Mosier Jarrod M, Malo Josh, Stolz Lori A, Bloom John W, Reyes Nathaniel A, Snyder Linda S, Adhikari Srikar
Section of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85721; Department of Emergency Medicine, University of Arizona, 1609 N. Warren Ave, Tucson, AZ 85724.
Section of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85721.
J Crit Care. 2014 Aug;29(4):645-9. doi: 10.1016/j.jcrc.2014.03.006. Epub 2014 Mar 21.
The purpose of this study is to describe the current state of bedside ultrasound use and training among critical care (CC) training programs in the United States.
This was a cross-sectional survey of all program directors for Accreditation Council for Graduate Medical Education accredited programs during the 2012 to 2013 academic year in CC medicine, surgical CC, pulmonary and critical care, and anesthesia CC. Availability, current use, and barriers to training in CC ultrasound were assessed.
Sixty of 195 (31%; 95% confidence interval [CI], 24%-38%) program directors responded. Most of the responding programs had an ultrasound system available for use (54/60, 90%; 95% CI, 79%-96%) and identified ultrasound training as useful (59/60, 98%; 95% CI, 91%-100%) but lacked a formal curriculum (25/60, 42%; 95% CI, 29%-55%) or trained faculty (mean percentage of faculty trained in ultrasound: pulmonary and critical care, 25%; surgical CC, 33%; anesthesia CC, 20%; CC medicine, 7%), and relied on informal teaching (45/60, 77%; 95% CI, 62%-85%). Faculty with expertise (53/60, 88%; 95% CI, 77%-95%), simulation training (60/60, 100%; 95% CI, 94%-100%), establishing and meeting required number of examinations (47/60, 78%; 95% CI, 66%-88%), and regular review sessions (49/60, 82%; 95% CI, 70%-90%) were identified as necessary to improve ultrasound training. Most responding programs (32/35 91%; 95% CI, 77%-98%) without a formal curriculum plan to create one in the next 5 years.
This study identified deficiencies in current training, suggesting a need for a formal curriculum for bedside ultrasound training in CC fellowship programs.
本研究旨在描述美国重症监护（CC）培训项目中床边超声使用和培训的现状。
这是一项对2012至2013学年美国毕业后医学教育认证委员会认可的CC医学、外科CC、肺与重症监护以及麻醉CC项目的所有项目主任进行的横断面调查。评估了CC超声培训的可用性、当前使用情况以及培训障碍。
195名项目主任中有60名（31%；95%置信区间[CI]，24% - 38%）回复。大多数回复项目都有可供使用的超声系统（54/60，90%；95% CI，79% - 96%），并认为超声培训有用（59/60，98%；95% CI，91% - 100%），但缺乏正式课程（25/60，42%；95% CI，29% - 55%）或经过培训的教员（接受超声培训的教员平均比例：肺与重症监护，25%；外科CC，33%；麻醉CC，20%；CC医学，�%），且依赖非正式教学（45/60，77%；95% CI，62% - 85%）。具备专业知识的教员（53/60，88%；95% CI，77% - 95%）、模拟培训（60/60，100%；95% CI،94% - 100%）、建立并达到所需的检查数量（47/60，78%；95% CI，6৬% - 88%）以及定期复习课程（49/60，82%；95% CI，70% - 90%）被认为是改善超声培训所必需的。大多数没有正式课程的回复项目（32/35，91%；95% CI，77% - 98%）计划在未来5年内制定一个。
本研究发现当前培训存在不足，表明CC专科培训项目需要床边超声培训的正式课程。
