Cooper University Health Care, Camden, NJ, United States of America.
Cooper Medical School of Rowan University, Camden, NJ, United States of America.
PLoS One. 2020 Dec 3;15(12):e0243086. doi: 10.1371/journal.pone.0243086. eCollection 2020.
Implementation of a point of care ultrasound curricula is valuable, but optimal integration for internal medicine residency is unclear. The purpose of this study was to evaluate if a structured ultrasound curriculum vs. structured ultrasound curriculum plus supervised thoracic ultrasounds would improve internal medicine residents' skill and retention 6 and 12 months from baseline.
We conducted a randomized controlled study evaluating internal medical residents' skill retention of thoracic ultrasound using a structured curriculum (control, n = 14) vs. structured curriculum plus 20 supervised bedside thoracic ultrasounds (intervention, n = 14). We used a stratified randomization based on program year. All subjects attended a half-day course that included 5 lectures and hands-on sessions at baseline. Assessments included written and practical exams at baseline, immediately post-course and at 6 and 12 months. Scores are reported as a percentage for the number of correct responses/number of questions (range 0-100%). The Mann Whitney U and the Friedman tests were used for analyses.
Twenty-eight residents were enrolled. Two subjects withdrew prior to the 6-month exams. Written exam scores for all subjects improved, baseline median (IQR) 60 (46.47 to 66.67) post-course 80 (65 to 86.67), 6-month 80 (66.67 to 86.67) and 12-month 86.67 (80 to 88.34), p = <0.001. All subjects practical exam scores median (IQR) significantly improved, baseline 18.18 (7.95 to 32.95), post-course 59.09 (45.45 to 70.45), 6 month 71.74 (60.87 to 82.61) and 12-month 76.09 (65.22 to 88.05), p = <0.001. Comparing the control group to the intervention group, there were statistically significant higher scores, median (IQR), in the intervention group on the practical exam at 6 months 63.05 (48.92 to 69.57) vs. 82.61(72.83 to89.13), p = <0.001.
In this cohort, internal medicine residents participating in a structured thoracic ultrasound course plus 20-supervised ultrasounds achieved higher practical exam scores long-term compared to controls.
实施即时超声课程具有重要意义，但针对内科住院医师培训的最佳整合方案尚不清楚。本研究的目的是评估结构化超声课程与结构化超声课程加 20 次监督床旁超声检查相比，是否会提高内科住院医师的技能，并在基线后 6 个月和 12 个月保持技能。
我们开展了一项随机对照研究，使用结构化课程（对照组，n=14）与结构化课程加 20 次监督床旁胸腔超声检查（干预组，n=14）评估内科住院医师胸腔超声技能保留情况。我们根据项目年份进行分层随机化。所有受试者均参加为期半天的课程，包括 5 次讲座和基础实践课程。评估包括基线、课程结束后即刻、6 个月和 12 个月的书面和实践考试。分数以正确回答问题的百分比表示（范围 0-100%）。采用 Mann-Whitney U 检验和 Friedman 检验进行分析。
共纳入 28 名住院医师。有 2 名受试者在 6 个月考试前退出。所有受试者的书面考试成绩均提高，基线中位数（IQR）为 60（46.47 至 66.67），课程结束后为 80（65 至 86.67），6 个月后为 80（66.67 至 86.67），12 个月后为 86.67（80 至 88.34），p<0.001。所有受试者的实践考试成绩中位数（IQR）均显著提高，基线为 18.18（7.95 至 32.95），课程结束后为 59.09（45.45 至 70.45），6 个月后为 71.74（60.87 至 82.61），12 个月后为 76.09（65.22 至 88.05），p<0.001。与对照组相比，干预组在 6 个月时的实践考试中得分更高，中位数（IQR）为 63.05（48.92 至 69.57）比 82.61（72.83 至 89.13），p<0.001。
在本队列中，与对照组相比，参加结构化胸腔超声课程加 20 次监督超声检查的内科住院医师在 6 个月时的实践考试成绩更高。
