Ma Irene, Wishart Ian, Kaminska Malgorzata, McLaughlin Kevin, Weeks Sarah, Lautner David, Baxter Heather, Wright Bruce
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada.
Can Med Educ J. 2013 Mar 31;4(1):e59-68. eCollection 2013.
Ultrasonography is increasingly used for teaching physical examination in medical schools. This study seeks the opinions of educators as to which physical examinations would be most enhanced by the addition of ultrasonography. We also asked when ultrasound-aided physical examination teaching could have deleterious effects if used outside its intended scope.
All of the educators from the University of Calgary Master Teacher Program were invited to complete a 22-item paper-based survey. Survey items were generated independently by two investigators, with input from an expert panel (n = 5).
Of the 36 educators, 27 (75%) completed the survey. Examinations identified to be potentially most useful included: measuring the size of the abdominal aorta, identifying the presence/absence of ascites, identifying the presence/absence of pleural effusions, and measuring the size of the bladder. Examinations thought to be potentially most harmful included: identifying the presence/absence of intrauterine pregnancy, measuring the size of the abdominal aorta, and identifying the presence/absence of pericardial effusion.
Examinations that are potentially the most useful may also be potentially the most harmful. When initiating an ultrasound curriculum for physical examinations, educators should weigh the risks and benefits of examinations chosen.
超声检查在医学院校的体格检查教学中应用日益广泛。本研究旨在征求教育工作者对于哪些体格检查通过增加超声检查能得到最大程度强化的意见。我们还询问了如果超声辅助体格检查教学超出其预期范围使用,何时可能会产生有害影响。
邀请了卡尔加里大学骨干教师项目的所有教育工作者完成一份包含22个项目的纸质调查问卷。调查问卷项目由两名研究人员独立生成,并得到一个专家小组(n = 5)的意见。
36名教育工作者中,27名(75%)完成了调查。被认为可能最有用的检查包括:测量腹主动脉大小、确定有无腹水、确定有无胸腔积液以及测量膀胱大小。被认为可能最有害的检查包括:确定有无宫内妊娠、测量腹主动脉大小以及确定有无心包积液。
可能最有用的检查也可能是最有害的。在启动体格检查超声课程时,教育工作者应权衡所选检查的风险和益处。