Kumar Andre, Weng Yingjie, Wang Libo, Bentley Jason, Almli Marta, Hom Jason, Witteles Ronald, Ahuja Neera, Kugler John
Department of Medicine, Stanford University School of Medicine, Stanford, California.
Quantitative Science Unit, Stanford University School of Medicine, Stanford, California.
J Hosp Med. 2020 Feb 11;15(2):e1-e6. doi: 10.12788/jhm.3351.
Little is known about how to effectively train residents with point-of-care ultrasonography (POCUS) despite increasing usage.
This study aimed to assess whether handheld ultrasound devices (HUDs), alongside a year-long lecture series, improved trainee image interpretation skills with POCUS.
Internal medicine intern physicians (N = 149) at a single academic institution from 2016 to 2018 participated in the study. The 2017 interns (n = 47) were randomized 1:1 to receive personal HUDs (n = 24) for patient care vs no-HUDs (n = 23). All 2017 interns received a repeated lecture series regarding cardiac, thoracic, and abdominal POCUS. Interns were assessed on their ability to interpret POCUS images of normal/abnormal findings. The primary outcome was the difference in end-of-the-year assessment scores between interns randomized to receive HUDs vs not. Secondary outcomes included trainee scores after repeating lectures and confidence with POCUS. Intern scores were also compared with historical (2016, N = 50) and contemporaneous (2018, N = 52) controls who received no lectures.
Interns randomized to HUDs did not have significantly higher image interpretation scores (median HUD score: 0.84 vs no-HUD score: 0.84; P = .86). However, HUD interns felt more confident in their abilities. The 2017 cohort had higher scores (median 0.84), compared with the 2016 historical control (median 0.71; P = .001) and 2018 contemporaneous control (median 0.48; P < .001). Assessment scores improved after first-time exposure to the lecture series, while repeated lectures did not improve scores.
Despite feeling more confident, personalized HUDs did not improve interns' POCUS-related knowledge or interpretive ability. Repeated lecture exposure without further opportunities for deliberate practice may not be beneficial for mastering POCUS.
尽管即时超声检查（POCUS）的使用日益增加，但对于如何有效地培训住院医师却知之甚少。
本研究旨在评估手持超声设备（HUD）与为期一年的系列讲座相结合，是否能提高学员对POCUS图像的解读技能。
2016年至2018年，一所学术机构的内科实习医师（N = 149）参与了该研究。2017年的实习医师（n = 47）按1:1随机分组，一组（n = 24）在患者护理中使用个人HUD，另一组（n = 23）不使用HUD。所有2017年的实习医师都接受了关于心脏、胸部和腹部POCUS的系列重复讲座。对实习医师解读正常/异常结果的POCUS图像的能力进行评估。主要结果是随机接受HUD的实习医师与未接受HUD的实习医师在年终评估分数上的差异。次要结果包括重复讲座后学员的分数以及对POCUS的信心。实习医师的分数还与未接受讲座的历史对照组（2016年，N = 50）和同期对照组（2018年，N = 52）进行比较。
随机分配到HUD组的实习医师的图像解读分数没有显著更高（HUD组中位数分数：0.84，无HUD组分数：0.84；P = 0.86）。然而，使用HUD的实习医师对自己的能力更有信心。201
