Sheehan Florence H, McConnaughey Shannon, Freeman Rosario, Zierler R Eugene
Department of Medicine, Division of Cardiology, University of Washington, Campus Box 356422, Seattle, WA.
Department of Surgery, Division of Vascular Surgery, University of Washington, Campus Box 356410, Seattle, WA.
Mil Med. 2019 Mar 1;184(Suppl 1):386-391. doi: 10.1093/milmed/usy388.
We developed simulator-based tools for assessing provider competence in transthoracic echocardiography (TTE) and vascular duplex scanning.
Psychomotor (technical) skill in TTE image acquisition was calculated from the deviation angle of an acquired image from the anatomically correct view. We applied this metric for formative assessment to give feedback to learners and evaluate curricula.Psychomotor skill in vascular ultrasound was measured in terms of dexterity and image plane location; cognitive skill was assessed from measurements of blood flow velocity, parameter settings, and diagnosis. The validity of the vascular simulator was assessed from the accuracy with which experts can measure peak systolic blood flow velocity (PSV).
In the TTE simulator, the skill metric enabled immediate feedback, formative assessment of curriculum efficacy, and comparison of curriculum outcomes. The vascular duplex ultrasound simulator also provided feedback, and experts' measurements of PSV deviated from actual PSV in the model by <10%.
Skill in acquiring diagnostic ultrasound images of organs and vessels can be measured using simulation in an objective, quantitative, and standardized manner. Current applications are provision of feedback to learners to enable training without direct faculty oversight and formative assessment of curricula. Simulator-based metrics could also be applied for summative assessment.
我们开发了基于模拟器的工具，用于评估经胸超声心动图（TTE）和血管超声检查中医疗人员的能力。
TTE图像采集的运动技能（技术）通过采集图像与解剖学正确视图的偏差角度来计算。我们将该指标用于形成性评估，以便向学习者提供反馈并评估课程。血管超声的运动技能通过灵活性和图像平面位置来衡量；认知技能通过血流速度测量、参数设置和诊断来评估。血管模拟器的有效性通过专家测量收缩期峰值血流速度（PSV）的准确性来评估。
在TTE模拟器中，技能指标能够提供即时反馈、对课程效果进行形成性评估以及比较课程结果。血管超声模拟器也提供了反馈，并且专家对PSV的测量与模型中的实际PSV偏差小于10%。
使用模拟可以客观、定量和标准化地测量获取器官和血管诊断超声图像的技能。当前的应用包括向学习者提供反馈，以便在没有教师直接监督的情况下进行培训以及对课程进行形成性评估。基于模拟器的指标也可用于总结性评估。
