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基本胃肠内镜操作培训:欧洲胃肠道内镜学会(ESGE)和欧洲胃肠病学和内镜护士及相关人员学会(ESGENA)立场声明。

Training in basic gastrointestinal endoscopic procedures: a European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement.

机构信息

Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, "Sapienza" University of Rome, Italy.

Gastroenterology and Digestive Endoscopy Unit, Ospedale dei Castelli Hospital, Ariccia, Rome, Italy.

出版信息

Endoscopy. 2024 Feb;56(2):131-150. doi: 10.1055/a-2205-2613. Epub 2023 Dec 1.

Abstract

This ESGE Position Statement provides structured and evidence-based guidance on the essential requirements and processes involved in training in basic gastrointestinal (GI) endoscopic procedures. The document outlines definitions; competencies required, and means to their assessment and maintenance; the structure and requirements of training programs; patient safety and medicolegal issues. 1:  ESGE and ESGENA define basic endoscopic procedures as those procedures that are commonly indicated, generally accessible, and expected to be mastered (technically and cognitively) by the end of any core training program in gastrointestinal endoscopy. 2:  ESGE and ESGENA consider the following as basic endoscopic procedures: diagnostic upper and lower GI endoscopy, as well as a limited range of interventions such as: tissue acquisition via cold biopsy forceps, polypectomy for lesions ≤ 10 mm, hemostasis techniques, enteral feeding tube placement, foreign body retrieval, dilation of simple esophageal strictures, and India ink tattooing of lesion location. 3:  ESGE and ESGENA recommend that training in GI endoscopy should be subject to stringent formal requirements that ensure all ESGE key performance indicators (KPIs) are met. 4:  Training in basic endoscopic procedures is a complex process and includes the development and acquisition of cognitive, technical/motor, and integrative skills. Therefore, ESGE and ESGENA recommend the use of validated tools to track the development of skills and assess competence. 5:  ESGE and ESGENA recommend incorporating a multimodal approach to evaluating competence in basic GI endoscopic procedures, including procedural thresholds and the measurement and documentation of established ESGE KPIs. 7:  ESGE and ESGENA recommend the continuous monitoring of ESGE KPIs during GI endoscopy training to ensure the trainee's maintenance of competence. 9:  ESGE and ESGENA recommend that GI endoscopy training units fulfil the ESGE KPIs for endoscopy units and, furthermore, be capable of providing the dedicated personnel, infrastructure, and sufficient case volume required for successful training within a structured training program. 10:  ESGE and ESGENA recommend that trainers in basic GI endoscopic procedures should be endoscopists with formal educational training in the teaching of endoscopy, which allows them to successfully and safely teach trainees.

摘要

本 ESGE 立场声明提供了关于基本胃肠道 (GI) 内镜操作培训所涉及的必要要求和流程的结构化和循证指导。本文档概述了定义、所需的能力以及评估和维护这些能力的方法、培训计划的结构和要求、患者安全和医疗法律问题。

  1. ESGE 和 ESGENA 将基本内镜操作定义为那些通常被指示、普遍可获得且预计在任何胃肠道内镜核心培训计划结束时都能掌握(技术和认知上)的操作。

  2. ESGE 和 ESGENA 认为以下操作是基本内镜操作:上消化道和下消化道诊断内镜检查,以及有限范围的干预措施,例如:通过冷活检钳获取组织、直径≤10mm 的息肉切除术、止血技术、肠内喂养管放置、异物取出、简单食管狭窄扩张和病变位置印度墨水纹身。

  3. ESGE 和 ESGENA 建议 GI 内镜培训应遵守严格的正式要求,以确保满足所有 ESGE 关键绩效指标 (KPI)。

  4. 基本内镜操作的培训是一个复杂的过程,包括认知、技术/运动和综合技能的发展和获取。因此,ESGE 和 ESGENA 建议使用经过验证的工具来跟踪技能的发展并评估能力。

  5. ESGE 和 ESGENA 建议在基本 GI 内镜操作中采用多模式方法评估能力,包括程序阈值以及既定 ESGE KPI 的测量和记录。

  6. ESGE 和 ESGENA 建议在 GI 内镜培训期间持续监测 ESGE KPI,以确保学员保持能力。

  7. ESGE 和 ESGENA 建议 GI 内镜培训单位满足内镜单位的 ESGE KPI,并且能够为成功培训提供所需的专门人员、基础设施和足够的病例量,以在结构化培训计划中进行。

  8. ESGE 和 ESGENA 建议基本 GI 内镜操作培训师应是具有内镜教学正规教育培训的内镜医师,使他们能够成功和安全地教授学员。

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