Ear Nose and Throat Department, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, UK.
Curr Opin Otolaryngol Head Neck Surg. 2021 Jun 1;29(3):204-212. doi: 10.1097/MOO.0000000000000718.
This article reviews the literature on the development of competency-based training and assessment in endoscopy, comparing gastrointestinal endoscopy and flexible endoscopic evaluation of swallowing (FEES). The discussion focusses on how a robust and explicit learning framework can be translated to the delivery of training in FEES to optimize trainee outcomes and supervisor skill.
Specialist Speech and Language Therapists (SLT) carry out FEES to inform the diagnosis and management of swallowing and voice disorders. Taught courses are generally followed by local workplace-based supervised practice to attain the competencies identified in the relevant professional guidelines. However, the curriculum for the workplace-based FEES training lacks a learning and assessment framework and little direction for the workplace-based supervisor. In gastrointestinal endoscopy training, this previously led to less than optimal outcomes for trainees and patients and so new models of training were developed.
A new learning framework for FEES underpinned by medical pedagogy has shown early promise in supporting the acquisition of competence. Incorporating a new FEES-specific systematic assessment, the framework provides direction for the supervisor and evidence of trainee progression, which subsequently enhances supervisor confidence to determine trainee competence.
本文综述了内镜检查中基于能力的培训和评估的文献,比较了胃肠内镜和吞咽的灵活内镜评估(FEES)。讨论集中在如何将强大而明确的学习框架转化为 FEES 的培训,以优化学员的学习成果和主管的技能。
专门的言语治疗师(SLT)进行 FEES 以确定吞咽和声音障碍的诊断和管理。通常在教授课程后,在当地进行基于工作场所的监督实践,以达到相关专业指南中确定的能力。然而,基于工作场所的 FEES 培训课程缺乏学习和评估框架,也缺乏对基于工作场所的主管的指导。在内镜检查培训中,这以前导致学员和患者的结果不理想,因此开发了新的培训模式。
基于医学教育学的 FEES 的新学习框架在支持能力的获取方面显示出了早期的希望。该框架结合了新的特定于 FEES 的系统评估,为主管提供了指导,并提供了学员进展的证据,从而增强了主管确定学员能力的信心。