肝胰胆外科手术超声技能掌握程度评估：这是一个委托问题。
Mastery skill assessment in hepato-pancreato-biliary surgical ultrasound: It's a Matter of Entrustment.
机构信息
Hackensack Meridian School of Medicine, Department of General Surgery, 123 Metro Blvd., 4th Floor, Nutley, NJ, 07110, USA.
Indiana University School of Medicine, Department of Surgery, 545 Barnhill Dr EH 519, Indianapolis, IN, 46202, USA.
出版信息
Am J Surg. 2022 May;223(5):905-911. doi: 10.1016/j.amjsurg.2021.08.014. Epub 2021 Aug 12.
BACKGROUND
A formative hepato-pancreato-biliary (HPB) ultrasound (US) skills practicum is offered annually to graduating HPB fellows, using entrustment assessments for open (IOUS) and laparoscopic (LAPUS) US. It is hypothesized that validity evidence will support the use of these assessments to determine if graduating fellows are well prepared to perform HPB US independently.
METHODS
Expert faculty were surveyed to set Mastery Entrustment standards for fellow performance. Standards were applied to fellow performances during two annual US skills practicums.
RESULTS
11 faculty questionnaires were included. Mean Entrustment cut scores across all items were 4.9/5.0 and 4.8/5.0 and Global Entrustment cut scores were 5.0/5.0 and 4.8/5.0 for IOUS and LAPUS, respectively. 78.5% (29/37) fellows agreed to have their de-identified data evaluated. Mean fellow Entrustments (across all skills) were 4.1 (SD 0.6; 2.6-4.9) and 3.9 (SD 0.7; 2.7-5), while the Global Entrustments were 3.6 (SD 0.8; 2-5) and 3.5 (SD 1.0; 2-5) for IOUS and LAPUS, respectively.
CONCLUSIONS
Two cohorts of graduating HPB fellows are not meeting Mastery Standards for HPB US performance determined by a panel of expert faculty.
背景
每年为即将毕业的肝胆胰（HPB）研究员提供形成性的肝胰胆超声（US）技能实习，使用委托评估进行开放式（IOUS）和腹腔镜（LAPUS）US。假设有效性证据将支持使用这些评估来确定即将毕业的研究员是否有能力独立进行 HPB US。
方法
专家教师对学员的表现进行了调查，以确定学员的卓越委托标准。标准适用于两次年度 US 技能实习中的学员表现。
结果
纳入了 11 份教师问卷。所有项目的平均委托得分均为 4.9/5.0 和 4.8/5.0，IOUS 和 LAPUS 的全球委托得分分别为 5.0/5.0 和 4.8/5.0。78.5%（29/37）的学员同意评估其匿名数据。平均学员委托（所有技能）分别为 4.1（SD 0.6；2.6-4.9）和 3.9（SD 0.7；2.7-5），而 Ious 和 LAPUS 的全球委托分别为 3.6（SD 0.8；2-5）和 3.5（SD 1.0；2-5）。
结论
两组即将毕业的 HPB 研究员未能达到专家小组确定的 HPB US 性能卓越标准。
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