Buesing Jessica, Weng Yingjie, Kugler John, Wang Libo, Blaha Ondrej, Hom Jason, Ahuja Neera, Kumar Andre
J Grad Med Educ. 2021 Feb;13(1):76-82. doi: 10.4300/JGME-D-20-00355.1. Epub 2021 Dec 29.
There is insufficient knowledge about how personal access to handheld ultrasound devices (HUDs) improves trainee learning with point-of-care ultrasound (POCUS).
To assess whether HUDs, alongside a yearlong lecture series, improved trainee POCUS usage and ability to acquire images.
Internal medicine intern physicians (n = 47) at a single institution from 2017 to 2018 were randomized 1:1 to receive personal HUDs (n = 24) for patient care/self-directed learning vs no-HUDs (n = 23). All interns received a repeated lecture series on cardiac, thoracic, and abdominal POCUS. Main outcome measures included self-reported HUD usage rates and post-intervention assessment scores using the Rapid Assessment of Competency in Echocardiography (RACE) scale between HUD and no-HUD groups.
HUD interns reported performing POCUS assessments on patients a mean 6.8 (SD 2.2) times per week vs 6.4 (SD 2.9) times per week in non-HUD arm ( = .66). There was no relationship between the number of self-reported examinations per week and a trainee's post-intervention RACE score (rho = 0.022, = .95). HUD interns did not have significantly higher post-intervention RACE scores (median HUD score 17.0 vs no-HUD score 17.8; = .72). Trainee confidence with cardiac POCUS did not correlate with RACE scores.
Personal HUDs without direct supervision did not increase the amount of POCUS usage or improve interns' acquisition abilities. Interns who reported performing more examinations per week did not have higher RACE scores. Improved HUD access and lectures without additional feedback may not improve POCUS mastery.
关于个人使用手持式超声设备（HUD）如何改善住院医师在床旁超声检查（POCUS）中的学习，目前了解不足。
评估HUD与为期一年的系列讲座相结合，是否能提高住院医师的POCUS使用情况和图像采集能力。
2017年至2018年，某单一机构的内科实习医师（n = 47）被1:1随机分组，一组（n = 24）接受个人HUD用于患者护理/自主学习，另一组（n = 23）不接受HUD。所有实习医师都接受了关于心脏、胸部和腹部POCUS的重复讲座系列。主要结局指标包括自我报告的HUD使用率，以及使用超声心动图能力快速评估（RACE）量表对HUD组和非HUD组进行干预后评估得分。
HUD组实习医师报告每周对患者进行POCUS评估的平均次数为6.8（标准差2.2）次，而非HUD组为每周6.4（标准差2.9）次（P = 0.66）。每周自我报告的检查次数与实习医师干预后的RACE评分之间没有关系（rho = 0.022，P = 0.95）。HUD组实习医师干预后的RACE评分没有显著更高（HUD组中位数评分17.0，非HUD组评分17.8；P = 0.72）。实习医师对心脏POCUS的信心与RACE评分无关。
在没有直接监督的情况下，个人HUD并没有增加POCUS的使用量，也没有提高实习医师的采集能力。报告每周进行更多检查的实习医师并没有更高的RACE评分。在没有额外反馈的情况下，改善HUD的获取和讲座可能无法提高对POCUS的掌握程度。
