| 特集名 | 内視鏡的粘膜下層剥離術 (ESD) のトレーニングとリスクマネージメント | |
|---|---|---|
| 題名 | トピックス -- 米国における治療内視鏡のトレーニングシステム | |
| 発刊年月 | 2006年 08月 | |
| 著者 | 深見 悟生 | Department of Gastrointestinal Medicine and Nutrition, The University of Texas M. D. Anderson Cancer Center |
| 著者 | John R. Stroehlein | Department of Gastrointestinal Medicine and Nutrition, The University of Texas M. D. Anderson Cancer Center |
| 著者 | Alexander A. Dekovich | Department of Gastrointestinal Medicine and Nutrition, The University of Texas M. D. Anderson Cancer Center |
| 【 要旨 】 | 内視鏡が高度になるにつれ内視鏡トレーニングシステムが課題となってくる．米国では早くから標準化が進められ，ガイドラインが出版されている．近年の治療内視鏡の発展で一般消化器内視鏡研修から治療内視鏡研修が切り離され後期研修となる傾向が強い．米国での一般消化器内科研修から治療内視鏡研修までを，順を追って概説する． | |
| Theme | Training System and Risk Management for Endoscopic Submucosal Dissection (ESD) | |
|---|---|---|
| Title | Therapeutic Endoscopy Training System in the United States | |
| Author | Norio Fukami | Department of Gastrointestinal Medicine and Nutrition, The University of Texas M. D. Anderson Cancer Center |
| Author | John R. Stroehlein | Department of Gastrointestinal Medicine and Nutrition, The University of Texas M. D. Anderson Cancer Center |
| Author | Alexander A. Dekovich | Department of Gastrointestinal Medicine and Nutrition, The University of Texas M. D. Anderson Cancer Center |
| [ Summary ] | Endoscopic procedures are taught in gastroenterology fellowship or surgical residency programs recognized by the Accreditation Council for Graduate Medical Education. The primary objective of any gastroenterology fellowship program is the teaching of endoscopic procedures and techniques and imparting to the trainee up to date knowledge of indications, contraindications, possible complications and associated limitations. Curriculum guidelines for EGD, colonoscopy, ERCP and EUS are available from the website of the American Society for Gastrointestinal Endoscopy. Fellows are monitored daily by the attending faculty. The program director in concert with the faculty completes on a quarterly basis an overall evaluation. Feedback from this global evaluation is presented to the fellows in written and face-to-face format allowing for resolution of problems and guidance for improvement. Procedures are divided into standard procedures (EGD, colonoscopy, etc.) and advanced procedures (ERCP, EUS, etc.). Proficiency in standard procedures is the goal of any gastroenterology fellowship program and provides a foundation for advanced procedure training. Advanced procedures are more readily taught in specialized referral centers usually requiring an additional year of fellowship. There is no consensus yet as to how novel procedures are to be mastered. In the U.S., novel procedures and techniques are first mastered in the animal laboratory before proceeding to human trials. Audiovisual materials, increasingly used to improve the training at the entry level, are readily available to supplement the “hands on” experience of various techniques and equipment. |
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