Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 200 Elizabeth Street EN3-400, Toronto, ON, M5G 2C4, Canada.
Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
Can J Anaesth. 2018 Apr;65(4):417-426. doi: 10.1007/s12630-018-1063-9. Epub 2018 Jan 16.
Point-of-care ultrasound (POCUS) is becoming an integral part of anesthesia practice throughout the world. Despite the growing interest in POCUS among trainees and faculty, POCUS training is variable among universities across Canada. This suggests a need for curriculum development and standardization. International guidelines for Emergency Medicine and Critical Care have common frameworks and may be used as a reference to model anesthesia-specific curricula. The Royal College of Anaesthetists of the United Kingdom currently offers the only nationally approved POCUS curriculum for anesthesia and critical care trainees. Most curricula have in common a stepwise approach that consists of foundation of knowledge and skills and competency building through practice. Nevertheless, a significant variety of didactic modalities have been described, and online learning and simulation offer clear advantages. What constitutes the minimum number of studies necessary to achieve competence is still debated as are the most appropriate tools for assessment of POCUS competency.Availability of trained staff anesthesiologists remains a major limitation to curricula implementation in most centres. A National Curriculum should be modeled on the Competency By Design Approach, in line with the CanMEDS 2015 roles, and start with a focus on basic POCUS modalities and applications. Guidance for the training and certification of POCUS among practicing anesthesiologists is lacking.
床边超声（POCUS）正在成为全球麻醉实践不可或缺的一部分。尽管培训人员和教师对 POCUS 的兴趣日益浓厚，但加拿大各大学之间的 POCUS 培训差异很大。这表明需要进行课程开发和标准化。紧急医学和重症监护的国际指南具有共同的框架，可作为模型麻醉专业课程的参考。英国皇家麻醉学院目前为麻醉和重症监护培训生提供唯一获得国家批准的 POCUS 课程。大多数课程都有一个共同的逐步方法，包括基础知识和技能以及通过实践建立能力。然而，已经描述了许多不同的教学模式，在线学习和模拟具有明显的优势。构成达到能力所需的最低研究数量仍存在争议，以及评估 POCUS 能力最适当的工具也是如此。在大多数中心，受过培训的麻醉师人员仍然是课程实施的主要限制因素。国家课程应根据 2015 年 CanMEDS 角色，采用基于能力设计的方法进行建模，并首先侧重于基本的 POCUS 方式和应用。在实践中的麻醉师中培训和认证 POCUS 的指南仍然缺乏。
