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让解剖学鲜活起来:在解剖实验室评估一门新颖的超声课程。

Bringing anatomy to life: Evaluating a novel ultrasound curriculum in the anatomy laboratory.

作者信息

Lufler Rebecca S, Davis Margaret L, Afifi Linda M, Willson Robert F, Croft Peter E

机构信息

Department of Medical Education, Tufts University School of Medicine, Boston, Massachusetts, USA.

Emergency Medicine Department, University of Washington, Seattle, Washington, USA.

出版信息

Anat Sci Educ. 2022 May;15(3):609-619. doi: 10.1002/ase.2148. Epub 2022 Jan 22.

Abstract

As point-of-care ultrasound (POCUS) invades medical specialties, more students covet earlier ultrasound (US) training programs in medical school. Determining the optimal placement and format in the curriculum remains a challenge. This study uses student perceptions and confidence in interpreting and acquiring images to evaluate the effectiveness of an US curriculum and assesses their performance on US content. A unique US curriculum was incorporated into first-year clinical anatomy at Tufts University School of Medicine (TUSM). Students completed surveys evaluating changes in US confidence and perceptions. Mean ratings on pre- and post-surveys were compared using Mann-Whitney U tests. Performance on US examination questions was evaluated. Two independent evaluators coded narrative responses and NVivo software was used to identify common themes. Two hundred eleven students completed the US curriculum. Students reported higher post-curriculum mean confidence ratings on US comprehension, operation, image acquisition, artifact recognition, and normal image interpretation (P < 0.0001). US reinforced anatomy concepts and clinical correlates (9.56, ±0.97 SD; 9.60, ±1.05). Students disagreed with items stating learning US is too difficult (1.2, ±2.2) and that it interferes with learning anatomy (0.68, ±1.7). Students scored above passing on practical US knowledge questions, supporting survey data, and the relation to learning spatial relationships. Qualitative analysis identified seven major themes and additional subthemes. Limited integration of US breaks barriers in students' perceptions and confidence in performing POCUS. The TUSM US curriculum is a natural marriage of anatomy and POCUS applications, serving as a template for medical schools.

摘要

随着床旁超声(POCUS)渗透到各个医学专业,越来越多的学生渴望在医学院更早地接受超声(US)培训项目。确定课程中最佳的设置位置和形式仍然是一项挑战。本研究利用学生对图像解读和采集的认知及信心来评估超声课程的有效性,并评估他们在超声内容方面的表现。塔夫茨大学医学院(TUSM)将一门独特的超声课程纳入了一年级临床解剖学。学生们完成了评估超声信心和认知变化的调查。使用曼-惠特尼U检验比较调查前后的平均评分。评估超声考试问题的表现。两名独立评估人员对叙述性回答进行编码,并使用NVivo软件识别共同主题。211名学生完成了超声课程。学生们报告说,课程结束后在超声理解、操作、图像采集、伪像识别和正常图像解读方面的平均信心评分更高(P < 0.0001)。超声强化了解剖学概念和临床相关性(9.56 ± 0.97标准差;9.60 ± 1.05)。学生不同意关于学习超声太难(1.2 ± 2.2)以及它会干扰解剖学学习(0.68 ± 1.7)的说法。学生在实用超声知识问题上的得分高于及格线,支持了调查数据以及与学习空间关系的相关性。定性分析确定了七个主要主题和其他子主题。超声的有限整合打破了学生在进行床旁超声时的认知和信心障碍。TUSM的超声课程是解剖学与床旁超声应用的自然结合,可作为医学院校的模板。

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