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急诊医学实习期间的床旁超声培训:一项前瞻性研究。

Point-of-care Ultrasound Training During an Emergency Medicine Clerkship: A Prospective Study.

作者信息

Cevik Arif Alper, Cakal Elif Dilek, Abu-Zidan Fikri

机构信息

Internal Medicine, Emergency Medicine Section, United Arab Emirates University, College of Medicine and Health Sciences, Al Ain, ARE.

Emergency Medicine, Mersin City Education and Research Hospital, Mersin, TUR.

出版信息

Cureus. 2019 Nov 10;11(11):e6118. doi: 10.7759/cureus.6118.

Abstract

Aim This study evaluated the effects of three-hour instructor-led training courses in the Extended Focused Assessment Sonography for Trauma (EFAST) and Rapid Ultrasound in Shock and Hypotension (RUSH) protocols on knowledge gain and retention by final-year medical students. Methods This prospective study evaluated 79 final year medical students participating in an emergency medicine (EM) clerkship during the 2017-2018 academic year. None of the included students had prior formal ultrasound training or hands-on experience. All students participated in three-hour training courses on the EFAST and RUSH protocols, with training on each protocol involving one hour of didactic training and two hours of practical training. Knowledge improvement was measured by testing before and after each course, and knowledge retention was evaluated on a final clerkship multiple choice question (MCQ) examination. Results Median scores were significantly higher after rather than before both the EFAST (15; range, 12-19 vs. 7; range, 2-18; p < 0.0001) and RUSH (16; range, 6-20 vs. 6; range, 1-13; p < 0.0001) courses. EFAST knowledge was significantly higher than RUSH knowledge before (p = 0.04) but not after (p = 0.82) taking the respective course. The RUSH score was significantly lower than the EFAST score on the final clerkship MCQ examination (p < 0.0001). Conclusions Three hours of instructor-led ultrasound training given during an EM clerkship significantly increased knowledge of both the EFAST and RUSH protocols. Knowledge retention after two weeks was higher for the EFAST than the RUSH protocol. A longer period of RUSH training may improve the retention of knowledge.

摘要

目的 本研究评估了由教员主导的为期三小时的创伤扩展聚焦超声评估(EFAST)和休克与低血压快速超声检查(RUSH)方案培训课程对医学专业最后一年学生知识获取和知识保留的影响。方法 这项前瞻性研究评估了79名在2017 - 2018学年参加急诊医学实习的医学专业最后一年学生。纳入的学生均无先前的正规超声培训或实践经验。所有学生都参加了关于EFAST和RUSH方案的三小时培训课程,每个方案的培训包括一小时的理论培训和两小时的实践培训。通过在每门课程前后进行测试来衡量知识的提高,并在实习期末的多项选择题(MCQ)考试中评估知识保留情况。结果 EFAST课程(中位数分数为15;范围为12 - 19,而之前为7;范围为2 - 18;p < 0.0001)和RUSH课程(中位数分数为16;范围为6 - 20,而之前为6;范围为1 - 13;p < 0.0001)结束后,中位数分数均显著高于课程开始前。在参加各自课程之前,EFAST知识显著高于RUSH知识(p = 0.04),但课程结束后无显著差异(p = 0.82)。在实习期末的MCQ考试中,RUSH分数显著低于EFAST分数(p < 0.0001)。结论 在急诊医学实习期间由教员主导的三小时超声培训显著增加了学生对EFAST和RUSH方案的知识。两周后的知识保留情况,EFAST方案高于RUSH方案。更长时间的RUSH培训可能会提高知识保留率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e3e/6844539/4cdbe43d3854/cureus-0011-00000006118-i01.jpg

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