Normahani Pasha, Powezka Katarzyna, Aslam Mohammed, Standfield Nigel J, Jaffer Usman
1 Department of Vascular Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom.
Angiology. 2018 Mar;69(3):220-227. doi: 10.1177/0003319717695994. Epub 2017 Feb 27.
We aimed to train podiatrists to perform a focused duplex ultrasound scan (DUS) of the tibial vessels at the ankle in diabetic patients; podiatry ankle (PodAnk) duplex scan. Thirteen podiatrists underwent an intensive 3-hour long simulation training session. Participants were then assessed performing bilateral PodAnk duplex scans of 3 diabetic patients with peripheral arterial disease. Participants were assessed using the duplex ultrasound objective structured assessment of technical skills (DUOSATS) tool and an "Imaging Score". A total of 156 vessel assessments were performed. All patients had abnormal waveforms with a loss of triphasic flow. Loss of triphasic flow was accurately detected in 145 (92.9%) vessels; the correct waveform was identified in 139 (89.1%) cases. Participants achieved excellent DUOSATS scores (median 24 [interquartile range: 23-25], max attainable score of 26) as well as "Imaging Scores" (8 [8-8], max attainable score of 8) indicating proficiency in technical skills. The mean time taken for each bilateral ankle assessment was 20.4 minutes (standard deviation ±6.7). We have demonstrated that a focused DUS for the purpose of vascular assessment of the diabetic foot is readily learned using intensive simulation training.
我们旨在培训足病医生对糖尿病患者的踝部胫血管进行聚焦双功超声扫描（DUS）；即足病学踝部（PodAnk）双功扫描。13名足病医生参加了为期3小时的强化模拟培训课程。随后对参与者进行评估，要求他们对3名患有外周动脉疾病的糖尿病患者进行双侧PodAnk双功扫描。使用双功超声技术技能客观结构化评估（DUOSATS）工具和“影像评分”对参与者进行评估。总共进行了156次血管评估。所有患者的波形均异常，三相血流消失。在145条（92.9%）血管中准确检测到三相血流消失；在139例（89.1%）病例中识别出正确的波形。参与者获得了优异的DUOSATS评分（中位数为24[四分位间距：23 - 25]，最高可获得分数为26）以及“影像评分”（8[8 - 8]，最高可获得分数为8），表明他们在技术技能方面达到了熟练水平。每次双侧踝部评估的平均用时为20.4分钟（标准差±6.7）。我们已经证明，通过强化模拟培训，为糖尿病足血管评估目的而进行的聚焦DUS很容易掌握。
