日美國ERCP培訓(xùn)與評估課件

11日美國ERCP培訓(xùn)與評估2022/12/16日美國ERCP培訓(xùn)與評估11日美國ERCP培訓(xùn)與評估2022/12/13日美國ERC1ERCPTrainingintheU.S.

美國的ERCP培訓(xùn)PartofaGIFellowship(ABIMaccredited)胃腸醫(yī)生培訓(xùn)的一部分(美國內(nèi)科學(xué)委員會認(rèn)證)ERCPtrainingofferedin3rdyear(traineesexposedtoERCPbutnotnecessarilycompetentinperforming)第3年開始進行ERCP培訓(xùn)(學(xué)員只需ERCP知識,并不要求獨立操作）Additional(advanced)4thyeartraining(notABIMaccredited)第4年高級培訓(xùn)一年（非美國內(nèi)科學(xué)委員會認(rèn)證要求）Traineesexpectedtocomplete180-200cases,with80%successrate,including75%therapeuticprocedures要求學(xué)員完成180-200例操作，成功率達80%以上（其中包括75%的治療性操作）日美國ERCP培訓(xùn)與評估ERCPTrainingintheU.S.

美國的E2WhyERCPTraining?

為什么要進行ERCP培訓(xùn)？ERCPiseffectiveinmanagementofpancreaticobiliarydiseasesERCP在膽胰系統(tǒng)疾病診治方面效果顯著ItiscomplexandpotentiallyhazardousERCP技術(shù)復(fù)雜，有相當(dāng)高的潛在風(fēng)險Requireseffectiveclinical/technicalteaching需要有效的臨床基礎(chǔ)和操作技巧指導(dǎo)Objectiveassessmenttodeterminequality需要客觀的評估，判斷學(xué)員操作能力Apprenticeship傳統(tǒng)的學(xué)徒式教學(xué)日美國ERCP培訓(xùn)與評估WhyERCPTraining?

為什么要進行ERCP培3KeyQuestionsinERCPTraining

ERCP培訓(xùn)中的關(guān)鍵問題Whoshouldbetrained?誰來學(xué)？Whatshouldbetaught,andhow?教什么，怎樣教？Whoshouldteach?誰來教？Howaretrainingandcompetenceassessed?如何對培訓(xùn)效果及學(xué)員能力進行有效評估？Whatlevelofperformanceisacceptable?培訓(xùn)目標(biāo)如何確定？日美國ERCP培訓(xùn)與評估KeyQuestionsinERCPTraining4WhoShouldbeTrained?

誰來學(xué)？GI/Surgicaltrainees部分消化科內(nèi)醫(yī)生和外科醫(yī)生Availabletrainingpositionsarevariable按照不同的階段目標(biāo)獲得多樣化培訓(xùn)Expectation-thosewhoreceivedtrainingshouldreachacceptablelevelofcompetenceforsafeindependentpractice預(yù)期在結(jié)束培訓(xùn)時，學(xué)員能夠達到相應(yīng)階段培訓(xùn)標(biāo)準(zhǔn)可以獨立安全的開展業(yè)務(wù)日美國ERCP培訓(xùn)與評估WhoShouldbeTrained?

誰來學(xué)？GI/5WhatShouldbeTaught,andHow?

教什么，怎么教？Knowledgeinpancreaticobiliarydiseases膽胰系統(tǒng)疾病的臨床理論知識SkillsinERCPincludingalternativediagnosticandtherapeuticmethodsERCP的實際操作技能，包括其他診斷性和治療性操作方法Skilledinbasictenetsofpatientcare醫(yī)學(xué)精神以及收治過程中與病人溝通能力日美國ERCP培訓(xùn)與評估WhatShouldbeTaught,andHow6LevelsofComplexity

ERCP技術(shù)難度分級（2011）Cottonetal.Gradingthecomplexityofendoscopicprocedures:resultsofanASGEworkingparty.GIE2011;73:868-741.深插管，膽道支架置入/交換/取出日美國ERCP培訓(xùn)與評估LevelsofComplexity

