Upadhrasta Sireesha, Raafat Mohamed Hussien, Conti Ricardo A S
Department of Internal Medicine, Saint Agnes Hospital, Baltimore, MD, USA.
American University of the Caribbean School of Medicine, Pembroke Pines, FL, USA.
J Community Hosp Intern Med Perspect. 2019 Nov 1;9(5):373-376. doi: 10.1080/20009666.2019.1659666. eCollection 2019.
The use of bedside ultrasound over the past few decades has created a new wave of options for visualizing pathological processes allowing for faster and better detection of disease. We aimed to evaluate the reliability of focused cardiac ultrasound (FCU) performed by first-year internal medicine residents at a community hospital after a short period of training. They received a two-hour lecture and initially performed a supervised FCU followed by ten unsupervised/independent FCUs each. The four parameters that were assessed were left systolic ventricular function, right systolic ventricular function, presence of pericardial effusion, and presence of IVC dilation. Interpretation and analysis of ultrasound images were then carried out by both the residents and an attending physician with expertise in FCU analysis and interpretation. Cohen's Kappa values were obtained comparing the results found by the interns versus the attending. Our findings indicate that more training is required for reliable analysis of FCU by first-year medical residents. Our results also emphasize the need to carefully evaluate the medical residents' FCU skills after the training.
在过去几十年中，床边超声的应用开创了可视化病理过程的新选择，能够更快、更好地检测疾病。我们旨在评估社区医院的一年级内科住院医师在经过短期培训后进行的聚焦心脏超声（FCU）的可靠性。他们参加了一场两小时的讲座，最初在监督下进行FCU检查，之后每人独立进行十次无监督的FCU检查。评估的四个参数为左心室收缩功能、右心室收缩功能、心包积液的存在情况以及下腔静脉扩张的存在情况。然后，住院医师和一位擅长FCU分析与解读的主治医师对超声图像进行解读和分析。通过比较实习生与主治医师的检查结果，得出科恩kappa值。我们的研究结果表明，一年级医学住院医师要对FCU进行可靠分析还需要更多培训。我们的结果还强调了在培训后仔细评估住院医师FCU技能的必要性。
