里程碑式教学法在内镜逆行胰胆管造影术培训中的应用

Implementation and practice of milestone learning trajectories in endoscopic retrograde cholangiopancreatography training

目的探讨里程碑式教学法在内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)专科培训中的应用问题。方法ERCP教学因缺乏理想模型,多由带教老师在术中通过“手把手”的方式进行,其操作难度大、手术风险高导致学习成功率低。通过借鉴美国毕业后医学教育认证委员会有关内镜医师专科培训的规范和经验,根据ERCP操作难度制定学习进程的里程碑,指导老师和学员按进程由易到难,由低风险到高风险,循序渐进达成目标。结果分析近年来培训学员的里程碑学习曲线结果,该方法利于因材施教,可实时追踪学习效果,便于指导老师及时分析、总结、制定合理的学习计划,既保证了患者权益,又满足了学员培训的要求。结论里程碑式教学方法具有非常大的应用价值。

Objective To evaluate the implementation and practice of milestone learning trajectories in endoscopic retrograde cholangiopancreatography(ERCP)training.Methods ERCP training is mostly performed by instructors through a“hands-on”approach intraoperatively due to the lack of an ideal model,which results in a low success rate and the high operative risk of difficult operations.We have drawn on the experience of the Accreditation Council for Graduate Medical Education(ACGME)to develop milestones for the learning process according to the difficulty of ERCP operations,and instructors and trainees can progress from easy to difficult and from low-risk to high-risk to reach their goals.Results Analyzing the trainees’results of milestone learning curves in recent years,the method facilitates tailor-made teaching,allows real-time tracking of learning effects,and provides timely analysis and summary by instructors to develop reasonable learning plans,which not only ensures patients’rights and interests,but also meets the requirements of trainees’training.Conclusion Milestone learning trajectories is a good method for both trainees and trainers,and has high application value and is worth promoting.