Ahn Justin S, French Andrew J, Thiessen Molly E W, Browne Vaughn, Deutchman Mark, Guiton Gretchen, Madigosky Wendy, Kendall John L
Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA.
J Ultrasound Med. 2015 Oct;34(10):1771-6. doi: 10.7863/ultra.15.14.11014. Epub 2015 Aug 31.
To determine whether the addition of ultrasound to traditional physical examination instruction improves junior medical students' abilities to locate the femoral pulse.
Initially, 150 second-year medical students were taught the femoral pulse examination using traditional bedside teaching on standardized patients and online didactic videos. Students were then randomized into 2 groups: group 1 received ultrasound training first and then completed the standardized examination; and group 2 performed the standardized examination first and then received ultrasound training. On the standardized patients, the femoral artery was marked with invisible ink before the sessions using ultrasound. Compared to these markers, students were then evaluated on the accuracy of femoral artery pulse palpation and the estimated location of the femoral vein. All students completed a self-assessment survey after the ultrasound sessions.
Ultrasound training improved the students' ability to palpate the femoral pulse (P= .02). However, ultrasound did not facilitate correct estimation of the femoral vein's anatomic location (P = .09). Confidence levels in localizing the femoral artery and vein were equal between groups at baseline, and both increased after the ultrasound sessions.
The addition of ultrasound teaching to traditional physical examination instruction enhanced medical student competency and confidence with the femoral vascular examination. However, understanding of anatomy may require emphasis on precourse didactic material, but further study is required.
确定在传统体格检查指导中加入超声检查是否能提高低年级医学生定位股动脉搏动的能力。
最初，150名二年级医学生通过对标准化病人进行传统床边教学以及观看在线教学视频来学习股动脉检查。然后，学生被随机分为两组：第1组先接受超声培训，然后完成标准化检查；第2组先进行标准化检查，然后接受超声培训。在标准化病人身上，使用超声在检查前用隐形墨水标记股动脉。然后，根据这些标记，评估学生股动脉搏动触诊的准确性以及股静脉估计位置。所有学生在超声检查课程结束后完成一份自我评估调查问卷。
超声培训提高了学生触诊股动脉搏动的能力（P = 0.02）。然而，超声检查并未有助于正确估计股静脉的解剖位置（P = 0.09）。两组在基线时定位股动脉和静脉的信心水平相当，且在超声检查课程结束后均有所提高。
在传统体格检查指导中加入超声教学可提高医学生对股血管检查的能力和信心。然而，对解剖学的理解可能需要强调课前教学材料，但仍需进一步研究。
