Kuza Catherine M, Hanifi M Tariq, Koç Melissa, Stopfkuchen-Evans Matthias
Department of Anesthesiology and Critical Care, Brigham and Women's Hospital, Boston, Massachusetts; Department of Anesthesiology and Critical Care, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Department of Anesthesiology and Critical Care, Brigham and Women's Hospital, Boston, Massachusetts; Department of Anesthesiology, Southern California Permanente Medical Group/Kaiser Permanente, San Diego, California.
J Surg Educ. 2018 Sep-Oct;75(5):1342-1350. doi: 10.1016/j.jsurg.2018.03.004. Epub 2018 Apr 9.
Transthoracic echocardiography (TTE) is important in the management of critically ill patients, yet it has not been incorporated into many residency programs' curricula. Our objective is to determine if trainees undergoing a 60-minute training session on TTE have improved knowledge, ultrasound skills, and increases the utilization of TTE during their rotation in the intensive care unit (ICU). We will also compare the results of participants with prior TTE exposure to TTE-naïve trainees. Our hypothesis is that after the training, participants' will have improved knowledge and ultrasound skills compared to before training. Our secondary hypotheses are that TTE-naïve trainees will have greater improvements in knowledge scores compared to those who have had prior TTE experience and trainees will increase their use of TTE in the ICU.
Single-center, prospective trial.
Brigham and Women's Hospital (academic hospital).
Residents and fellows rotating through the ICU, at any level of postgraduate training.
Forty-two trainees participated in the study. Statistically significant improvement after training was observed for all multiple choice questions (MCQ) and practical assessments (p < 0.001). When assessing the differences in score improvement between TTE-experienced versus TTE-naïve users, mean score improvements were notably higher for TTE-naïve participants (MCQ: 28.2 ± 11.6; echo clinical: 48.6 ± 23.4) compared to TTE-experienced users (MCQ: 18.6 ± 13.5, p = 0.01; echo clinical: 38.3 ± 30.2, p = 0.04).
A short didactic presentation on TTE use may be useful in teaching ICU trainees basic TTE skills and encouraging the use of bedside TTE in the ICU.
经胸超声心动图（TTE）在危重症患者管理中具有重要作用，但尚未纳入许多住院医师培训项目的课程。我们的目的是确定接受60分钟TTE培训的学员在重症监护病房（ICU）轮转期间知识、超声技能是否得到提高，以及TTE的使用是否增加。我们还将比较有TTE经验的参与者与无TTE经验的学员的结果。我们的假设是，培训后，参与者的知识和超声技能将比培训前有所提高。我们的次要假设是，与有TTE经验的学员相比，无TTE经验的学员在知识得分上的提高更大，且学员在ICU中会增加TTE的使用。
单中心前瞻性试验。
布莱根妇女医院（教学医院）。
在ICU轮转的各级研究生培训阶段的住院医师和研究员。
42名学员参与了研究。所有多项选择题（MCQ）和实践评估在培训后均有统计学显著改善（p < 0.001）。在评估有TTE经验与无TTE经验的使用者在得分改善方面的差异时，无TTE经验的参与者的平均得分改善明显高于有TTE经验的使用者（MCQ：28.2±11.6；超声临床：48.6±23.4），而有TTE经验的使用者为（MCQ：18.6±13.5，p = 0.01；超声临床：38.3±30.2，p = 0.04）。
关于TTE使用的简短授课可能有助于向ICU学员传授基本的TTE技能，并鼓励在ICU中使用床旁TTE。
