Pediatric Gastroenterology, Hepatology & Nutrition

  • 제27권4호
  • /
  • Pages.258-265
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  • 2024
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  • 2234-8646(pISSN)
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  • 2234-8840(eISSN)
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)
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Current Pediatric Endoscopy Training Situation in the Asia-Pacific Region: A Collaborative Survey by the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition Endoscopy Scientific Subcommittee

  • Nuthapong Ukarapol (Department of Pediatrics, Faculty of Medicine, Chiang Mai University) ;
  • Narumon Tanatip (Department of Pediatrics, Faculty of Medicine, Chiang Mai University) ;
  • Ajay Sharma (Department of Pediatrics and Pediatric Gastroenterology, Fiona Stanley Hospital, Joondalup Health Campus and SJOG Midland, Curtin Medical School) ;
  • Maribel Vitug-Sales (Department of Pediatrics, Makati Medical Center) ;
  • Robert Nicholas Lopez (Department of Pediatrics, Faculty of Medical and Health Sciences, University of Auckland) ;
  • Rohan Malik (Division of Pediatric Gastroenterology and Hepatology, All India Institute of Medical Sciences) ;
  • Ruey Terng Ng (Department of Pediatrics, University of Malaya) ;
  • Shuichiro Umetsu (Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohamashi Tobu Hospital) ;
  • Songpon Getsuwan (Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University) ;
  • Tak Yau Stephen Lui (Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital) ;
  • Yao-Jong Yang (Department of Pediatrics, National Cheng Kung University Hospital) ;
  • Yeoun Joo Lee (Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University College of Medicine) ;
  • Katsuhiro Arai (Division of Gastroenterology, National Center for Child Health and Development) ;
  • Kyung Mo Kim (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • APPSPGHAN Endoscopy Scientific Subcommittee ( APPSPGHAN Endoscopy Scientific Subcommittee)
  • 투고 : 2024.04.11
  • 심사 : 2024.05.29
  • 발행 : 2024.07.15
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초록

Purpose: To date, there is no region-specific guideline for pediatric endoscopy training. This study aimed to illustrate the current status of pediatric endoscopy training in Asia-Pacific region and identify opportunities for improvement. Methods: A cross-sectional survey, using a standardized electronic questionnaire, was conducted among medical schools in the Asia-Pacific region in January 2024. Results: A total of 57 medical centers in 12 countries offering formal Pediatric Gastroenterology training programs participated in this regional survey. More than 75% of the centers had an average case load of <10 cases per week for both diagnostic and therapeutic endoscopies. Only 36% of the study programs employed competency-based outcomes for program development, whereas nearly half (48%) used volume-based curricula. Foreign body retrieval, polypectomy, percutaneous endoscopic gastrostomy, and esophageal variceal hemostasis, that is, sclerotherapy or band ligation (endoscopic variceal sclerotherapy and endoscopic variceal ligation), comprised the top four priorities that the trainees should acquire in the autonomous stage (unconscious) of competence. Regarding the learning environment, only 31.5% provided formal hands-on workshops/simulation training. The direct observation of procedural skills was the most commonly used assessment method. The application of a quality assurance (QA) system in both educational and patient care (Pediatric Endoscopy Quality Improvement Network) aspects was present in only 28% and 17% of the centers, respectively. Conclusion: Compared with Western academic societies, the limited availability of cases remains a major concern. To close this gap, simulation and adult endoscopy training are essential. The implementation of reliable and valid assessment tools and QA systems can lead to significant development in future programs.

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참고문헌

  1. Lee WS, Arai K, Alex G, Treepongkaruna S, Kim KM, Choong CL, et al. Management and monitoring of pediatric inflammatory bowel disease in the Asia-Pacific region: a position paper by the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group: surgical management, disease monitoring, and special considerations. J Gastroenterol Hepatol 2023;38:510-22.
  2. van Rheenen PF, Aloi M, Assa A, Bronsky J, Escher JC, Fagerberg UL, et al. The medical management of paediatric Crohn's disease: an ECCO-ESPGHAN guideline update. J Crohn's Colitis 2021;15:171-94.
  3. Thomson M, Tringali A, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, et al. Paediatric gastrointestinal endoscopy: European Society for Paediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy guidelines. J Pediatr Gastroenterol Nutr 2017;64:133-53.
  4. Leichtner AM, Gillis LA, Gupta S, Heubi J, Kay M, Narkewicz MR, et al. NASPGHAN guidelines for training in pediatric gastroenterology. J Pediatr Gastroenterol Nutr 2013;56 Suppl 1:S1-8.
  5. Taylor JA, Ivry RB. The role of strategies in motor learning. Ann N Y Acad Sci 2012;1251:1-12.
  6. Kuenzig ME, Fung SG, Marderfeld L, Mak JWY, Kaplan GG, Ng SC, et al. Twenty-first century trends in the global epidemiology of pediatric-onset inflammatory bowel disease: systematic review. Gastroenterology 2022;162:1147-59.e4.
  7. Maulahela H, Annisa NG, Konstantin T, Syam AF, Soetikno R. Simulation-based mastery learning in gastrointestinal endoscopy training. World J Gastrointest Endosc 2022;14:512-23.
  8. Yodoshi T, Iwama I, Shinoura S. Pediatric endoscopy training in a community hospital in Japan. Pediatr Int 2020;62:740-1.
  9. Powell DE, Carraccio C. Toward competency-based medical education. N Engl J Med 2018;378:3-5.
  10. Scarallo L, Russo G, Renzo S, Lionetti P, Oliva S. A journey towards pediatric gastrointestinal endoscopy and its training: a narrative review. Front Pediatr 2023;11:1201593.
  11. Walsh CM. Training and assessment in pediatric endoscopy. Gastrointest Endosc Clin N Am 2016;26:13-33.
  12. Patel SG, Keswani R, Elta G, Saini S, Menard-Katcher P, Del Valle J, et al. Status of competency-based medical education in endoscopy training: a nationwide survey of US ACGME-accredited Gastroenterology training programs. Am J Gastroenterol 2015;110:956-62.
  13. Zanchetti DJ, Schueler SA, Jacobson BC, Lowe RC. Effective teaching of endoscopy: a qualitative study of the perceptions of gastroenterology fellows and attending gastroenterologists. Gastroenterol Rep (Oxf ) 2016;4:125-30.
  14. Armstrong D, Barkun A, Bridges R, Carter R, de Gara C, Dube C, et al. Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy. Can J Gastroenterol 2012;26:17-31.
  15. Walsh CM, Lightdale JR, Mack DR, Amil-Dias J, Bontems P, Brill H, et al. Overview of the pediatric endoscopy quality improvement network quality standards and indicators for pediatric endoscopy: a joint NASPGHAN/ESPGHAN guideline. J Pediatr Gastroenterol Nutr 2022;74 (Suppl 1):S3-15.