性试点研究，评估为期六小时的基于病例的阴道镜检查课程对阴道镜相关知识的短期和长期学习、诊断准确性水平及信心的影响。我们招募了213名参加欧洲阴道镜检查联合会（EFC）三个基础阴道镜检查课程（芬兰、挪威、英国）的阴道镜检查医师。该研究包括在课程前、课程后及课程后2个月进行的三项内容相同的测试，包括十张阴道镜图像、十个患者病例以及用于标记对答案信心程度的量表。结果指标包括正确病例管理、诊断（包括高级别病变识别）、转化区识别及答案信心方面的平均得分。对三项测试结果进行比较，并根据经验进行分层。所有参与者在课程结束后的平均测试得分均有所提高。初学者的提高幅度最大。答案信心有所提升，且低得分却表现出高信心的阴道镜检查医师数量减少。一个结构化的基于病例的课程尤其能提高经验不足的阴道镜检查医师的技能和信心；然而，培训者应意识到过度自信的风险。为补充理论培训，建议进一步开展包括高质量反馈的实践培训。由于随访测试的参与率较低，从长期学习得出的结论有限。
