Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark; Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Odense, Demark; Regional Center for Technical Simulation (TechSim), Odense University Hospital, Odense, Denmark.
Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Odense, Demark; Department of Radiology, Odense University Hospital, Odense, Denmark; Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark.
Ultrasound Med Biol. 2022 May;48(5):912-923. doi: 10.1016/j.ultrasmedbio.2022.01.015. Epub 2022 Feb 25.
Contrast-enhanced ultrasound (CEUS) is used in various medical specialties as a diagnostic imaging tool and for procedural guidance. Experience in the procedure is currently attained via supervised clinical practice that is challenged by patient availability and risks. Prior simulation-based training and subsequent assessment could improve and ensure competence before performance on patients, but no simulator currently exists. Immersive virtual reality (IVR) is a new promising simulation tool that can replicate complex interactions and environments that are unfeasible to achieve by traditional simulators. This study was aimed at developing an IVR simulation-based test for core CEUS competencies and gathering validity evidence for the test in accordance with Messick's framework. The test was developed by IVR software specialists and clinical experts in CEUS and medical education and imitated a CEUS examination of a patient with a focal liver lesion with emphasis on the pre-contrast preparations. Twenty-five medical doctors with varying CEUS experience were recruited as test participants, and their results were used to analyze test quality and to establish a pass/fail standard. The final test of 23 test items had good internal reliability (Cronbach's α = 0.85) and discriminatory abilities. The risks of false positives and negatives (9.1% and 23.6%, respectively) were acceptable for the test to be used as a certification tool prior to supervised clinical training in CEUS.
对比增强超声（CEUS）在多个医学专业领域被用作诊断成像工具和手术指导。目前，该技术的操作经验是通过监督下的临床实践获得的，但这种实践受到患者可用性和风险的限制。基于模拟的预先培训和随后的评估可以提高和确保在患者身上进行操作之前的能力，但目前还没有模拟器。沉浸式虚拟现实（IVR）是一种新的有前途的模拟工具，可以复制传统模拟器无法实现的复杂交互和环境。本研究旨在开发一种基于 IVR 模拟的核心 CEUS 能力测试，并根据 Messick 框架为该测试收集有效性证据。该测试由 IVR 软件专家、CEUS 和医学教育方面的临床专家共同开发，模拟了对有局灶性肝病变的患者进行的 CEUS 检查，重点是对比前的准备工作。招募了 25 名具有不同 CEUS 经验的医生作为测试参与者，他们的测试结果用于分析测试质量并建立通过/不通过标准。最终的 23 项测试项目具有良好的内部可靠性（Cronbach's α = 0.85）和区分能力。对于在监督下的 CEUS 临床培训之前用作认证工具的测试，假阳性和假阴性的风险（分别为 9.1%和 23.6%）是可以接受的。
