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巴伦氏学会提出的前庭医学课程(VestMed)。

Curriculum for Vestibular Medicine (VestMed) proposed by the Bárány Society.

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands.

Guy's and St Thomas' NHS Foundation Trust, and Ear Institute, UCL, London, UK.

出版信息

J Vestib Res. 2022;32(2):89-98. doi: 10.3233/VES-210095.

Abstract

This document presents the initiative of the Bárány Society to improve diagnosis and care of patients presenting with vestibular symptoms worldwide.The Vestibular Medicine (VestMed) concept embraces a wide approach to the potential causes of vestibular symptoms, acknowledging that vertigo, dizziness, and unsteadiness are non-specific symptoms that may arise from a broad spectrum of disorders, spanning from the inner ear to the brainstem, cerebellum and supratentorial cerebral networks, to many disorders beyond these structures.The Bárány Society Vestibular Medicine Curriculum (BS-VestMed-Cur) is based on the concept that VestMed is practiced by different physician specialties and non-physician allied health professionals. Each profession has its characteristic disciplinary role and profile, but all work in overlapping areas. Each discipline requires good awareness of the variety of disorders that can present with vestibular symptoms, their underlying mechanisms and etiologies, diagnostic criteria and treatment options. Similarly, all disciplines require an understanding of their own limitations, the contribution to patient care from other professionals and when to involve other members of the VestMed community. Therefore, the BS-VestMed-Cur is the same for all health professionals involved, the overlaps and differences of the various relevant professions being defined by different levels of detail and depth of knowledge and skills.The BS-VestMed-Cur defines a Basic and an Expert Level Curriculum. The Basic Level Curriculum covers the VestMed topics in less detail and depth, yet still conveys the concept of the wide net approach. It is designed for health professionals as an introduction to, and first step toward, VestMed expertise. The Expert Level Curriculum defines a Focused and Broad Expert. It covers the VestMed spectrum in high detail and requires a high level of understanding. In the Basic and Expert Level Curricula, the range of topics is the same and runs from anatomy, physiology and physics of the vestibular system, to vestibular symptoms, history taking, bedside examination, ancillary testing, the various vestibular disorders, their treatment and professional attitudes. Additionally, research topics relevant to clinical practice are included in the Expert Level Curriculum. For Focused Expert proficiency, the Basic Level Curriculum is required to ensure a broad overview and additionally requires an expansion of knowledge and skills in one or a few specific topics related to the focused expertise, e.g. inner ear surgery. Broad Expert proficiency targets professionals who deal with all sorts of patients presenting with vestibular symptoms (e.g. otorhinolaryngologists, neurologists, audiovestibular physicians, physical therapists), requiring a high level of VestMed expertise across the whole spectrum. For the Broad Expert, the Expert Level Curriculum is required in which the minimum attainment targets for all the topics go beyond the Basic Level Curriculum. The minimum requirements regarding knowledge and skills vary between Broad Experts, since they are tuned to the activity profile and underlying specialty of the expert.  The BS-VestMed-Cur aims to provide a basis for current and future teaching and training programs for physicians and non-physicians. The Basic Level Curriculum could also serve as a resource for inspiration for teaching VestMed to students, postgraduate generalists such as primary care physicians and undergraduate health professionals, or anybody wishing to enter VestMed.  VestMed is considered a set of competences related to an area of practice of established physician specialties and non-physician health professions rather than a separate clinical specialty. This curriculum does not aim to define a new single clinical specialty.  The BS-VestMed-Cur should also integrate with, facilitate and encourage translational research in the vestibular field.

摘要

本文件介绍了巴伦氏学会为改善全球前庭症状患者的诊断和护理而采取的举措。前庭医学(VestMed)概念涵盖了对潜在前庭症状原因的广泛方法,承认眩晕、头晕和不稳是可能源于广泛疾病谱的非特异性症状,从内耳到脑干、小脑和大脑皮质网络,以及许多超出这些结构的疾病。巴伦氏学会前庭医学课程(BS-VestMed-Cur)基于这样一种理念,即不同的医师专业和非医师辅助医疗专业人员实践 VestMed。每个专业都有其特征性的学科角色和特征,但都在重叠领域工作。每个学科都需要很好地了解可能出现前庭症状的各种疾病、其潜在机制和病因、诊断标准和治疗选择。同样,所有学科都需要了解自己的局限性、其他专业人员对患者护理的贡献以及何时需要邀请 VestMed 社区的其他成员参与。因此,BS-VestMed-Cur 对所有参与的医疗保健专业人员都是相同的,不同相关专业之间的重叠和差异由知识和技能的不同详细程度和深度来定义。BS-VestMed-Cur 定义了基础和专家水平课程。基础水平课程较少地详细和深入地涵盖 VestMed 主题,但仍传达了广泛网络方法的概念。它是为医疗保健专业人员设计的,作为 VestMed 专业知识的介绍和第一步。专家水平课程定义了专注和广泛的专家。它涵盖了 VestMed 领域的高细节,并需要高水平的理解。在基础和专家水平课程中,主题范围相同,从前庭系统的解剖、生理学和物理学到前庭症状、病史采集、床边检查、辅助检查、各种前庭障碍、它们的治疗和专业态度。此外,还包括与临床实践相关的研究主题专家水平课程。对于专注专家的熟练程度,需要基础水平课程来确保广泛的概述,并另外需要在一个或几个与专注专业相关的特定主题中扩展知识和技能,例如内耳手术。广泛专家的熟练程度针对处理所有出现前庭症状的患者的专业人员(例如耳鼻喉科医生、神经科医生、听觉前庭医师、物理治疗师),需要在整个范围内具有高度的 VestMed 专业知识。对于广泛专家,需要专家水平课程,其中所有主题的最低达标目标都超出了基础水平课程。知识和技能方面的最低要求因广泛专家而异,因为它们是根据专家的活动概况和潜在专业来调整的。BS-VestMed-Cur 的目的是为当前和未来的医生和非医生的教学和培训计划提供基础。基础水平课程也可以作为向学生、初级保健医生等普通研究生和本科医疗保健专业人员或任何希望进入 VestMed 的人教授 VestMed 的资源。VestMed 被认为是一套与既定医师专业和非医师健康专业实践领域相关的能力,而不是一个单独的临床专业。本课程并不旨在定义一个新的单一临床专业。BS-VestMed-Cur 还应与前庭领域的转化研究相结合、促进和鼓励转化研究。

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