ERCP技術(shù)難度分7GoalsofERCPtraining

ERCP培訓(xùn)目標(biāo)Abletoprovidefundamental(life-saving)ERCPproceduresatthecommunitylevele.g.urgentbiliarydrainingforacute(suppurative)cholangitis初級培訓(xùn)：能夠在當(dāng)?shù)蒯t(yī)院急診情況下提供最基本的（”救命式”）ERCP操作，如急性化膿性膽管炎引流Thosecompletedtrainingshouldbecompetentinperforminglevel1and2procedures完成培訓(xùn)：能夠熟練掌握技術(shù)難度1、2級的ERCP操作Levels3and4procedureswillrequireadvancedtraining3,4級技術(shù)難度的操作需要高級的培訓(xùn)日美國ERCP培訓(xùn)與評估GoalsofERCPtraining

ERCP培訓(xùn)目8TrainingCurriculum

培訓(xùn)科目DifferencesbetweenASGEandSAGES美國胃腸鏡學(xué)會與胃腸道內(nèi)鏡外科醫(yī)生學(xué)會要求的分別Lectures,didactics,atlases,videosandbooks講座，授課，圖片，視頻以及教科書Supervisedclinicalpractice監(jiān)督下的臨床實踐History/physicalexam,laboratorytests病史，體征，實驗室檢查Managementofpancreaticobiliaryproblemsasin-andoutpatients,withdiscussionondiagnosticandtreatmentoptions,includingassessmentofrisks膽胰系統(tǒng)疾病門診及住院病人的處理,診斷和治療的選擇以及風(fēng)險評估Multi-disciplinaryapproach(surgery/radiology)多學(xué)科討論

（外科、放射科）日美國ERCP培訓(xùn)與評估TrainingCurriculum

培訓(xùn)科目Differ9ConceptofTraining(Preparingtheendoscopist) 培訓(xùn)的概念Howtodoit(basicskills)怎樣做Whentouseit(clinicalapplication)何時應(yīng)用于臨床Specificprocedures 具體步驟Managementofcomplications并發(fā)癥的處理Documentationofperformance操作記錄Credentialing 證書1/2015日美國ERCP培訓(xùn)與評估ConceptofTraining1/2015日美國E10TrainingMethods

培訓(xùn)方法Selfstudies:videos,recordedlectures,selfassessment自學(xué)：視頻，

聽課,自我評估Radiologicalinterpretation,safetywithfluoroscopy影像學(xué)資料學(xué)習(xí)，放射學(xué)安全Observationofclinicalprocedures臨床操作觀摩學(xué)習(xí)Laboratorypracticeofbasicskills,includinghandlingscopeandaccessories內(nèi)鏡室基礎(chǔ)操作，包括持鏡，附件等Clinicaltraining:hands-onpracticewithscopehandlingandselectivecannulation臨床操作培訓(xùn)：控制十二指腸鏡和選擇性插管的練習(xí)Guidewiremanipulationandoperatedifferentaccessories導(dǎo)絲和其他附件操作Learninginstepsandeventuallyabletoassimilateskillsandcompleteentireprocedure循序漸進掌握ERCP操作技巧Successfulprocedurewithnocomplications成功獨立操作,沒有并發(fā)癥的手術(shù)TraineesalsolearnhowtoassistwithERCPprocedure學(xué)員同時應(yīng)當(dāng)學(xué)習(xí)如何當(dāng)好ERCP助手日美國ERCP培訓(xùn)與評估TrainingMethods

培訓(xùn)方法Selfstud11SupplementalTraining

補充培訓(xùn)Seminarsandworkshops研討會和培訓(xùn)班Modelpracticeincludingsimulators包括模擬器在內(nèi)的模擬訓(xùn)練Hands-onteampracticetoimprovecoordinationwithassistants(TEAMwork)手把手ERCP團隊協(xié)作訓(xùn)練日美國ERCP培訓(xùn)與評估SupplementalTraining

補充培訓(xùn)Semi12Simulation(Optional)Training

模擬器（可選擇）培訓(xùn)Understandanatomy,motility理解解剖及胃腸蠕動特性Practicewithrealscopeandaccessories使用十二指腸鏡和附件練習(xí)Familiarwithscopehandling熟悉持鏡技巧Learnandpracticebasicsteps學(xué)習(xí)掌握基本操作步驟Coordinatedpracticewithassistantwithoutriskingapatient與助手合作練習(xí)減少病人風(fēng)險(RCTshowedimprovedcannulationsuccessratewithinitialsimulationpracticefornoviceendoscopists)(RCT顯示模擬器插管練習(xí)明顯提升ERCP初學(xué)者臨床操作插管成功率)日美國ERCP培訓(xùn)與評估Simulation(Optional)Training13SimulationModels

