[聚焦心脏超声培训后的知识保留：一项前瞻性队列试点研究]
[Knowledge retention after focused cardiac ultrasound training: a prospective cohort pilot study].
作者信息
Mizubuti Glenio B, Allard Rene V, Ho Anthony M-H, Wang Louie, Beesley Theresa, Hopman Wilma M, Egan Rylan, Sydor Devin, Engen Dale, Saha Tarit, Tanzola Robert C
机构信息
Queen's University, Kingston General Hospital, Department of Anesthesiology and Perioperative Medicine, Kingston, Canadá.
McGill University, Department of Medicine, Montreal, Canadá.
出版信息
Braz J Anesthesiol. 2019 Mar-Apr;69(2):177-183. doi: 10.1016/j.bjan.2018.10.002. Epub 2019 Jan 18.
BACKGROUND AND OBJECTIVES
Focused Cardiac Ultrasound (FoCUS) has proven instrumental in guiding anesthesiologists’ clinical decision-making process. Training residents to perform and interpret FoCUS is both feasible and effective. However, the degree of knowledge retention after FoCUS training remains a subject of debate. We sought to provide a description of our 4-week FoCUS curriculum, and to assess the knowledge retention among anesthesia residents at 6 months after FoCUS rotation.
METHODS
A prospective analysis involving eleven senior anesthesia residents was carried out. At end of FoCUS Rotation (EOR) participants completed a questionnaire (evaluating the number of scans completed and residents’ self-rated knowledge and comfort level with FoCUS), and a multiple-choice FoCUS exam comprised of written- and video-based questions. Six months later, participants completed a follow-up questionnaire and a similar exam. Self-rated knowledge and exam scores were compared at EOR and after 6 months. Spearman correlations were conducted to test the relationship between number of scans completed and exam scores, perceived knowledge and exam scores, and number of scans and perceived knowledge.
RESULTS
Mean exam scores (out of 50) were 44.1 at EOR and 43 at the 6-month follow-up. Residents had significantly higher perceived knowledge (out of 10) at EOR (8.0) than at the 6-month follow-up (5.5), = 0.003. At the EOR, all trainees felt comfortable using FoCUS, and at 6 months 10/11 still felt comfortable. All the trainees had used FoCUS in their clinical practice after EOR, and the most cited reason for not using FoCUS more frequently was the lack of perceived clinical need. A strong and statistically significant (rho = 0.804, = 0.005) correlation between number of scans completed during the FoCUS rotation and 6-month follow-up perceived knowledge was observed.
CONCLUSION
Four weeks of intensive FoCUS training results in adequate knowledge acquisition and 6-month knowledge retention.
背景与目的
心脏聚焦超声（FoCUS）已被证明有助于指导麻醉医生的临床决策过程。培训住院医师进行FoCUS检查及解读结果是可行且有效的。然而，FoCUS培训后的知识保留程度仍是一个有争议的问题。我们试图描述我们为期4周的FoCUS课程，并评估麻醉住院医师在FoCUS轮转6个月后的知识保留情况。
方法
对11名高级麻醉住院医师进行前瞻性分析。在FoCUS轮转结束时（EOR），参与者完成一份问卷（评估完成的扫描次数以及住院医师对FoCUS的自我评估知识和舒适度），以及一项由书面和视频问题组成的FoCUS多项选择题考试。6个月后，参与者完成一份随访问卷和类似的考试。比较EOR时和6个月后的自我评估知识和考试成绩。进行Spearman相关性分析，以测试完成的扫描次数与考试成绩、感知知识与考试成绩以及扫描次数与感知知识之间的关系。
结果
EOR时的平均考试成绩（满分50分）为44.1分，6个月随访时为43分。住院医师在EOR时（满分10分）的感知知识（8.0分）显著高于6个月随访时（5.5分），P = 0.003。在EOR时，所有学员都对使用FoCUS感到满意，6个月时11人中有10人仍有此感受。所有学员在EOR后都在临床实践中使用了FoCUS，而未更频繁使用FoCUS的最常见原因是感觉缺乏临床需求。观察到FoCUS轮转期间完成的扫描次数与6个月随访时的感知知识之间存在强且具有统计学意义的相关性（rho = 0.804，P = 0.005）。
结论
为期4周的强化FoCUS培训可带来足够的知识获取和6个月的知识保留。
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