Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9068, USA
Department of Physiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1751, USA.
Br J Anaesth. 2016 Oct;117(4):477-481. doi: 10.1093/bja/aew295.
The role of transoesophageal echocardiography (TOE) in anaesthetic practice is expanding. We evaluated the effect of a TOE perceptual and adaptive learning module (PALM) on first-yr anaesthesiology residents' performance, in diagnosing cardiac pathology by TOE.
First-yr residents were assigned to a group (n = 12) that used a TOE PALM or a control group that did not (n = 12). Both groups received a TOE pretest that measured their accuracy and response times. The PALM group completed the PALM and a posttest within 30 min and a delayed test six months later. The control group received a delayed test six months after their pretest. Accuracy and fluency (accurate responses within 10 s) were measured.
The PALM group had statistically significant improvements for both accuracy and fluency (P < 0.0001) in diagnosing cardiac pathology by TOE. After six months, the PALM group's performance remained significantly higher than their pretest values for accuracy (P = 0.0002, d = 2.7) and fluency (P < 0.0001, d = 2.3).
In this pilot study, exposure to a PALM significantly improved accuracy and fluency in diagnosing TOE cardiac pathology, in a group of first-year anaesthesiology residents. PALMs can significantly improve learning and pattern recognition in medical education.
经食管超声心动图（TOE）在麻醉实践中的作用正在扩大。我们评估了 TOE 感知和适应学习模块（PALM）对第一年麻醉学住院医师通过 TOE 诊断心脏病理学表现的影响。
将第一年住院医师分配到使用 TOE PALM 的组（n = 12）或未使用 TOE PALM 的对照组（n = 12）。两组均接受了一项 TOE 预测试，以衡量他们的准确性和反应时间。PALM 组在 30 分钟内完成了 PALM 和后测，并在六个月后进行了延迟测试。对照组在预测试六个月后进行了延迟测试。测量准确性和流畅性（在 10 秒内准确回答）。
TOE 诊断心脏病理学时，PALM 组的准确性和流畅性均有统计学显著提高（P < 0.0001）。六个月后，PALM 组的表现仍然明显高于其预测试的准确性（P = 0.0002，d = 2.7）和流畅性（P < 0.0001，d = 2.3）。
在这项试点研究中，暴露于 PALM 显著提高了第一年麻醉学住院医师通过 TOE 诊断心脏病理学的准确性和流畅性。PALM 可以显著提高医学教育中的学习和模式识别。
