Читать книгу Successful Training in Gastrointestinal Endoscopy - Группа авторов - Страница 20

Since the early establishment that training in endoscopy was a high‐priority activity among academic endoscopy centers and GI societies, a great deal of effort has been devoted to assess the efficacy of training, determine learning curves for various procedures, and explore new methods for imparting proficiency. A number of important guidelines on the subject have incorporated much of this data and expert opinion on the subject [5]. One large review delved into the data for each procedure in great detail [16]. Specific chapters in this volume address training as it relates to quality in endoscopy and to specific standards for each of the major endoscopic procedures that are performed. Apart from the specific recommendations about learning particular procedures, a number of themes have emerged throughout all current guidelines, which reflect the evolution of the concepts of optimal training in endoscopy. Key principles include the following:

 Specificity of training and privileging: Individuals must be trained for each particular procedure they wish to perform.

 Threshold numbers for competency: Guidelines have steered away from earlier emphasis that trainees gain competence after independently performing a certain minimum number of procedures. It has been increasingly accepted that numbers do not guarantee competency; individuals develop proficiency at different rates; and accordingly, the best way to assess competency is to do so on the basis of some objective measures. Threshold numbers have been derived from evidence‐based studies in which objective competency for a particular procedure is achieved after a particular amount of training; however, these numbers are now viewed merely as a minimum amount of training that must be performed before competency can even be assessed. The end point of successful endoscopic training should be objective demonstration of competency.