模擬器類型Animalmodel(anatomicalvariations)動物模型（解剖差異）Anesthetizedpig麻醉下的活體豬Ex-vivoporcinestomachmodel離體的豬胃腸模型Neopapillamodel新型乳頭模型（雞心）ComputerSimulator(probesinsteadofrealinstrument)計算機模擬器（探頭代替真實設(shè)備）GIMentorIIMechanicalSimulator(rigidmodel)機械模擬器(rigidmodel)EMSX-vision日美國ERCP培訓(xùn)與評估SimulationModels

模擬器類型Animal14IDEALSimulationPractice

最理想模擬器訓(xùn)練Improvesskills提高基本操作技能Demonstratesrealism：展示解剖、胃腸運動的實際情況Easeofincorporationintotraining：方便操作配合培訓(xùn)Applicableintraining：實用訓(xùn)練，可以模擬治療性ERCPLearningwithrealscopeandaccessories：用真的十二指腸鏡及附件學(xué)習(xí)操作日美國ERCP培訓(xùn)與評估IDEALSimulationPractice

最理想15ERCPMechanicalSimulator(EMS)

機械模擬器Artificialbiliarypapillotomy人工乳頭切開Pancreaticstenting胰管支架置入日美國ERCP培訓(xùn)與評估ERCPMechanicalSimulator(EMS16WhoShouldTeach?

誰來教？Askilledendoscopistmaynotbeagoodteacher技術(shù)全面的內(nèi)鏡醫(yī)生不一定能勝任教學(xué)Trainershouldrecognizemistakesmadebytrainees教師應(yīng)該分辨學(xué)員操作中的錯誤Offersguidance,coachingandassistance適當(dāng)提供指導(dǎo)，訓(xùn)練和輔助Supportiveandnotpunitiveattitude態(tài)度積極，避免懲罰性教學(xué)日美國ERCP培訓(xùn)與評估WhoShouldTeach?

誰來教？Askille17AssessmentofCompetence

能力評估臨床評估ClinicalassessmentProcedurelog臨床操作記錄Success/failure成功/失敗Complications并發(fā)癥Trainerinvolvement(step-by-steptrainingdependingoncomplexity,riskandpotentialcomplications)教師參與程度Verbal口頭指令Hands-onassistance手把手輔助Takeover教師接鏡操作模擬器評估SimulationProcedurelog操作記錄Typeofpractice操作類型Variationindifficulty不同難度Success/failure成功/失敗Errorinpractice操作中的錯誤Proceduretime操作時間Simulatedfluoroscopytime模擬放射線時間日美國ERCP培訓(xùn)與評估AssessmentofCompetence

能力評估臨18OverallAssessment

評估Acquisitionofknowledgeandapplication學(xué)員掌握理論知識和操作技巧Clinicalknowledge臨床基礎(chǔ)知識Understandingofpathologies,interpretationofradiologicalfindings,choiceoftherapy掌握疾病病理生理，能夠閱片和選擇治療方式Technicalproficiencyandcompetencyinperformingprocedure技術(shù)熟練程度和臨床操作的實際能力日美國ERCP培訓(xùn)與評估OverallAssessment

評估Acquisiti19ObjectiveAssessment

客觀評價指標(biāo)Examinationtodeterminequalityoftrainee學(xué)員綜合能力考試Knowledge基礎(chǔ)理論Skills操作技巧Compassion對患者的同情關(guān)懷(愛心）Exam測驗/考試Written(multiplechoice)筆試（包括多項選擇）Oral口試Practical現(xiàn)場操作日美國ERCP培訓(xùn)與評估ObjectiveAssessment

客觀評價指標(biāo)Exa20NumberofProcedures(LogBook)

病例數(shù)（記錄）Arbitrarilyusedasasurrogateofexperience病例數(shù)可以用于粗略估計學(xué)員經(jīng)驗程度Complexityandspectrum病例復(fù)雜性和不同類型Degreeofinvolvementwithtrainee/trainer教師在學(xué)員的操作輔助程度Objectiveoutcomeassessment客觀評價指標(biāo)Successwithcannulation插管成功率Postproceduralcomplications術(shù)后并發(fā)癥Reportcard臨床操作記錄卡Benchmarking達標(biāo)的指標(biāo)日美國ERCP培訓(xùn)與評估NumberofProcedures(LogBook21WhatisAcceptablePerformance?

