Markowitz Joshua E, Hwang James Q, Moore Christopher L
Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
J Ultrasound Med. 2011 Mar;30(3):371-5. doi: 10.7863/jum.2011.30.3.371.
Extended focused assessment with sonography in trauma (EFAST) examinations are routinely performed by emergency physicians and general surgeons as an integral part of trauma care. Although guidelines for competency in the EFAST examination exist, tools to assess competency are lacking. Our goal was to develop and validate a Web-based competency assessment tool to evaluate providers who perform the EFAST examination.
A multiple-choice test regarding the performance and interpretation of the EFAST examination was developed following National Board of Medical Examiner guidelines. Five emergency physician experts with fellowship training in emergency ultrasound established face and content validity. The test was administered to emergency medicine residents and ultrasound fellows. Concurrent validity was evaluated by assessing the correlation of scores on our test with guidelines set by the American College of Emergency Physicians (ACEP) for emergency ultrasound. Scores were analyzed, and statistical analysis was performed.
Sixty-three emergency medicine residents and 2 ultrasound fellows from 2 residency programs completed the assessment tool. Examinees who met ACEP guidelines scored significantly higher than those who had not: 70.4% (95% confidence interval, 67.3%-73.4%) versus 48.3% (43.2%-53.5%). Evaluation of scores showed a significant correlation between an increased level of training, participation in an ultrasound rotation, and the number of EFAST and total ultrasound examinations performed with higher test scores. However, overall test scores were lower than initially anticipated.
Use of this assessment tool for interpretation of EFAST images showed face and content validity. Score trends showed a significant correlation with existing ACEP guidelines, ultrasound experience, and the training level. Scores continued to improve with experience beyond ACEP recommended guidelines.
创伤超声重点评估扩展检查（EFAST）由急诊医师和普通外科医生常规执行，作为创伤护理的一个组成部分。尽管存在EFAST检查能力的指南，但缺乏评估能力的工具。我们的目标是开发并验证一种基于网络的能力评估工具，以评估进行EFAST检查的人员。
根据美国医学考试委员会的指南，开发了一项关于EFAST检查操作和解读的多项选择题测试。五名接受过急诊超声 fellowship 培训的急诊医师专家确定了表面效度和内容效度。该测试面向急诊医学住院医师和超声 fellows 进行。通过评估我们测试的分数与美国急诊医师学会（ACEP）制定的急诊超声指南之间的相关性来评估同时效度。对分数进行分析并进行统计分析。
来自两个住院医师培训项目的63名急诊医学住院医师和2名超声 fellows 完成了评估工具。符合ACEP指南的考生得分显著高于未符合者：70.4%（95%置信区间，67.3%-73.4%）对48.3%（43.2%-53.5%）。分数评估显示，培训水平提高、参与超声轮转以及进行的EFAST和总超声检查次数增加与更高的测试分数之间存在显著相关性。然而，总体测试分数低于最初预期。
使用该评估工具解读EFAST图像显示出表面效度和内容效度。分数趋势与现有的ACEP指南、超声经验和培训水平显著相关。超出ACEP推荐指南的经验使分数持续提高。
