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如何实现超声内镜(EUS)培训的长期目标——新培训的内镜超声医师诊断性EUS操作表现的调查及影响因素分析

How to achieve the long-term goals of EUS training--survey on the performance of diagnostic EUS by newly trained endosonographers and analysis of the influencing factors.

作者信息

Zhang Song, Shen Congqiang, Shen Shanshan, Shen Yonghua, Wang Lei, Lv Ying

机构信息

Department of Gastroenterology, Clinical College of Traditional Chinese and Western Medicine, Nanjing Drum Tower Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210008, China.

Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China.

出版信息

BMC Med Educ. 2025 May 17;25(1):721. doi: 10.1186/s12909-025-07208-5.

DOI:10.1186/s12909-025-07208-5
PMID:40382563
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12085813/
Abstract

OBJECTIVES

This study endeavors to evaluate the integration of endoscopic ultrasonography (EUS) by trainees upon their return to the hospital and discern the influencing factors.

METHODS

A questionnaire survey was administered to trainees who completed EUS training at the Department of Gastroenterology, Nanjing Drum Tower Hospital from October 2016 to April 2022. The impact of various factors, including trainees' characteristics, working conditions, and EUS procedure numbers during training was analyzed.

RESULTS

65 valid questionnaires were categorized into two groups based on the median number of EUS procedures performed by trainees within one year post-training: a group with fewer EUS cases (< 30 cases) and a group with more EUS cases (≥ 30 cases). Significant differences were found in annual EUS procedures (P < 0.001), endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cases (P < 0.001), and complete scan rates (P = 0.007). Favorable conditions for trainees in performing EUS included higher-level hospitals (P = 0.001), more hospital beds (P = 0.015) and department beds (P = 0.033), greater annual endoscopy volume (P < 0.001), a longer prior duration of the use of EUS on the hospital (P = 0.003), higher departmental EUS volume (P < 0.001) and presence of established staff endosonographers (P < 0.001). Additionally, trainees in the group with more EUS cases had more guidance from experienced colleagues (P = 0.009). Multivariate logistic regression analysis highlighted annual endoscopy volume and EUS volume as independent influencing factors.

CONCLUSION

Tertiary hospitals with larger bed capacities and high endoscopy volumes foster optimal EUS skill development among trainees. Moreover, factors such as longer duration of EUS implementation, increased caseload and guidance from experienced colleagues all contribute to the professional growth of trainees.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

目的

本研究旨在评估学员返回医院后内镜超声检查(EUS)技术的掌握情况,并识别影响因素。

方法

对2016年10月至2022年4月在南京鼓楼医院消化内科完成EUS培训的学员进行问卷调查。分析了包括学员特征、工作条件以及培训期间EUS操作数量等各种因素的影响。

结果

65份有效问卷根据学员培训后一年内EUS操作的中位数分为两组:EUS病例较少组(<30例)和EUS病例较多组(≥30例)。在年度EUS操作(P<0.001)、内镜超声引导下细针穿刺活检(EUS-FNA)病例(P<0.001)和完整扫描率(P=0.007)方面发现了显著差异。学员进行EUS操作的有利条件包括更高等级的医院(P=0.001)、更多的医院床位(P=0.015)和科室床位(P=0.033)、更高的年度内镜检查量(P<0.001)、医院使用EUS的时间更长(P=0.003)、科室EUS操作量更高(P<0.001)以及有固定的内镜超声检查人员(P<0.001)。此外,EUS病例较多组的学员从经验丰富的同事那里得到了更多指导(P=0.009)。多因素logistic回归分析强调年度内镜检查量和EUS操作量是独立的影响因素。

结论

床位容量大且内镜检查量高的三级医院有利于学员最佳EUS技能的发展。此外,EUS实施时间更长、病例量增加以及经验丰富的同事的指导等因素都有助于学员的专业成长。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f27/12085813/97f2410119e4/12909_2025_7208_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f27/12085813/97f2410119e4/12909_2025_7208_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f27/12085813/97f2410119e4/12909_2025_7208_Fig1_HTML.jpg

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本文引用的文献

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Endoscopy. 2024 Mar;56(3):222-240. doi: 10.1055/a-2224-8704. Epub 2023 Dec 8.
2
Utility of contrast-enhanced harmonic endoscopic ultrasonography for prediction of pathological response after neoadjuvant chemotherapy in patients with pancreatic cancer.对比增强谐波内镜超声检查在预测胰腺癌患者新辅助化疗后病理反应中的应用价值。
Pancreatology. 2023 Dec;23(8):1014-1019. doi: 10.1016/j.pan.2023.10.016. Epub 2023 Oct 31.
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Tissue amount and diagnostic yield of a novel franseen EUS-FNB and a standard EUS-FNA needle-A randomized controlled study in solid pancreatic lesions.
新型 Franseen EUS-FNB 与标准 EUS-FNA 针的组织获取量及诊断率——胰腺实性病变的一项随机对照研究
Endosc Ultrasound. 2023 May-Jun;12(3):319-325. doi: 10.1097/eus.0000000000000007. Epub 2023 Jul 25.
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Endoscopic Ultrasound (EUS) Guided Elastography.内镜超声(EUS)引导下弹性成像
Diagnostics (Basel). 2023 May 10;13(10):1686. doi: 10.3390/diagnostics13101686.
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EUS development in China: Results from national surveys in 2013 and 2020.中国内镜超声检查的发展:2013年和2020年全国性调查结果
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