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基础超声内镜技能核心课程:采用德尔菲法达成的国际共识

A core curriculum for basic EUS skills: An international consensus using the Delphi methodology.

作者信息

Karstensen John Gásdal, Nayahangan Leizl Joy, Konge Lars, Vilmann Peter

机构信息

Pancreatitis Centre East, Gastro Unit, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Copenhagen Academy for Medical Education and Simulation, Centre for Human Resources and Education, The Capital Region of Denmark, Copenhagen, Denmark.

出版信息

Endosc Ultrasound. 2022 Mar-Apr;11(2):122-132. doi: 10.4103/EUS-D-21-00125.

Abstract

BACKGROUND AND OBJECTIVES

During recent years, the demand for EUS has increased. However, standardized training programs and assessments of clinical quality measures are lacking. We therefore aimed to establish a basic curriculum for EUS fellows that includes a prioritized list of interpretational capabilities and technical skills.

MATERIALS AND METHODS

International key-opinion leaders were invited to participate in a Delphi process. An electronic three-round iterative survey was performed to attain consensus on skills that 70% of the participants found either very important or essential for a newly graduated endosonographer.

RESULTS

Of 125 invited experts, 77 participated in the survey. Initially, 1,088 skills were suggested, resulting in a core curriculum containing 29 interpretational skills and 12 technical skills. The top-five interpretation skills included abilities to discern between normal anatomy and pathology, to identify the entire pancreas and ampullary region, to identify solid versus fluid-filled structures, to detect bile duct and gallstones, and to identify a pancreatic mass of 5 mm or larger. For technical skills, ability to insert the endoscope from the mouth to the second part of duodenum, to obtain FNA adequately and safely, to navigate the scope tip to follow anatomical landmark structures, to achieve endoscopic position of each of the four stations, and to perform passage of the scope past a hiatal hernia were given the highest ranking.

CONCLUSIONS

After a structured Delphi process involving 77 international experts, a consensus was reached for a basic curriculum for EUS fellows to be included during training.

摘要

背景与目的

近年来,内镜超声(EUS)的需求不断增加。然而,缺乏标准化的培训项目和临床质量指标评估。因此,我们旨在为EUS进修医生制定一个基础课程,其中包括一份按优先级排列的解释能力和技术技能清单。

材料与方法

邀请国际关键意见领袖参与德尔菲法。进行了三轮电子迭代调查,以就70%的参与者认为对新毕业的内镜超声医生非常重要或必不可少的技能达成共识。

结果

125名受邀专家中,77名参与了调查。最初,共提出了1088项技能,最终形成了一个核心课程,包含29项解释技能和12项技术技能。排名前五的解释技能包括辨别正常解剖结构与病理结构的能力、识别整个胰腺和壶腹区域的能力、区分实性与液性结构的能力、检测胆管和胆结石的能力,以及识别直径5毫米或更大胰腺肿块的能力。对于技术技能,将内镜从口腔插入十二指肠第二部的能力、充分且安全地获取细针穿刺抽吸(FNA)的能力、将内镜尖端导航至解剖标志结构的能力、在内镜下到达四个部位中每个部位的能力,以及使内镜通过食管裂孔疝的能力列为最高等级。

结论

在77名国际专家参与的结构化德尔菲法过程之后,就培训期间EUS进修医生的基础课程达成了共识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5e3/9059795/296dc7d00d81/EUS-11-122-g001.jpg

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