Schnobrich Daniel J, Olson Andrew P J, Broccard Alain, Duran-Nelson Alisa
J Grad Med Educ. 2013 Sep;5(3):493-7. doi: 10.4300/JGME-D-12-00214.1.
Point-of-care ultrasound has emerged as a powerful diagnostic tool and is also being increasingly used by clinicians to guide procedures. Many current and future internists desire training, yet no formal, multiple-application, program-wide teaching interventions have been described.
We describe a structured 30-hour ultrasound training course in diagnostic and procedural ultrasound implemented during intern orientation. Internal medicine interns learned basic ultrasound physics and machine skills; focused cardiac, great vessel, pulmonary, and abdominal ultrasound diagnostic examinations; and procedural applications.
In postcourse testing, learners demonstrated the ability to acquire images, had significantly increased knowledge scores (P < .001), and demonstrated good performance on practical scenarios designed to test abilities in image acquisition, interpretation, and incorporation into medical decision making. In the postcourse survey, learners strongly agreed (4.6 of 5.0) that ultrasound skills would be valuable during residency and in their careers.
A structured ultrasound course can increase knowledge and can result in learners who have skills in image acquisition, interpretation, and integration in management. Future work will focus on refining and improving these skills to allow these learners to be entrusted with the use of ultrasound independently for patient care decisions.
床旁超声已成为一种强大的诊断工具,临床医生也越来越多地使用它来指导操作。许多现任和未来的内科医生都希望接受培训,但尚未有正式的、适用于多种应用场景、针对整个项目的教学干预措施被描述。
我们描述了一个在实习医生入职培训期间实施的为期30小时的结构化超声培训课程,内容涵盖诊断性和操作性超声。内科实习医生学习了基本的超声物理学和仪器操作技能;重点学习了心脏、大血管、肺部和腹部的超声诊断检查;以及操作应用。
在课程结束后的测试中,学习者展示了获取图像的能力,知识得分显著提高(P < 0.001),并且在旨在测试图像获取、解读以及将其纳入医疗决策能力的实际场景中表现良好。在课程结束后的调查中,学习者强烈同意(5.0分中的4.6分)超声技能在住院医师期间及其职业生涯中会很有价值。
结构化的超声课程可以增加知识,并使学习者具备图像获取、解读以及在管理中整合的技能。未来的工作将集中在完善和提高这些技能,以使这些学习者能够被信任独立使用超声进行患者护理决策。