Souleymane Mamdouh, Rajendram Rajkumar, Mahmood Naveed, Ghazi Amro M T, Kharal Yousuf M S, Hussain Arif
Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
College of Medicine, King Saud Bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia.
Ultrasound J. 2021 Apr 13;13(1):20. doi: 10.1186/s13089-021-00221-x.
Training in procedural skills is often suboptimal. The aim of this study was to quantify the needs of residents in internal medicine (IM), critical care (CC), and emergency medicine (EM) for instruction in ultrasound-guided procedures.
All IM, EM and CC residents (n = 200) at King Abdulaziz Medical City, Riyadh, Saudi Arabia, were invited to participate in a questionnaire-based survey to identify skill and experience gaps. The contribution of procedural skills to patient care (i.e. applicability) and proficiency in the sterile technique required to perform ultrasound-guided procedures were rated on Likert scales. Data on training, accreditation, and experience with and without ultrasound were collected.
The overall response rate was 72% (IM 91%, CC 100%, EM 40%). Although the sample reported that procedural skills were very applicable, 19% (IM n = 25, EM n = 2) had not performed any procedures. However, five residents were accredited in point-of-care ultrasound, 61% of the sample had performed ultrasound-guided procedures and 65% had used landmark techniques. Whilst more internists had performed procedures using landmark techniques, CC and EM residents had performed more ultrasound-guided procedures. Whilst CC residents had not missed any opportunities to perform procedures because supervisors were less available, EM (6) and IM (89) residents had. Whilst skill gaps were only identified in the IM residency programme, experience gaps were present in all three residency programmes. The IM residency programme had larger experience gaps than the CC and EM programmes for all procedural skills.
Residents in IM, CC and EM perceive that ultrasound-guided procedures are relevant to their practice. However, the IM residents performed fewer procedures than CC residents and EM residents at least partly because internists also lack skills in ultrasound. Training in ultrasound-guided procedures may reduce the use of landmark techniques and improve patient safety. Residents in IM, CC and EM therefore require training in ultrasound-guided procedures.
操作技能培训往往不尽人意。本研究旨在量化内科（IM）、重症监护（CC）和急诊医学（EM）住院医师对超声引导操作指导的需求。
邀请沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城的所有IM、EM和CC住院医师（n = 200）参与一项基于问卷的调查，以确定技能和经验差距。使用李克特量表对操作技能对患者护理的贡献（即适用性）以及执行超声引导操作所需的无菌技术熟练程度进行评分。收集有关培训、认证以及有无超声经验的数据。
总体回复率为72%（IM为91%，CC为100%，EM为40%）。尽管样本报告操作技能非常适用，但19%（IM中n = 25，EM中n = 2）从未进行过任何操作。然而，有5名住院医师获得了床旁超声认证，61%的样本进行过超声引导操作，65%使用过体表定位技术。虽然更多内科住院医师使用体表定位技术进行操作，但CC和EM住院医师进行的超声引导操作更多。虽然CC住院医师没有因为上级指导人员较少而错过任何操作机会，但EM（6名）和IM（89名）住院医师有过。虽然仅在IM住院医师培训项目中发现了技能差距，但所有三个住院医师培训项目中都存在经验差距。对于所有操作技能，IM住院医师培训项目的经验差距比CC和EM项目更大。
IM、CC和EM住院医师认为超声引导操作与他们的实践相关。然而，IM住院医师进行的操作比CC住院医师和EM住院医师少，至少部分原因是内科医师也缺乏超声技能。超声引导操作培训可能会减少体表定位技术的使用并提高患者安全性。因此，IM、CC和EM住院医师需要接受超声引导操作培训。
