Millington Scott J, Arntfield Robert T, Guo Robert Jie, Koenig Seth, Kory Pierre, Noble Vicki, Mallemat Haney, Schoenherr Jordan R
Division of Critical Care, University of Ottawa, 501 Smyth Road, Box 207, Ottawa, ON, K1H 8L6, Canada.
Crit Ultrasound J. 2017 Nov 22;9(1):25. doi: 10.1186/s13089-017-0081-0.
The rapid adoption of point-of-care ultrasound (POCUS) has created a need to develop assessment tools to ensure that learners can competently use these technologies. In this study, the authors developed and tested a rating scale to assess the quality of point-of-care thoracic ultrasound studies performed by novices. In Phase 1, the Assessment of Competency in Thoracic Sonography (ACTS) scale was developed based on structured interviews with subject matter experts. The tool was then piloted on a small series of ultrasound studies in Phase 2. In Phase 3 the tool was applied to a sample of 150 POCUS studies performed by ten learners; performance was then assessed by two independent raters.
Evidence for the content validity of the ACTS scale was provided by a consensus exercise wherein experts agreed on the general principles and specific items that make up the scale. The tool demonstrated reasonable inter-rater reliability despite minimal requirements for evaluator training and displayed evidence of good internal structure, with related scale items correlating well with each other. Analysis of the aggregate learning curves suggested a rapid early improvement in learner performance with slower improvement after approximately 25-30 studies.
The ACTS scale provides a straightforward means to assess learner performance. Our results support the conclusion that the tool is an effective means of making valid judgments regarding competency in point-of-care thoracic ultrasound, and that the majority of learner improvement occurs during their first 25-30 practice studies.
即时超声检查（POCUS）的迅速普及使得开发评估工具成为必要，以确保学习者能够熟练使用这些技术。在本研究中，作者开发并测试了一种评分量表，用于评估新手进行的即时胸部超声检查的质量。在第一阶段，基于对主题专家的结构化访谈，开发了胸部超声检查能力评估（ACTS）量表。然后在第二阶段对一小系列超声检查进行了试点。在第三阶段，该工具应用于由十名学习者进行的150项POCUS检查样本；然后由两名独立评分者评估表现。
通过一项共识活动提供了ACTS量表内容效度的证据，其中专家们就构成该量表的一般原则和具体项目达成了一致。尽管对评估者培训的要求很低，但该工具显示出合理的评分者间信度，并显示出良好的内部结构证据，相关量表项目之间相关性良好。对总体学习曲线的分析表明，学习者的表现早期快速提高，在大约25 - 30次检查后提高速度减慢。
ACTS量表提供了一种直接的方法来评估学习者的表现。我们的结果支持以下结论：该工具是对即时胸部超声检查能力做出有效判断的有效手段，并且大多数学习者的提高发生在他们最初的25 - 30次实践检查期间。
