Henwood Patricia C, Beversluis David, Genthon Alissa A, Wilson Christina N, Norwood Brendan, Silva Daniel, Foran Mark, Romero Mauricio G, Martinez Yury B, Vargas Luis E, Ocampo Alejandro C, Vallejo Carlos E, Arbelaez Christian
Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Int J Emerg Med. 2014 Feb 5;7(1):7. doi: 10.1186/1865-1380-7-7.
Emergency medicine (EM) is a growing specialty in Colombia with five residency programs in the country. EM leadership is interested in incorporating point-of-care (POC) ultrasound into a standardized national EM residency curriculum. This study is a nationwide survey of Colombian EM residents designed to explore the current state of POC ultrasound use within EM residencies and examine specific barriers preventing its expansion.
We conducted a mix-methodology study of all available current EM residents in the five EM residencies in Colombia. The quantitative survey assessed previous ultrasound experience, current use of various applications, desire for further training, and perceived barriers to expanded use. Focus group discussions (FGDs) were conducted with current EM residents to gather additional qualitative insight into their practice patterns and perceived barriers to clinician-performed ultrasound.
Sixty-nine EM residents completed the quantitative survey, a response rate of 85% of all current EM residents in Colombia; 52% of resident respondents had previously used ultrasound during their training. Of these, 58% indicated that they had performed <10 scans and 17% reported >40 scans. The most frequently used applications indicated by respondents were trauma, obstetrics, and procedures including vascular access. A quarter indicated they had previously received some ultrasound training, but almost all expressed an interest in learning more. Significant barriers included lack of trained teachers (indicated by 78% of respondents), absence of machines (57%), and limited time (41%). In FGDs, the barriers identified were inter-specialty conflicts over the control of ultrasonography, both institutionally and nationally, and program-specific curriculum decisions to include POC ultrasound.
While currently limited in their access, EM residents in Colombia have a strong interest in integrating POC ultrasound into their training. Current barriers to expanded use include traditional barriers such as a lack of equipment seen in many developing countries, as well as inter-specialty conflicts typical of developed countries. Further collaboration is underway to help overcome these obstacles and integrate POC ultrasound into Colombian EM residency training.
急诊医学（EM）在哥伦比亚是一个不断发展的专业领域，该国设有五个住院医师培训项目。急诊医学领域的领导层有意将床旁（POC）超声纳入标准化的全国急诊医学住院医师培训课程。本研究是一项针对哥伦比亚急诊医学住院医师的全国性调查，旨在探究急诊医学住院医师培训中床旁超声的使用现状，并审视阻碍其推广的具体障碍。
我们对哥伦比亚五个急诊医学住院医师培训项目中所有现有的急诊医学住院医师进行了一项混合方法研究。定量调查评估了以往的超声经验、当前各种应用的使用情况、进一步培训的意愿以及对扩大使用的认知障碍。与现有的急诊医学住院医师进行了焦点小组讨论（FGD），以收集关于他们的实践模式以及对临床医生进行超声检查的认知障碍的更多定性见解。
69名急诊医学住院医师完成了定量调查，回复率为哥伦比亚所有现有的急诊医学住院医师的85%；52%的住院医师受访者在培训期间曾使用过超声。其中，58%表示他们进行的扫描次数少于10次，17%报告扫描次数超过40次。受访者指出最常使用的应用是创伤、产科以及包括血管通路在内的操作。四分之一的人表示他们之前接受过一些超声培训，但几乎所有人都表示有兴趣学习更多。重大障碍包括缺乏训练有素的教师（78%的受访者指出）、设备缺失（57%）以及时间有限（41%）。在焦点小组讨论中，所确定的障碍是在机构和国家层面上超声检查控制权方面的跨专业冲突，以及将床旁超声纳入培训项目特定课程的决策。
虽然目前哥伦比亚急诊医学住院医师使用床旁超声的机会有限，但他们对将其纳入培训有着浓厚的兴趣。扩大使用的当前障碍包括许多发展中国家常见的传统障碍，如设备短缺，以及发达国家典型的跨专业冲突。目前正在开展进一步的合作，以帮助克服这些障碍，并将床旁超声纳入哥伦比亚急诊医学住院医师培训。
