复杂结直肠癌的手术是复杂的：术前评估、患者选择、影像判读、手术策略、手术技术、手术标准化、术后护理和并发症管理都是关键组成部分。鉴于这种复杂性，涵盖所有这些关键方面的培训对于培养受过适当教育的外科医生至关重要。迄今为止，尚无课程可指导晚期和复发性盆腔恶性肿瘤（尤其是复杂结直肠癌）的培训。这样的课程可能会带来许多优势，不仅对于个体外科医生，而且对于研究、治理、国际合作和基准测试。本研究的目的是设计和开发复杂结直肠癌进修培训课程框架，其中包括盆腔切除手术。克恩描述了一种课程设计的六步方法，该方法现已在医学教育中广泛采用。我们的研究利用克恩方法的步骤 1-4 制定了针对复杂结直肠癌（包括盆腔切除术）的进修培训的课程开发大纲和评估框架。针对第 1 步进行了文献综述，然后在第 2 步中进行有针对性的需求评估，通过与学员、研究员和专家进行焦点小组讨论，确定学习需求和目标，并为第 3 步设定目标。然后，专家共识小组对这些建议进行了投票并制定了教育策略建议作为步骤 4。为了简洁起见，文中的“盆腔切除术”也包括属于复杂[结直肠]癌范围的扩大和多内脏切除术。克恩方法的步骤 1 确定了关于复杂癌症手术课程的文献存在空白。第二步确定了学员认为需要学习的关键领域，包括解剖学、实践经验和病例量。第三步定义了进修课程的目的和目标，定义为六个领域，包括理论知识、决策、技术技能、术后管理和持续专业发展。最后，作为第 5 阶段和第 6 阶段的前奏，专家共识会议商定了实施、反馈和评估策略，该策略定义了病例数量（研究金期内至少 20 例盆腔切除手术）以及本教学大纲的覆盖范围派生指标。我们的工作组开发了英国复杂癌症高级研究员培训的课程框架。需要通过实施进行验证，并且必须在国内和国际上寻求对其效用的肯定。© 2024 作者。约翰·威利出版的《结直肠疾病》

Surgery for complex colorectal cancer is elaborate: preoperative assessment, patient selection, radiological interpretation, operative strategy, operative technical skills, operative standardization, postoperative care and management of complications are all critical components. Given this complexity, training that encompasses all these crucial aspects to generate suitably edified surgeons is essential. To date, no curriculum exists to guide training in advanced and recurrent pelvic malignancy, particularly for complex colorectal cancer. Such a curriculum would potentially offer numerous advantages, not only for individual surgeons but also for research, governance, international collaboration and benchmarking. The aim of this study was to design and develop a framework for a curriculum for fellowship training in complex colorectal cancer that encompasses pelvic exenteration surgery.Kern described a six-step method for curriculum design that is now widely adopted in medical education. Our study utilizes steps 1-4 of Kern's method to develop a syllabus and assessment framework for curriculum development for fellowship training in complex colorectal cancer encompassing pelvic exenteration. A literature review was conducted to address step 1, followed by targeted needs assessment in step 2 by conducting focus groups with trainees, fellows and experts to identify learning needs and goals with objective setting for step 3. An expert consensus group then voted on these recommendations and developed educational strategy recommendations as step 4. For the purposes of brevity, 'pelvic exenteration' in the text is taken to also encompass extended and multivisceral resections that fall under the remit of complex [colorectal] cancer.Step 1 of Kern's method identified a gap in the literature on curricula in complex cancer surgery. Step 2 identified key areas regarded as learning needs by trainees, including anatomy, hands-on experience and case volume. Step 3 defined the goals and objectives of a fellowship curriculum, defined in six domains including theoretical knowledge, decision-making, technical skills, postoperative management and continuing professional development. Finally, as a prelude to stages 5 and 6, a strategy for implementation and for feedback and assessment was agreed by an expert consensus meeting that defined case volume (a minimum of 20 pelvic exenteration operations within a fellowship period) and coverage of this syllabus with derived metrics.Our working group has developed a curriculum framework for advanced fellowship training in complex cancer in the UK. Validation is needed through implementation, and affirmation of its utility, both nationally and internationally, must be sought.© 2024 The Author(s). Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.