Department of Anesthesiology and Intensive care, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark.
BMC Med Educ. 2012 Aug 3;12:65. doi: 10.1186/1472-6920-12-65.
Previous studies addressing teaching and learning in point-of-care ultrasound have primarily focussed on image interpretation and not on the technical quality of the images. We hypothesized that a limited intervention of 10 supervised examinations would improve the technical skills in Focus Assessed Transthoracic Echocardiography (FATE) and that physicians with no experience in FATE would quickly adopt technical skills allowing for image quality suitable for interpretation.
Twenty-one physicians with no previous training in FATE or echocardiography (Novices) participated in the study and a reference group of three examiners with more than 10 years of experience in echocardiography (Experts) was included. Novices received an initial theoretical and practical introduction (2 hours), after which baseline examinations were performed on two healthy volunteers. Subsequently all physicians were scheduled to a separate intervention day comprising ten supervised FATE examinations. For effect measurement a second examination (evaluation) of the same two healthy volunteers from the baseline examination was performed.
At baseline 86% of images obtained by novices were suitable for interpretation, on evaluation this was 93% (p = 0.005). 100% of images obtained by experts were suitable for interpretation. Mean global image rating on baseline examinations was 70.2 (CI 68.0-72.4) and mean global image rating after intervention was 75.0 (CI 72.9-77.0), p = 0.0002. In comparison, mean global image rating in the expert group was 89.8 (CI 88.8-90.9).
Improvement of technical skills in FATE can be achieved with a limited intervention and upon completion of intervention 93% of images achieved are suitable for clinical interpretation.
以前关于即时超声教学和学习的研究主要集中在图像解读上,而不是图像的技术质量上。我们假设,经过 10 次有监督的检查,可有限度地提高 Focus Assessed Transthoracic Echocardiography(FATE)的技术技能,并且没有 FATE 经验的医生可以快速掌握技术技能,从而获得适合解读的图像质量。
21 名没有 FATE 或超声心动图培训经验的医生(新手)参与了这项研究,并纳入了一个具有 10 多年超声心动图经验的三位考官(专家)的参考组。新手接受了初始的理论和实践介绍(2 小时),之后对两名健康志愿者进行了基线检查。随后,所有医生都安排在一个单独的干预日进行 10 次有监督的 FATE 检查。为了进行效果测量,对基线检查中同两名健康志愿者的第二次检查(评估)进行了评估。
在基线时,新手获得的 86%的图像适合解读,在评估时,这一比例上升到 93%(p=0.005)。专家获得的 100%的图像都适合解读。基线检查时的平均整体图像评分(CI 68.0-72.4)为 70.2,干预后为 75.0(CI 72.9-77.0),p=0.0002。相比之下,专家组的平均整体图像评分(CI 88.8-90.9)为 89.8。
通过有限的干预,可提高 FATE 的技术技能,干预完成后,93%的图像可用于临床解读。