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资源匮乏环境下的可持续复苏超声教育:库马西经验

Sustainable Resuscitation Ultrasound Education in a Low-Resource Environment: The Kumasi Experience.

作者信息

Tafoya Chelsea A, Tafoya Matthew J, Osei-Ampofo Maxwell, Oteng Rockefeller A, Becker Torben K

机构信息

University of Michigan Medical School, Ann Arbor, Michigan.

Accident & Emergency Department, Komfo Anokye Teaching Hospital, Kumasi, Ghana.

出版信息

J Emerg Med. 2017 May;52(5):723-730. doi: 10.1016/j.jemermed.2017.01.050. Epub 2017 Mar 9.

Abstract

BACKGROUND

Point-of-care-ultrasound (POCUS) is an increasingly important tool for emergency physicians and has become a standard component of emergency medicine residency training in high-income countries. Cardiopulmonary ultrasound (CPUS) is emerging as an effective way to quickly and accurately assess patients who present to the emergency department with shock and dyspnea. Use of POCUS, including CPUS, is also becoming more prevalent in low- and middle-income countries (LMICs); however, formal ultrasound training for emergency medicine resident physicians in these settings is not widely available.

OBJECTIVES

To evaluate the feasibility of integrating a high-intensity ultrasound training program into the formal curriculum for emergency medicine resident physicians in an LMIC.

METHODS

We conducted a pilot ultrasound training program focusing on CPUS for 20 emergency medicine resident physicians in Kumasi, Ghana, which consisted of didactic sessions and hands-on practice. Competency was assessed by comparing pretest and posttest scores and with an Objective Structured Clinical Examination (OSCE) performed after the final training session.

RESULTS

The mean score on the pretest was 61%, and after training, the posttest score was 96%. All residents obtained passing scores above 70% on the OSCE.

CONCLUSION

A high-intensity ultrasound training program can be successfully integrated into an emergency medicine training curriculum in an LMIC.

摘要

背景

床旁超声(POCUS)对急诊医生而言是一种日益重要的工具,在高收入国家已成为急诊医学住院医师培训的标准组成部分。心肺超声(CPUS)正成为快速准确评估因休克和呼吸困难就诊于急诊科患者的有效方法。在低收入和中等收入国家(LMICs),包括CPUS在内的POCUS应用也越来越普遍;然而,这些地区的急诊医学住院医师并未广泛接受正规的超声培训。

目的

评估在一个低收入和中等收入国家将高强度超声培训项目纳入急诊医学住院医师正规课程的可行性。

方法

我们在加纳库马西为20名急诊医学住院医师开展了一项以CPUS为重点的超声培训试点项目,该项目包括理论课程和实践操作。通过比较培训前和培训后的分数以及在最后一次培训课程后进行的客观结构化临床考试(OSCE)来评估能力。

结果

培训前测试的平均分数为61%,培训后测试分数为96%。所有住院医师在OSCE中均获得了70%以上的及格分数。

结论

高强度超声培训项目可以成功纳入低收入和中等收入国家的急诊医学培训课程。

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