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管理医学、超声和其他学生在进行教育超声检查时报告的偶然发现。

Managing Incidental Findings Reported by Medical, Sonography and Other Students Performing Educational Ultrasound Examinations.

机构信息

Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland.

Department of Cardiology, University Hospital of Wales, Cardiff, UK.

出版信息

Ultrasound Med Biol. 2022 Feb;48(2):180-187. doi: 10.1016/j.ultrasmedbio.2021.09.015. Epub 2021 Oct 27.

DOI:10.1016/j.ultrasmedbio.2021.09.015
PMID:34756465
Abstract

The evolution of ultrasound imaging into a key technology for diagnostic practice has resulted in its incorporation into the education of medical students worldwide. Although the introduction of ultrasound into medical schools' curricula is relatively recent, training of sonographers and other ultrasound users is mature. Ultrasound is being used in a variety of learning environments and clinical settings, from courses in anatomy and physiology to clinical rotations where medical and other students may scan healthy volunteers or patients, sometimes with little to no supervision. Educators may be apprehensive about a perceived high likelihood that students will encounter unexpected findings during these sessions, which could distress the patient or ultrasound model as well as the student, and result in problems that would be more pronounced if such incidental findings are complex. Policies are needed to address how to manage incidental ultrasound findings that are identified during educational activities. This article summarizes the background and provides a framework for establishing and implementing a well-designed and thoughtful approach for dealing with incidental findings observed in volunteer subjects by medical students during training courses in ultrasound diagnostic scanning. Subject confidentiality should be respected, and review of incidental findings should be transparent without provoking unnecessary anxiety. It is the responsibility of the instructor or supervisor to ensure adequate clinical follow-up if indicated.

摘要

超声成像技术已发展成为诊断实践的关键技术,并已纳入全球医学生的教育中。尽管超声技术在医学院课程中的引入相对较晚,但超声技师和其他超声使用者的培训已经成熟。超声技术已在各种学习环境和临床环境中得到应用,从解剖学和生理学课程到临床实习,医学生和其他学生可以对健康志愿者或患者进行扫描,有时甚至没有监督。教育者可能会担心学生在这些课程中遇到意外发现的可能性很大,这可能会使患者或超声模型以及学生感到不安,并导致如果这些偶然发现复杂,问题会更加突出。需要制定政策来解决如何处理在教育活动中发现的偶然超声发现。本文总结了背景,并为制定和实施处理医学生在超声诊断扫描培训课程中观察到的志愿者受试者偶然发现的精心设计和深思熟虑的方法提供了框架。应尊重受试者的保密性,并对偶然发现进行透明审查,而不会引起不必要的焦虑。如果需要,指导员或主管有责任确保进行充分的临床随访。

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