基础医学与临床 ›› 2025, Vol. 45 ›› Issue (5): 686-690.doi: 10.16352/j.issn.1001-6325.2025.05.0686

• 医学教育 • 上一篇    下一篇

消化专科医师ERCP入门培训模式与教学效果评估

施文, 王强*, 冯云路, 吴晰, 张晟瑜, 蒋青伟, 杨爱明   

  1. 中国医学科学院 北京协和医学院 北京协和医院 消化内科,北京 100730
  • 收稿日期:2025-02-13 修回日期:2025-03-18 出版日期:2025-05-05 发布日期:2025-04-23
  • 通讯作者: * pekingunion@aliyun.com
  • 基金资助:
    北京协和医学院2023年教学质量工程项目青年教育学者项目(2023zlgc0706);北京协和医学院2022年中央高校教育教学改革专项资金(2022zlgc0108)

Evaluation of the ERCP introductory training model and the teaching effect for gastroenterology specialists

SHI Wen, WANG Qiang*, FENG Yunlu, WU Xi, ZHANG Shengyu, JIANG Qingwei, YANG Aiming   

  1. Department of Gastroenterology, Peking Union Medical College Hospital, CAMS & PUMC,Beijing 100730, China
  • Received:2025-02-13 Revised:2025-03-18 Online:2025-05-05 Published:2025-04-23
  • Contact: * pekingunion@aliyun.com

摘要: 目的 通过对经内镜逆行胰胆管造影术(ERCP)入门培训模式建立和教学效果评估,探讨消化科医师高级内镜操作继续教育的方式。方法 纳入2023年9月至2024年9月参加北京协和医院ERCP入门培训班共3期26位学员,通过问卷调查、现场测试和高年资ERCP操作医生评估的形式,对培训班及其5个模块的教学效果进行主观和客观评估。结果 通过ERCP入门培训班,学员对十二指肠镜构造(培训前得分:2.4±2.4,培训后得分:8.2±1.5,P<0.001)、十二指肠镜操作(培训前得分:1.2±2.2,培训后得分:6.6±1.8,P<0.001)、乳头插管(培训前得分:0.5±1.3,培训后得分:5.4±1.8,P<0.001)、胆管内操作(培训前得分:0.2±0.6,培训后得分:4.9±2.1,P<0.001)和胆管内病变辨认(培训前得分:1.7±2.1,培训后得分:6.0±2.0,P<0.001)的熟练程度自评均有显著提升。学员在培训前理论测试和图片识别的正确率为37.2%,培训后提升至62.8%。培训前所有学员均被高年资操作医师认为不能开始ERCP真人培训,培训后69.2%(18/26)的学员被认为可开始ERCP真人培训。结论 包含多模块的ERCP入门培训班效果显著,为学员开始真人ERCP操作培训奠定了基础,也为中国消化专科医生高级内镜操作继续教育模式提供了参考。

关键词: 内镜逆行胰胆管造影术, 入门培训, 继续教育, 置信职业行为

Abstract: Objective To explore the methods of continuing education for advanced endoscope operations by digestive specialists through the establishment and teaching effect evaluation of the ERCP (endoscope retrograde cholangiopancreatography) introductory training mode. Methods A total of 26 trainees from 3 sessions of the ERCP introductory training courses at Peking Union Medical College Hospital from September 2023 to September 2024 were included. The teaching effects of the training courses and its 5 modules were subjectively and objectively evaluated by questionnaires, on - site tests and evaluations by senior ERCP operators. Results Through the ERCP introductory training courses, the trainees′ self-evaluated proficiency in duodenoscope structure (pre-training: 2.4±2.4, post- training: 8.2±1.5, P<0.001), duodenoscope operation (pre-training: 1.2±2.2, post-training: 6.6±1.8, P<0.001), papillary cannulation (pre-training: 0.5±1.3, post-training: 5.4±1.8, P<0.001), intra-bile duct operation (pre-training: 0.2±0.6, post-training: 4.9±2.1, P<0.001), and identification of intra-bile duct lesions (pre-training: 1.7±2.1, post-training: 6.0±2.0, P<0.001) was significantly improved. The accuracy rate of the trainees′ theoretical tests and picture recognition before training was 37.2% and then increased up to 62.8% after training. Before training, all trainees were considered by senior operators as not ready to start ERCP training on real patients, while after training, 69.2% (18/26) of the trainees were considered ready to start ERCP training on real patients. Conclusions The multi-module ERCP introductory training courses have a significant effect in terms of laying a foundation for trainees to start ERCP training on patients and of providing a reference for the continuing education mode of advanced endoscope operations for digestive specialists in China.

Key words: endoscopic retrograde cholangiopancreatography, introductory training, continuing education, entrustable professional activities

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