怎樣算合格Highsuccessratesandlowcomplications操作的成功率高和并發(fā)癥率低Levelofcomplexityvs.experienceofoperator操作復(fù)雜性跟操作者經(jīng)驗Levelofurgencyvs.typeof(life-saving)procedure緊急程度跟

操作種類（救命操作）Traineesoloperformance學(xué)員單獨完成操作日美國ERCP培訓(xùn)與評估WhatisAcceptablePerformance22CredentialingandCertification

合格與授予證書TraineesmettrainingrequirementandbecomeGIBoardEligible學(xué)員達到訓(xùn)練要求即可取得胃腸病專家資格Trainingexperienceconfirmedbyprogramdirector

獲得培訓(xùn)導(dǎo)師認(rèn)可的培訓(xùn)經(jīng)歷TraineesthenpasstheGIBoard(written)ExaminationandbecomeBoardCertifiedinGastroenterology

學(xué)員經(jīng)過參加胃腸病協(xié)會組織的書面考試并授予合格證Noobjective/practicalexaminationfortechnical(ERCP)skill無ERCP的實際技能考核NocertificationforERCP

無ERCP合格證書日美國ERCP培訓(xùn)與評估CredentialingandCertificatio23演講完畢，謝謝聽講!再見，seeyouagain3rew2022/12/16日美國ERCP培訓(xùn)與評估演講完畢，謝謝聽講!再見，seeyouagain3rew2411日美國ERCP培訓(xùn)與評估2022/12/16日美國ERCP培訓(xùn)與評估11日美國ERCP培訓(xùn)與評估2022/12/13日美國ERC25ERCPTrainingintheU.S.

美國的ERCP培訓(xùn)PartofaGIFellowship(ABIMaccredited)胃腸醫(yī)生培訓(xùn)的一部分(美國內(nèi)科學(xué)委員會認(rèn)證)ERCPtrainingofferedin3rdyear(traineesexposedtoERCPbutnotnecessarilycompetentinperforming)第3年開始進行ERCP培訓(xùn)(學(xué)員只需ERCP知識,并不要求獨立操作）Additional(advanced)4thyeartraining(notABIMaccredited)第4年高級培訓(xùn)一年（非美國內(nèi)科學(xué)委員會認(rèn)證要求）Traineesexpectedtocomplete180-200cases,with80%successrate,including75%therapeuticprocedures要求學(xué)員完成180-200例操作，成功率達80%以上（其中包括75%的治療性操作）日美國ERCP培訓(xùn)與評估ERCPTrainingintheU.S.

美國的E26WhyERCPTraining?

為什么要進行ERCP培訓(xùn)？ERCPiseffectiveinmanagementofpancreaticobiliarydiseasesERCP在膽胰系統(tǒng)疾病診治方面效果顯著ItiscomplexandpotentiallyhazardousERCP技術(shù)復(fù)雜，有相當(dāng)高的潛在風(fēng)險Requireseffectiveclinical/technicalteaching需要有效的臨床基礎(chǔ)和操作技巧指導(dǎo)Objectiveassessmenttodeterminequality需要客觀的評估，判斷學(xué)員操作能力Apprenticeship傳統(tǒng)的學(xué)徒式教學(xué)日美國ERCP培訓(xùn)與評估WhyERCPTraining?

為什么要進行ERCP培27KeyQuestionsinERCPTraining

ERCP培訓(xùn)中的關(guān)鍵問題Whoshouldbetrained?誰來學(xué)？Whatshouldbetaught,andhow?教什么，怎樣教？Whoshouldteach?誰來教？Howaretrainingandcompetenceassessed?如何對培訓(xùn)效果及學(xué)員能力進行有效評估？Whatlevelofperformanceisacceptable?培訓(xùn)目標(biāo)如何確定？日美國ERCP培訓(xùn)與評估KeyQuestionsinERCPTraining28WhoShouldbeTrained?

誰來學(xué)？GI/Surgicaltrainees部分消化科內(nèi)醫(yī)生和外科醫(yī)生Availabletrainingpositionsarevariable按照不同的階段目標(biāo)獲得多樣化培訓(xùn)Expectation-thosewhoreceivedtrainingshouldreachacceptablelevelofcompetenceforsafeindependentpractice預(yù)期在結(jié)束培訓(xùn)時，學(xué)員能夠達到相應(yīng)階段培訓(xùn)標(biāo)準(zhǔn)可以獨立安全的開展業(yè)務(wù)日美國ERCP培訓(xùn)與評估WhoShouldbeTrained?

