Denny Sean P, Minteer William B, Fenning Reece T H, Aggarwal Sahil, Lee Debora H, Raja Shella K, Raman Kaavya R, Farfel Allison O, Patel Priya A, Bernstein Megan E, Lahham Shadi, Fox John C
School of Medicine, University of California Irvine, Orange, California 92868, USA.
Department of Emergency Medicine, University of California Irvine, Orange, California 92868, USA.
World J Emerg Med. 2018;9(1):33-40. doi: 10.5847/wjem.j.1920-8642.2018.01.005.
Diagnostic imaging is an integral aspect of care that is often insufficient, if not altogether absent, in rural and remote regions of low to middle income countries (LMICs) such as Tanzania. The introduction of ultrasound can significantly impact treatment in these countries due to its portability, low cost, safety, and usefulness in various medical assessments. This study reviews the implementation of a four-week ultrasound course administered annually from 2013-2016 in a healthcare professional school in Mwanza, Tanzania by first-year allopathic US medical students.
Participants (=582, over 4 years) were recruited from the Tandabui Institute of Health Sciences and Technology to take the ultrasound course. Subjects were predominantly clinical officer students, but other participants included other healthcare professional students, practicing healthcare professionals, and school employees. Data collected includes pre-course examination scores, post-course examination scores, course quiz scores, demographic surveys, and post-course feedback surveys. Data was analyzed using two-tailed -tests and the single factor analysis of variance (ANOVA).
For all participants who completed both the pre- and post-course examinations (=229, 39.1% of the total recruited), there was a significant mean improvement in their ultrasound knowledge of 42.5%, <0.01.
Our data suggests that trained first-year medical students can effectively teach a point of care ultrasound course to healthcare professional students within four weeks in Tanzania. Future investigation into the level of long-term knowledge retention, impact of ultrasound training on knowledge of human anatomy and diagnostic capabilities, and how expansion of an ultrasound curriculum has impacted access to care in rural Tanzania is warranted.
诊断成像在医疗保健中是不可或缺的一部分,但在坦桑尼亚等低收入和中等收入国家(LMICs)的农村和偏远地区,其往往不足,甚至完全缺失。超声检查因其便携性、低成本、安全性以及在各种医学评估中的实用性,在这些国家的治疗中可产生重大影响。本研究回顾了2013年至2016年每年在坦桑尼亚姆万扎一所医疗专业学校由美国一年级全科医学学生开设的为期四周的超声课程的实施情况。
从坦达布伊健康科学与技术学院招募参与者(共582人,历时4年)参加超声课程。受试者主要是临床医学生,但其他参与者包括其他医疗专业学生、执业医疗专业人员和学校员工。收集的数据包括课前考试成绩、课后考试成绩、课程测验成绩、人口统计学调查和课后反馈调查。使用双尾检验和单因素方差分析(ANOVA)对数据进行分析。
对于所有完成课前和课后考试的参与者(共229人,占招募总数的39.1%),他们的超声知识平均显著提高了42.5%,P<0.01。
我们的数据表明,经过培训的一年级医学生能够在坦桑尼亚四周内有效地向医疗专业学生讲授即时超声课程。有必要对长期知识保留水平、超声培训对人体解剖学知识和诊断能力的影响以及超声课程的扩展如何影响坦桑尼亚农村地区的医疗服务可及性进行进一步调查。