Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Department of Emergency Medicine, Highland Hospital, Oakland, California, USA.
Emerg Med J. 2018 Nov;35(11):704-707. doi: 10.1136/emermed-2018-207716. Epub 2018 Aug 28.
Brief training courses in bedside ultrasound are commonly done by visiting faculty in low-income and middle-income countries, and positive short-term effects have been reported. Long-term outcomes are poorly understood. We held a training course on a cardiopulmonary ultrasound (CPUS) protocol over two separate 10-day periods in 2016. In 2017, 9-11 months after the initial training, we assessed skill and knowledge retention as well as perceived impact on local practice.
A written test using six clinical vignettes and an observed structured clinical examination were used to assess theoretical knowledge and practical skills. Additionally, in-person interviews and a written survey were completed with the physicians who had participated in the initial training.
All 20 participants passed the written and clinical examination. The median follow-up test score was 10 out of 12, compared with a median score of 12 on a test completed immediately after the initial training. Physicians identified the ability to narrow their differential diagnosis and to initiate critical interventions earlier than without ultrasound as a key benefit of the CPUS training. They rated the cardiac, abdominal and inferior vena cava components of the CPUS protocol as most relevant to their everyday practice.
Long-term ultrasound knowledge and skill retention was high after a brief and intensive training intervention at an academic tertiary hospital in Ghana. Clinicians reported improvements in patient care and local practice patterns.
在中低收入国家,客座教师通常会进行床边超声短期培训课程,且已有研究报道其具有积极的短期效果。然而,对于长期效果却知之甚少。我们在 2016 年分两个 10 天的时间段进行了心肺超声(CPUS)方案的培训课程。在初始培训后的 9-11 个月,即 2017 年,我们评估了技能和知识的保留情况以及对当地实践的影响。
使用六个临床病例和一项观察性结构化临床考试的书面测试来评估理论知识和实践技能。此外,我们还对参加初始培训的医生进行了面对面访谈和书面调查。
所有 20 名参与者均通过了书面和临床考试。随访测试的中位数评分为 12 分中的 10 分,而初始培训后立即完成的测试中位数评分为 12 分。医生们认为,CPUS 培训的一个关键益处是能够缩小鉴别诊断范围并更早地开始关键干预。他们认为 CPUS 方案中的心脏、腹部和下腔静脉部分与他们的日常实践最相关。
在加纳的一家学术性三级医院进行了简短而密集的培训干预后,长期的超声知识和技能保留率较高。临床医生报告说,患者的护理和当地的实践模式得到了改善。