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外科重症监护 fellowship 中的超声培训:项目主任调查

Ultrasound Training in Surgical Critical Care Fellowship: A Survey of Program Directors.

作者信息

Carver Thomas W

机构信息

Division of Trauma, Acute Care Surgery, and Surgical Critical Care, Medical College of Wisconsin, Milwaukee, Wisconsin.

出版信息

J Surg Educ. 2018 Sep-Oct;75(5):1250-1255. doi: 10.1016/j.jsurg.2018.01.017. Epub 2018 Feb 12.

Abstract

OBJECTIVE

Surgical critical care (SCC) fellows are expected to receive training in critical care ultrasound (CCUS) but training is sporadic and there is no standardized curriculum to guide educators. Previous studies show wide variation in CCUS training during fellowship across specialties but SCC has been underrepresented. This study was performed to assess SCC program directors' views regarding CCUS during fellowship training.

DESIGN

Adult SCC program directors were surveyed regarding the role of CCUS in fellowship training. This survey assessed how CCUS training was performed, perceived barriers to education, and importance of specific studies. Survey responses were measured using a Likert scale ranging from 5 (strongly agree) to 1 (strongly disagree).

SETTING

Web-based survey.

PARTICIPANTS

Adult Surgical Critical Care Fellowship Program Directors.

RESULTS

A total 67 of 108 (62%) SCC program directors responded to the survey. Over 75% felt that CCUS during training should be a priority. Fifteen (24.6%) programs required a specific number of ultrasounds to be performed. Five programs (7.5%) provided no CCUS training at all. Over 75% felt that training in FAST, transthoracic echocardiography, inferior vena cava assessment, and US for procedures (line placement, thoracentesis, and paracentesis) were either important or very important but experience in transesophageal echocardiography, assessment for deep vein thrombosis, and pulmonary US were not important. Lack of time (63.8%) and trained faculty (51.2%) were the most cited barriers to training.

CONCLUSIONS

There is a wide variation in how CCUS training is performed during SCC fellowship. SCC programs will need trained faculty, appropriate time allocation, and implementation of a standardized curriculum to provide consistent and high-quality CCUS education during fellowship.

摘要

目的

外科重症监护(SCC)专科住院医师预计要接受重症监护超声(CCUS)培训,但培训是零散的,且没有标准化课程来指导教育工作者。先前的研究表明,各专科住院医师培训期间CCUS培训差异很大,但SCC方面的研究较少。本研究旨在评估SCC项目主任对住院医师培训期间CCUS的看法。

设计

对成年SCC项目主任就CCUS在住院医师培训中的作用进行调查。该调查评估了CCUS培训的实施方式、感知到的教育障碍以及特定研究的重要性。调查回复采用李克特量表进行衡量,范围从5(强烈同意)到1(强烈不同意)。

地点

基于网络的调查。

参与者

成年外科重症监护住院医师培训项目主任。

结果

108名SCC项目主任中有67名(62%)回复了调查。超过75%的人认为培训期间的CCUS应作为优先事项。15个(24.6%)项目要求完成特定数量的超声检查。5个项目(7.5%)根本没有提供CCUS培训。超过75%的人认为,快速扫查(FAST)、经胸超声心动图、下腔静脉评估以及操作相关超声检查(置管、胸腔穿刺和腹腔穿刺)方面的培训很重要或非常重要,但经食管超声心动图、深静脉血栓形成评估和肺部超声方面的经验并不重要。时间不足(63.8%)和师资不足(51.2%)是最常被提及的培训障碍。

结论

SCC住院医师培训期间CCUS培训的实施方式差异很大。SCC项目需要有经验的师资、合理的时间分配以及实施标准化课程,以便在住院医师培训期间提供一致且高质量的CCUS教育。

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