誰來學(xué)？GI/29WhatShouldbeTaught,andHow?

教什么，怎么教？Knowledgeinpancreaticobiliarydiseases膽胰系統(tǒng)疾病的臨床理論知識SkillsinERCPincludingalternativediagnosticandtherapeuticmethodsERCP的實際操作技能，包括其他診斷性和治療性操作方法Skilledinbasictenetsofpatientcare醫(yī)學(xué)精神以及收治過程中與病人溝通能力日美國ERCP培訓(xùn)與評估WhatShouldbeTaught,andHow30LevelsofComplexity

ERCP技術(shù)難度分級（2011）Cottonetal.Gradingthecomplexityofendoscopicprocedures:resultsofanASGEworkingparty.GIE2011;73:868-741.深插管，膽道支架置入/交換/取出日美國ERCP培訓(xùn)與評估LevelsofComplexity

ERCP技術(shù)難度分31GoalsofERCPtraining

ERCP培訓(xùn)目標(biāo)Abletoprovidefundamental(life-saving)ERCPproceduresatthecommunitylevele.g.urgentbiliarydrainingforacute(suppurative)cholangitis初級培訓(xùn)：能夠在當(dāng)?shù)蒯t(yī)院急診情況下提供最基本的（”救命式”）ERCP操作，如急性化膿性膽管炎引流Thosecompletedtrainingshouldbecompetentinperforminglevel1and2procedures完成培訓(xùn)：能夠熟練掌握技術(shù)難度1、2級的ERCP操作Levels3and4procedureswillrequireadvancedtraining3,4級技術(shù)難度的操作需要高級的培訓(xùn)日美國ERCP培訓(xùn)與評估GoalsofERCPtraining

ERCP培訓(xùn)目32TrainingCurriculum

培訓(xùn)科目DifferencesbetweenASGEandSAGES美國胃腸鏡學(xué)會與胃腸道內(nèi)鏡外科醫(yī)生學(xué)會要求的分別Lectures,didactics,atlases,videosandbooks講座，授課，圖片，視頻以及教科書Supervisedclinicalpractice監(jiān)督下的臨床實踐History/physicalexam,laboratorytests病史，體征，實驗室檢查Managementofpancreaticobiliaryproblemsasin-andoutpatients,withdiscussionondiagnosticandtreatmentoptions,includingassessmentofrisks膽胰系統(tǒng)疾病門診及住院病人的處理,診斷和治療的選擇以及風(fēng)險評估Multi-disciplinaryapproach(surgery/radiology)多學(xué)科討論

（外科、放射科）日美國ERCP培訓(xùn)與評估TrainingCurriculum

培訓(xùn)科目Differ33ConceptofTraining(Preparingtheendoscopist) 培訓(xùn)的概念Howtodoit(basicskills)怎樣做Whentouseit(clinicalapplication)何時應(yīng)用于臨床Specificprocedures 具體步驟Managementofcomplications并發(fā)癥的處理Documentationofperformance操作記錄Credentialing 證書1/2015日美國ERCP培訓(xùn)與評估ConceptofTraining1/2015日美國E34TrainingMethods

培訓(xùn)方法Selfstudies:videos,recordedlectures,selfassessment自學(xué)：視頻，

聽課,自我評估Radiologicalinterpretation,safetywithfluoroscopy影像學(xué)資料學(xué)習(xí)，放射學(xué)安全Observationofclinicalprocedures臨床操作觀摩學(xué)習(xí)Laboratorypracticeofbasicskills,includinghandlingscopeandaccessories內(nèi)鏡室基礎(chǔ)操作，包括持鏡，附件等Clinicaltraining:hands-onpracticewithscopehandlingandselectivecannulation臨床操作培訓(xùn)：控制十二指腸鏡和選擇性插管的練習(xí)Guidewiremanipulationandoperatedifferentaccessories導(dǎo)絲和其他附件操作Learninginstepsandeventuallyabletoassimilateskillsandcompleteentireprocedure循序漸進掌握ERCP操作技巧Successfulprocedurewithnocomplications成功獨立操作,沒有并發(fā)癥的手術(shù)TraineesalsolearnhowtoassistwithERCPprocedure學(xué)員同時應(yīng)當(dāng)學(xué)習(xí)如何當(dāng)好ERCP助手日美國ERCP培訓(xùn)與評估TrainingMethods

