Guy's and St Thomas' Hospitals NHS Trust, London, UK.
Cardiology, Guy's and St Thomas' Hospitals NHS Trust, London, UK.
Open Heart. 2024 Nov 25;11(2):e002865. doi: 10.1136/openhrt-2024-002865.
Valvular heart disease (VHD) represents a significant burden on healthcare systems worldwide, necessitating specialised care through multidisciplinary valve clinics. However, there is a lack of a standardised training and certification framework for clinical scientists and specialist physiologists (CSSPs) working within specialist valve clinics (SVCs). This study aimed to design, implement and validate a competency framework dedicated to training and certifying valve CSSPs to enhance patient outcomes and establish standardised care.
A comprehensive competency framework was developed and implemented, consisting of two levels: Enhanced Valve Clinic Training (EVCT) and Advanced Valve Clinic Training (AVCT). The programme was trialled at Guy's Valve Clinic, London, over a 12-month period. Validation was undertaken through trainee and patient feedback, including multiple-choice questions, clinical skills assessments, and patient satisfaction surveys.
Nine CSSPs completed the EVCT and four the AVCT. All participants passed their certification examinations with scores ranging from 80% to 95%. The time to complete each programme averaged 6 months. After certification, clinical queries raised by EVCT trainees averaged 1.2 per session but dropped by 75% to 0.3 per session in the AVCT group, indicating greater confidence and independence in managing cases. Physician review of trainee-led cases led to additional tests or treatment changes in 23% of cases and referrals to physician clinics in 11%. Patient feedback was positive: 95% felt confident in the clinical scientists' knowledge, and 100% were satisfied with the clarity of their care plans and follow-up.
The implementation of this training and certification framework demonstrated enhanced clinical outcomes and care delivery in SVCs. By advocating for formal recognition and accreditation of valve clinic training, this framework could serve as a model for national and international standardisation in valve care and clinical training.
瓣膜性心脏病（VHD）在全球医疗体系中造成了巨大负担，需要通过多学科瓣膜诊所提供专业护理。然而，在专门的瓣膜诊所（SVC）工作的临床科学家和专科生理学家（CSSP）缺乏标准化的培训和认证框架。本研究旨在设计、实施和验证专门用于培训和认证瓣膜 CSSP 的能力框架，以提高患者的治疗效果并建立标准化的护理。
制定并实施了一个全面的能力框架，分为两个层次：增强型瓣膜诊所培训（EVCT）和高级瓣膜诊所培训（AVCT）。该计划在伦敦的盖伊瓣膜诊所进行了为期 12 个月的试验。通过学员和患者的反馈进行验证，包括多项选择题、临床技能评估和患者满意度调查。
9 名 CSSP 完成了 EVCT，4 名完成了 AVCT。所有参与者都通过了认证考试，得分在 80%至 95%之间。完成每个项目的平均时间为 6 个月。认证后，EVCT 学员平均每节课提出 1.2 个临床问题，而在 AVCT 组中减少了 75%，降至 0.3 个。这表明他们在处理病例时更有信心和独立性。医生对学员主导病例的审查导致 23%的病例增加了额外的检查或治疗改变，11%的病例转至医生诊所。患者的反馈是积极的：95%的患者对临床科学家的知识有信心，100%的患者对他们的护理计划和随访感到满意。
实施该培训和认证框架在 SVC 中提高了临床治疗效果和护理质量。通过倡导正式承认瓣膜诊所培训，该框架可以成为瓣膜护理和临床培训国家和国际标准化的模型。
