Sepulveda-Ortiz Veronica, Warkentine Fred, Starr-Seal Rebecca, Rominger Anna
Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Louisville, 571 S. Floyd Street, Suite 412, Louisville, KY, 40202, USA.
Ultrasound J. 2020 Apr 21;12(1):20. doi: 10.1186/s13089-020-00169-4.
The Hospital Pediatrico Universitario (HOPU) is the principal institution in Puerto Rico offering medical services to the children of the island and the Caribbean. There is limited use of point-of-care ultrasound (PoCUS) in their emergency department (ED) and obtaining an ultrasound through radiology is prohibitively time consuming. The objective of this study is to increase PoCUS knowledge and comfort by the ED physicians in the HOPU pediatric emergency department.
Thirteen general pediatricians completed the entire PoCUS course, but only 10 completed both the pre- and post-tests and therefore included in the analysis (N = 10). Pretest scores ranged from 30 to 63.3% with a mean of 41.6% [standard deviation (SD) 9.95]. The posttest scores ranged from 55 to 96%, with a mean of 66.1% (SD 12.26). The mean difference in scores was 24.42% (95% confidence interval 17.9, 30.9) with a significance of p < 0.05 and range of 8.3-36.6%. Physician experience and confidence with each topic improved from baseline. After the course, the majority of the participants (> 70%) had at least some confidence in 5 of the 6 topics.
In EDs with limited resources, a longitudinal PoCUS educational curriculum is effective in improving the knowledge and comfort of physicians with limited PoCUS experience. The effectiveness of scheduled, repeated courses to refresh and refocus participants was highlighted following the unexpected challenges encountered during the course, including multiple natural disasters.
波多黎各大学儿童医院（HOPU）是波多黎各为该岛及加勒比地区儿童提供医疗服务的主要机构。其急诊科对即时超声（PoCUS）的使用有限，通过放射科获取超声检查耗时极长。本研究的目的是提高HOPU儿科急诊科医生对PoCUS的知识水平和操作熟练度。
13名普通儿科医生完成了整个PoCUS课程，但只有10名完成了课前和课后测试，因此纳入分析（N = 10）。课前分数范围为30%至63.3%，平均为41.6%[标准差（SD）9.95]。课后分数范围为55%至96%，平均为66.1%（SD 12.26）。分数的平均差异为24.42%（95%置信区间17.9, 30.9），p值<0.05，范围为8.3 - 36.6%。医生对每个主题的经验和信心较基线有所提高。课程结束后，大多数参与者（> 70%）对6个主题中的5个至少有一定信心。
在资源有限的急诊科，纵向PoCUS教育课程对于提高PoCUS经验有限的医生的知识水平和操作熟练度是有效的。在课程中遇到意外挑战（包括多次自然灾害）后，强调了定期重复课程以更新和重新聚焦参与者的有效性。
