Swanson Jeffrey R, Shook Douglas C, Vacanti Joshua C, Molloy Lindsey M, Fields Kara G, Palmer Louisa J
J Educ Perioper Med. 2020 Apr 1;22(2):E642. doi: 10.46374/volxxii-issue2-swanson. eCollection 2020 Apr-Jun.
Focused cardiac ultrasound (FoCUS) is an increasingly used diagnostic modality for anesthesiologists and intensivists. However, training residents in its use can be resource intensive. We investigated the feasibility of implementing a self-guided FoCUS curriculum for anesthesiology residents rotating in the postanesthesia care unit (PACU).
We created a FoCUS curriculum with the aim of providing a consistent largely self-guided experience that would improve FoCUS knowledge and skills while minimizing ongoing time commitment from faculty. To achieve this, we used several methods: (1) developed video didactics and quizzes; (2) used an online educational delivery platform to automate delivery of educational content, monitor resident progress, and elicit feedback; (3) used the transthoracic echocardiography simulator for aided hands-on learning; (4) dedicated educational time that integrated into PACU workflow; (5) worked with a cardiac sonographer; and (6) used image storage software to facilitate remote feedback by ultrasound faculty. The response to the curriculum was evaluated using Kirkpatrick levels 1-3.
Forty-one anesthesiology residents rotated through the PACU over a 1-year period and completed this weeklong self-guided FoCUS curriculum. Interesting findings include: (1) favorable evaluation from the residents and (2) improvement in image acquisition skills by objective measures. Once the curriculum was established, ongoing faculty time commitment was approximately 1 hour 20 minutes per week.
The implementation of a FoCUS curriculum in the PACU resulted in favorable resident evaluation and improved FoCUS skills. The curriculum was feasible and self-sustainable because of the novel educational approach employed.
心脏聚焦超声（FoCUS）越来越多地被麻醉医生和重症监护医生用作诊断手段。然而，培训住院医师使用该技术可能需要大量资源。我们调查了为在麻醉后护理单元（PACU）轮转的麻醉科住院医师实施自我指导FoCUS课程的可行性。
我们创建了一个FoCUS课程，旨在提供一种一致的、主要是自我指导的体验，既能提高FoCUS知识和技能，又能尽量减少教员持续投入的时间。为实现这一目标，我们采用了几种方法：（1）开发视频教学内容和测验；（2）使用在线教育交付平台自动交付教育内容、监控住院医师的进度并获取反馈；（3）使用经胸超声心动图模拟器辅助实践学习；（4）将专门的教育时间融入PACU工作流程；（5）与心脏超声检查技师合作；（6）使用图像存储软件以便超声教员进行远程反馈。使用柯克帕特里克1 - 3级评估对该课程的反应。
在1年时间里，41名麻醉科住院医师在PACU轮转并完成了为期一周的自我指导FoCUS课程。有趣的发现包括：（1）住院医师给予好评；（2）通过客观指标显示图像采集技能有所提高。课程建立后，教员每周持续投入的时间约为1小时20分钟。
在PACU实施FoCUS课程得到了住院医师的好评，并提高了FoCUS技能。由于采用了新颖的教育方法，该课程是可行且自我维持的。
