Blake Holloway W, Grove Jordan, Tyson Anna, Rochford Laura, Day Lee, Resuehr David
The University of Alabama School of Medicine, Birmingham, AL USA.
Department of Cellular, Developmental, and Integrative Biology, University of Alabama in Birmingham, Birmingham, AL USA.
Med Sci Educ. 2020 Jan 6;30(1):31-39. doi: 10.1007/s40670-019-00831-0. eCollection 2020 Mar.
With continuing advancements in software, electronics, and miniaturization, ultrasound (US) is quickly becoming an everyday tool of numerous medical specialties. With the advent of new handheld and other small-scale units, physicians have a tool to obtain on demand imaging without exposing the patient to ionizing radiation in the pocket of their white coat. As such, the need for competency in US is increasing. Currently, US training primarily occurs in residency, with only a handful of institutions incorporating US into the undergraduate medical education (UME) curriculum. To date, no ideal method has been presented (Amini et al., Intern Emerg Med. 10(5):613-8, 2015; Wilson et al., J Ultrasound Med. 36(2):321-5, 2017). Presented herein is a method for the addition of US training into the undergraduate medical curriculum. Utilizing a co-enrolled course format, 6 medical students were given basic training in the history and physics of US, echocardiography (ECHO), right upper quadrant (RUQ) ultrasound, focused assessment with sonography for trauma (FAST), and extended (eFAST) exams, vascular access techniques, and MSK ultrasound over 17 sessions. Students theoretical knowledge was assessed during team-based learning (TBL) sessions in an individual and group readiness assurance test (IRAT/GRAT) format. Students' practical skill was assessed in an objective structured clinical examination (OSCE) format. Students demonstrated notable proficiency with the US unit and were able to conduct both US-guided peripheral and central vascular access techniques. Furthermore, students were able to identify 80% or more of the required structures for the RUQ, ECHO, and eFAST US exams.
随着软件、电子技术以及小型化的不断进步，超声（US）正迅速成为众多医学专业日常使用的工具。随着新型手持式及其他小型设备的出现，医生在白大褂口袋里就有了一种工具，能够按需获取影像，而无需让患者暴露于电离辐射之下。因此，对超声技能的需求日益增加。目前，超声培训主要在住院医师阶段进行，仅有少数机构将超声纳入本科医学教育（UME）课程。迄今为止，尚未出现理想的方法（阿米尼等人，《国际急诊医学》。10(5):613 - 8，2015；威尔逊等人，《超声医学杂志》。36(2):321 - 5，2017）。本文介绍了一种将超声培训添加到本科医学课程中的方法。采用联合注册课程形式，6名医学生在17次课程中接受了超声的历史与物理学、超声心动图（ECHO）、右上腹（RUQ）超声、创伤超声重点评估（FAST）及扩展（eFAST）检查、血管穿刺技术和肌肉骨骼超声的基础培训。在基于团队的学习（TBL）课程中，通过个人和小组准备情况保证测试（IRAT/GRAT）形式评估学生的理论知识。以客观结构化临床考试（OSCE）形式评估学生的实践技能。学生们在超声设备操作方面表现出显著的熟练程度，能够进行超声引导下的外周和中心血管穿刺技术。此外，学生能够识别RUQ、ECHO和eFAST超声检查中80%或更多的所需结构。