培訓(xùn)方法Selfstud35SupplementalTraining

補充培訓(xùn)Seminarsandworkshops研討會和培訓(xùn)班Modelpracticeincludingsimulators包括模擬器在內(nèi)的模擬訓(xùn)練Hands-onteampracticetoimprovecoordinationwithassistants(TEAMwork)手把手ERCP團隊協(xié)作訓(xùn)練日美國ERCP培訓(xùn)與評估SupplementalTraining

補充培訓(xùn)Semi36Simulation(Optional)Training

模擬器（可選擇）培訓(xùn)Understandanatomy,motility理解解剖及胃腸蠕動特性Practicewithrealscopeandaccessories使用十二指腸鏡和附件練習(xí)Familiarwithscopehandling熟悉持鏡技巧Learnandpracticebasicsteps學(xué)習(xí)掌握基本操作步驟Coordinatedpracticewithassistantwithoutriskingapatient與助手合作練習(xí)減少病人風(fēng)險(RCTshowedimprovedcannulationsuccessratewithinitialsimulationpracticefornoviceendoscopists)(RCT顯示模擬器插管練習(xí)明顯提升ERCP初學(xué)者臨床操作插管成功率)日美國ERCP培訓(xùn)與評估Simulation(Optional)Training37SimulationModels

模擬器類型Animalmodel(anatomicalvariations)動物模型（解剖差異）Anesthetizedpig麻醉下的活體豬Ex-vivoporcinestomachmodel離體的豬胃腸模型Neopapillamodel新型乳頭模型（雞心）ComputerSimulator(probesinsteadofrealinstrument)計算機模擬器（探頭代替真實設(shè)備）GIMentorIIMechanicalSimulator(rigidmodel)機械模擬器(rigidmodel)EMSX-vision日美國ERCP培訓(xùn)與評估SimulationModels

模擬器類型Animal38IDEALSimulationPractice

最理想模擬器訓(xùn)練Improvesskills提高基本操作技能Demonstratesrealism：展示解剖、胃腸運動的實際情況Easeofincorporationintotraining：方便操作配合培訓(xùn)Applicableintraining：實用訓(xùn)練，可以模擬治療性ERCPLearningwithrealscopeandaccessories：用真的十二指腸鏡及附件學(xué)習(xí)操作日美國ERCP培訓(xùn)與評估IDEALSimulationPractice

最理想39ERCPMechanicalSimulator(EMS)

機械模擬器Artificialbiliarypapillotomy人工乳頭切開Pancreaticstenting胰管支架置入日美國ERCP培訓(xùn)與評估ERCPMechanicalSimulator(EMS40WhoShouldTeach?

誰來教？Askilledendoscopistmaynotbeagoodteacher技術(shù)全面的內(nèi)鏡醫(yī)生不一定能勝任教學(xué)Trainershouldrecognizemistakesmadebytrainees教師應(yīng)該分辨學(xué)員操作中的錯誤Offersguidance,coachingandassistance適當(dāng)提供指導(dǎo)，訓(xùn)練和輔助Supportiveandnotpunitiveattitude態(tài)度積極，避免懲罰性教學(xué)日美國ERCP培訓(xùn)與評估WhoShouldTeach?

誰來教？Askille41AssessmentofCompetence

能力評估臨床評估ClinicalassessmentProcedurelog臨床操作記錄Success/failure成功/失敗Complications并發(fā)癥Trainerinvolvement(step-by-steptrainingdependingoncomplexity,riskandpotentialcomplications)教師參與程度Verbal口頭指令Hands-onassistance手把手輔助Takeover教師接鏡操作模擬器評估SimulationProcedurelog操作記錄Typeofpractice操作類型Variationindifficulty不同難度Success/failure成功/失敗Errorinpractice操作中的錯誤Proceduretime操作時間Simulatedfluoroscopytime模擬放射線時間日美國ERCP培訓(xùn)與評估AssessmentofCompetence

能力評估臨42OverallAssessment

評估Acquisitionofknowledgeandapplication學(xué)員掌握理論知識和操作技巧Clinicalknowledge臨床基礎(chǔ)知識Understandingofpathologies,interpretationofradiologicalfindings,choice