PoSaw Leila L, Wubben Brandon M, Bertucci Nicholas, Bell Gregory A, Healy Heather, Lee Sangil
Division of Emergency Medicine Jackson Memorial Hospital Miami Florida USA.
Department of Emergency Medicine University of Iowa Iowa City Iowa USA.
J Am Coll Emerg Physicians Open. 2021 Jun 14;2(3):e12439. doi: 10.1002/emp2.12439. eCollection 2021 Jun.
Over the past 2 decades, emergency ultrasound has become essential to patient care, and is a mandated competency for emergency medicine residency graduation. However, the best evidence regarding emergency ultrasound education in residency training is not known. We performed a scoping review to determine the (1) characteristics and (2) outcomes of published structured training methods, (3) the quality of publications, and (4) the implications for research and training.
We searched broadly on multiple electronic databases and screened studies from the United States and Canada describing structured emergency ultrasound training methods for emergency medicine residents. We evaluated methodological quality with the Medical Education Research Study Quality Instrument (MERSQI), and qualitatively summarized study and intervention characteristics.
A total of 109 studies were selected from 6712 identified publications. Publications mainly reported 1 group pretest-posttest interventions (38%) conducted at a single institution (83%), training in image acquisition (82%) and interpretation (94%) domains with assessment of knowledge (44%) and skill (77%) outcomes, and training in cardiac (18%) or vascular access (15%) applications. Innovative strategies, such as gamification, cadaver models, and hand motion assessment are described. The MERSQI scores of 48 articles ranged from 0 to 15.5 (median, 11.5; interquartile range, 9.6-13.0) out of 18. Low scores reflected the absence of reported valid assessment tools (73%) and higher level outcomes (90%).
Although innovative strategies are illustrated, the overall quality of research could be improved. The use of standardized planning and assessment tools, intentionally mapped to targeted domains and outcomes, might provide valuable formative and summative information to optimize emergency ultrasound research and training.
在过去20年中,急诊超声已成为患者护理的重要组成部分,并且是急诊医学住院医师毕业所需具备的一项技能。然而,关于住院医师培训中急诊超声教育的最佳证据尚不清楚。我们进行了一项范围综述,以确定(1)已发表的结构化培训方法的特征和(2)结果、(3)出版物的质量以及(4)对研究和培训的影响。
我们在多个电子数据库中广泛搜索,并筛选了来自美国和加拿大的描述针对急诊医学住院医师的结构化急诊超声培训方法的研究。我们使用医学教育研究质量工具(MERSQI)评估方法学质量,并对研究和干预特征进行定性总结。
从6712篇已识别的出版物中总共筛选出109项研究。出版物主要报告了在单一机构(83%)进行的1组前测-后测干预(38%),在图像采集(82%)和解读(94%)领域的培训以及知识(44%)和技能(77%)结果的评估,以及在心脏(18%)或血管通路(15%)应用方面的培训。文中描述了一些创新策略,如游戏化、尸体模型和手部动作评估。48篇文章的MERSQI分数在18分制中从0到15.5不等(中位数为11.5;四分位间距为9.6 - 13.0)。低分反映出缺乏报告有效的评估工具(73%)和更高层次的结果(90%)。
尽管展示了创新策略,但研究的整体质量仍有待提高。使用标准化的规划和评估工具,并有意映射到目标领域和结果,可能会提供有价值的形成性和总结性信息,以优化急诊超声的研究和培训。