Department of Medicine, Stanford University School of Medicine, Pasteur Drive, Stanford, CA, USA.
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
J Gen Intern Med. 2019 Jun;34(6):1025-1031. doi: 10.1007/s11606-019-04945-4.
Point-of-care ultrasonography (POCUS) has the potential to transform healthcare delivery through its diagnostic expediency. Trainee competency with POCUS is now mandated for emergency medicine through the Accreditation Council for Graduate Medical Education (ACGME), and its use is expanding into other medical specialties, including internal medicine. However, a key question remains: how does one define "competency" with this emerging technology? As our trainees become more acquainted with POCUS, it is vital to develop validated methodology for defining and measuring competency amongst inexperienced users. As a framework, the assessment of competency should include evaluations that assess the acquisition and application of POCUS-related knowledge, demonstration of technical skill (e.g., proper probe selection, positioning, and image optimization), and effective integration into routine clinical practice. These assessments can be performed across a variety of settings, including web-based applications, simulators, standardized patients, and real clinical encounters. Several validated assessments regarding POCUS competency have recently been developed, including the Rapid Assessment of Competency in Echocardiography (RACE) or the Assessment of Competency in Thoracic Sonography (ACTS). However, these assessments focus mainly on technical skill and do not expand upon other areas of this framework, which represents a growing need. In this review, we explore the different methodologies for evaluating competency with POCUS as well as discuss current progress in the field of measuring trainee knowledge and technical skill.
床边超声检查（POCUS）具有通过其诊断便利性改变医疗保健服务的潜力。通过研究生医学教育认证委员会（ACGME），急诊医学培训生现在必须具备 POCUS 能力，其使用范围正在扩展到包括内科在内的其他医学专业。然而，一个关键问题仍然存在：如何定义这项新兴技术的“能力”？随着我们的学员越来越熟悉 POCUS，开发针对无经验用户定义和衡量能力的经过验证的方法至关重要。作为一个框架，能力评估应包括评估获取和应用与 POCUS 相关的知识、演示技术技能（例如，正确选择、定位和图像优化探头）以及将其有效整合到常规临床实践中的评估。这些评估可以在各种环境中进行，包括基于网络的应用程序、模拟器、标准化患者和真实临床接触。最近已经开发了几种关于 POCUS 能力的经过验证的评估方法，包括快速评估超声心动图能力（RACE）或评估胸腔超声能力（ACTS）。然而，这些评估主要侧重于技术技能，并没有扩展到该框架的其他领域，这是一个日益增长的需求。在这篇综述中，我们探讨了评估 POCUS 能力的不同方法，并讨论了衡量学员知识和技术技能领域的当前进展。
