Adult Intensive Care Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
Resuscitation. 2010 Nov;81(11):1534-9. doi: 10.1016/j.resuscitation.2010.07.001. Epub 2010 Aug 19.
Echocardiography performed in an ALS-compliant manner provides a tool whereby some of the potentially reversible causes of cardiac arrest can be diagnosed in real time by minimally trained practitioners. One of the major concerns this raises is how to deliver effective training to the required standard. The objective of this study was to determine the effectiveness of number of different educational methods used teach echocardiography to novices. This involved assessment of cognitive, psychomotor skills and affective aspects in five key areas.
The study population was a convenience sample from participants attending standardised structured one-day training courses in peri-resuscitation echocardiography (n=204). Subjects were assessed for five learning outcomes including knowledge and image interpretation, practical performance of echocardiography including time taken to obtain a diagnostic view, integration into the ALS algorithm and overall compliance with established resuscitation guidelines.
There was a significant improvement in knowledge and interpretation of echocardiographic images before and after completion of the one-day course (pre 62%, post 78%, p<0.01). Skills acquisition resulted in 100% of participants being able to obtain a subcostal view of diagnostic quality by the end of the course, and 86% with a mean time to acquisition of <10s. On completion of the training programme, incorporation of echocardiography into current resuscitation practice did not compromise ALS-compliance.
Novice echocardiographers can obtain knowledge and skills relevant to ALS-compliant peri-resuscitation echocardiography using a range of educational techniques. In addition to the standard one-day training courses available, continued mentored practice and didactic adherence to ALS algorithms is required.
以符合 ALS 要求的方式进行超声心动图检查，为即时诊断潜在可逆转的心脏骤停病因提供了一种工具，而这可能需要经过最低限度培训的从业者来完成。由此引发的一个主要问题是，如何按照既定要求提供有效的培训。本研究的目的是确定使用多种不同教育方法教授初学者超声心动图的效果。这涉及评估认知、心理运动技能和五个关键领域的情感方面。
研究人群为参加标准结构化复苏后超声心动图培训课程的参与者的便利样本（n=204）。对五项学习结果进行评估，包括知识和图像解释、包括获得诊断视图所需时间在内的超声心动图实际操作、纳入 ALS 算法以及整体符合既定复苏指南的情况。
在完成为期一天的课程前后，对超声心动图图像的知识和解释都有了显著提高（课前 62%，课后 78%，p<0.01）。技能的获得使所有参与者在课程结束时都能够获得具有诊断质量的肋下视图，86%的参与者获得该视图的平均时间<10s。在完成培训计划后，将超声心动图纳入当前复苏实践并未影响 ALS 合规性。
新手超声心动图医师可以使用多种教育技术获得与 ALS 兼容的复苏后超声心动图相关的知识和技能。除了提供标准的为期一天的培训课程外，还需要继续接受导师指导下的实践以及对 ALS 算法的理论学习。
