Socransky Steve, Lang Eddy, Bryce Rhonda, Betz Martin
Emergency Medicine, Northern Ontario School of Medicine.
Emergency Medicine, University of Calgary.
Cureus. 2017 Jun 8;9(6):e1324. doi: 10.7759/cureus.1324.
Point-of-care ultrasound (POCUS) is a novel technique for the assessment of jugular venous pressure. Distance education may allow for efficient dissemination of this technique. We compared online learning to a live course for teaching ultrasonography jugular venous pressure (u-JVP) to determine if these teaching methods yielded different levels of comfort with and use of u-JVP.
This was an interventional trial of Canadian emergency physicians who had taken a basic POCUS course. The participants were in one of three Groups: online learning (Group OL), live teaching (Group LT), control (Group C). Group LT participants also took an advanced course prior to the study that included instruction in u-JVP. The participants who took the basic course were randomized to Group OL or Group C. Group OL was subject to the intervention, online learning. Group C only received an article citation regarding u-JVP. Questionnaires were completed before and after the intervention. The primary outcome was physician self-reported use and comfort with the technique of u-JVP after online learning compared to live teaching.
Of the 287 advanced course participants, 42 completed the questionnaires (Group LT). Of the 3303 basic course participants, 47 who were assigned to Group OL completed the questionnaires and 47 from Group C completed the questionnaires. Use of u-JVP increased significantly in Group OL (from 15% to 55%) and Group C (from 21% to 47%) with the intervention. The comfort with use did not differ between Group LT and Group OL (p=0.14). The frequency of use remained higher in Group LT than Group OL (p=0.07).
Online learning increases the use and comfort with performing u-JVP for emergency physicians with prior POCUS experience. Although the comfort with use of u-JVP was similar in Groups LT and OL, online learning appears to yield levels of use that are less than those of a live course.
床旁超声（POCUS）是一种用于评估颈静脉压的新技术。远程教育可能有助于该技术的有效传播。我们将在线学习与现场课程进行比较，以教授超声检查颈静脉压（u-JVP），以确定这些教学方法是否会使医生对u-JVP的操作舒适度和使用程度有所不同。
这是一项针对参加过基本POCUS课程的加拿大急诊医生的干预性试验。参与者分为三组之一：在线学习组（OL组）、现场教学组（LT组）、对照组（C组）。LT组的参与者在研究前还参加了一门高级课程，其中包括u-JVP的教学内容。参加基础课程的参与者被随机分为OL组或C组。OL组接受在线学习干预。C组仅收到一篇关于u-JVP的文章引用。干预前后均完成问卷调查。主要结果是与现场教学相比，在线学习后医生自我报告的u-JVP技术使用情况和操作舒适度。
在287名高级课程参与者中，42人完成了问卷调查（LT组）。在3303名基础课程参与者中，47名被分配到OL组的参与者完成了问卷调查，47名C组参与者完成了问卷调查。干预后，OL组（从15%增至55%）和C组（从21%增至47%）使用u-JVP的情况显著增加。LT组和OL组在操作舒适度方面无差异（p=0.14）。LT组的使用频率仍高于OL组（p=0.07）。
对于有POCUS经验的急诊医生，在线学习可提高其进行u-JVP操作的使用情况和舒适度。虽然LT组和OL组在使用u-JVP的舒适度方面相似，但在线学习的使用程度似乎低于现场课程。
