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我们能否在一次集中培训中成功地向初级新手医生教授基本的介入超声?

Can we successfully teach novice junior doctors basic interventional ultrasound in a single focused training session?

机构信息

Medical Education, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK.

Emergency Department, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK.

出版信息

Postgrad Med J. 2018 May;94(1111):259-262. doi: 10.1136/postgradmedj-2018-135590. Epub 2018 Mar 15.

Abstract

BACKGROUND

Ultrasonography is recognised as an invaluable imaging modality for assessing critically unwell patients and obtaining vascular access. Senior emergency medicine and anaesthetic clinicians will regularly use ultrasound-guided imaging to establish vascular access for unwell patients; however, junior doctors, who are routinely the first clinicians to review deteriorating patients, are not encouraged or required to develop basic ultrasound interventional skills and are therefore ill equipped to use ultrasonography.

AIM

To demonstrate that teaching basic interventional ultrasound skills to novice junior doctors in a single focused session is an achievable outcome.

METHOD

We reviewed the success of the 'Junior doctor Ultrasound Training' (JUST) course in teaching basic interventional ultrasound skills to junior clinicians. We collated information from 237 JUST delegates. We surveyed candidates' prior ultrasound experience and retrospectively analysed their level 2 Kirkpatrick formative assessment outcome following the JUST course.

RESULTS

The overwhelming majority of doctors had no prior ultrasound experience (>95%). 99% (235) of candidates performed ultrasound to an acceptable standard to pass the formative assessment. 73% (174) achieved the course outcomes independent of faculty prompting. 1% (2) candidates failed the formative assessment.

CONCLUSION

Basic ultrasound competency is an achievable educational outcome for the overwhelming majority of novice junior doctors. Our findings add to growing evidence that early ultrasound tuition can be both valuable and economical for training clinicians. By arming junior doctors with a relevant and versatile skill set, we can provide opportunity for clinicians to develop their expertise and prepare for the future challenges of clinical medicine.

摘要

背景

超声检查被认为是评估重病患者和获得血管通路的一种非常有价值的成像方式。资深的急诊医学和麻醉临床医生经常使用超声引导成像来为不适患者建立血管通路;然而,初级医生,他们通常是第一个审查病情恶化患者的临床医生,并没有被鼓励或要求发展基本的超声介入技能,因此他们不具备使用超声的能力。

目的

证明在单次集中培训中向初级医生教授基本的介入性超声技能是可行的。

方法

我们回顾了“初级医生超声培训”(JUST)课程在向初级临床医生教授基本介入性超声技能方面的成功。我们收集了 237 名 JUST 代表的信息。我们调查了候选人之前的超声经验,并回顾性分析了他们在 JUST 课程后的二级柯克帕特里克形成性评估结果。

结果

绝大多数医生没有之前的超声经验(>95%)。99%(235 名)的考生通过了形成性评估,达到了可接受的超声标准。73%(174 名)的考生在没有教师提示的情况下独立达到了课程目标。1%(2 名)的考生未能通过形成性评估。

结论

对于绝大多数新手初级医生来说,基本的超声能力是可以实现的教育目标。我们的发现增加了越来越多的证据,表明早期的超声教学对培训临床医生既具有价值又经济实惠。通过为初级医生提供相关和多功能的技能组合,我们可以为临床医生提供发展专业知识和为未来临床医学挑战做好准备的机会。

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