一项关于即时超声能力与信心的新型课程评估。

Evaluation of a novel curriculum on point-of-care ultrasound competency and confidence.

作者信息

Filler Levi, Orosco Daniel, Rigdon Daniel, Mitchell Carl, Price James, Lotz Scott, Stowell Jeffrey R

机构信息

Department of Emergency Medicine, Maricopa Integrated Health System, 2601 E Roosevelt St, Phoenix, AZ, 85008, USA.

Department of Emergency Medicine, University of Arizona College of Medicine- Phoenix, Phoenix, AZ, USA.

出版信息

Emerg Radiol. 2020 Feb;27(1):37-40. doi: 10.1007/s10140-019-01726-8. Epub 2019 Sep 4.

DOI:10.1007/s10140-019-01726-8

PMID:31485848

Abstract

INTRODUCTION

Point-of-care ultrasound (POCUS) education is a requirement of graduate medical education in EM. Milestones have been established to assess resident US competency. However, the delivery of POCUS education has not been standardized. This study aims to evaluate the impact of implementing a longitudinal, structured POCUS curriculum during EM residency on trainee competency and confidence.

METHODS

A prospective study of PGY-3 trainees before and after implementation of a novel POCUS curriculum was performed over an 18-month period at an EM residency training program. Curriculum design included longitudinal POCUS application-based monthly electronic content, bi-monthly residency conference sessions, and hands-on rotations. PGY-3 resident's POCUS knowledge was assessed with a 38-question multiple-choice and image-based exam. Further, PGY-3 residents were surveyed regarding POCUS confidence. Survey results evaluated provider confidence, satisfaction with the novel curriculum, and overall perception of POCUS utility scored on a 1 (low) to 5 (high) scale. Results were evaluated using an unpaired t test for data analysis.

RESULTS

Mean quiz scores of 8 pre-curriculum PGY-3 residents (84%; 95%CI 78.46-89.54) were not significantly different when compared with 13 post-curriculum PGY-3 residents (82%; 95%CI 77.11-86.89) (p = 0.6126). Survey results for pre-curriculum trainees across each section were 4.13 (95%CI 3.91-4.35), 3.68 (95%CI 3.32-4.04), and 4.33 (95%CI 4.06-4.6). Results for post-curriculum trainees trended higher for each section at 4.22 (95%CI 4.04-4.40) (p = 0.4738), 3.84 (95%CI 3.52-4.16) (p = 0.5279), and 4.49 (95%CI 4.21-4.77) (p = 0.4534).

CONCLUSIONS

Implementation of a structured, longitudinal POCUS curriculum resulted in a trend towards improved trainee confidence, satisfaction, and perception of POCUS. Future studies are needed to identify the optimal structure for POCUS educational content delivery and competency assessment for EM resident providers.

摘要

引言

即时超声（POCUS）教育是急诊医学研究生医学教育的一项要求。已制定了里程碑来评估住院医师的超声能力。然而，POCUS教育的实施尚未标准化。本研究旨在评估在急诊医学住院医师培训期间实施纵向、结构化的POCUS课程对学员能力和信心的影响。

方法

在一个急诊医学住院医师培训项目中，对实施新的POCUS课程前后的三年级住院医师进行了为期18个月的前瞻性研究。课程设计包括基于POCUS应用的每月纵向电子内容、每两个月一次的住院医师会议以及实践轮转。通过38道选择题和基于图像的考试评估三年级住院医师的POCUS知识。此外，对三年级住院医师进行了关于POCUS信心的调查。调查结果评估了提供者的信心、对新课程的满意度以及对POCUS效用的总体感知，评分范围为1（低）至5（高）。使用非配对t检验进行数据分析。

结果

8名课程前三年级住院医师的平均测验成绩（84%；95%置信区间78.46 - 89.54）与13名课程后三年级住院医师（82%；95%置信区间77.11 - 86.89）相比无显著差异（p = 0.6126）。课程前学员各部分的调查结果分别为4.13（95%置信区间3.91 - 4.35）、3.68（95%置信区间3.32 - 4.04）和4.33（95%置信区间4.06 - 4.6）。课程后学员各部分的结果在趋势上更高，分别为4.22（95%置信区间4.04 - 4.40）（p = 0.4738）、3.84（95%置信区间3.52 - 4.16）（p = 0.5279）和4.49（95%置信区间4.21 - 4.77）（p = 0.4534）。