Kappel Coralea, Chaudhuri Dipayan, Hassall Kelly, Theune Shannon, Sharif Sameer, Alhazzani Waleed, Lewis Kim
Department of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, ON.
Department of Medicine, Division of Critical Care, McMaster University, Hamilton, ON.
Can J Respir Ther. 2022 Mar 7;58:28-33. doi: 10.29390/cjrt-2021-065. eCollection 2022.
Point-of-care ultrasound (POCUS), although commonly used in clinical practice, is not currently included in training programs for respiratory therapists (RTs). In fact, given its ubiquity and clinical utility, RTs in Ontario, Canada, are changing their mandate to incorporate POCUS into their daily patient assessment. Therefore, we conducted a scoping review of the literature, aiming to describe the current evidence of POCUS training and methods of curriculum delivery for RTs to inform an evidence-based program design.
We systematically searched MEDLINE, EMBASE, CINAHL, and Web of Science from inception to 8 July 2020. We included all studies reporting on RT training in POCUS. Documents included English language, full-text reports of all study designs. Title and abstract screening, full-text review, and data abstraction were done independently and in duplicate.
Seven studies met our inclusion criteria, including four full texts and three abstracts; all were prospective and single-center studies, except one multicenter study. Reports were from nine different countries. Studies described cardiac, lung, and procedural ultrasonography use. The majority used a combination of educational methods; didactic talks, hands-on sessions, and practical assessments being the most common methods. There was a median of 11 participants enrolled in a training session. The instructors were physicians from various specialties such as critical care, pulmonology, and radiology.
This scoping review identified seven papers that explored different methods of a POCUS curriculum delivery for RTs. From the interventions outlined, teaching POCUS skills to RTs seems feasible. However, further work needs to be done to solidify a POCUS curriculum specific to RTs and examine the impact on patient-related outcomes.
即时超声检查(POCUS)虽在临床实践中常用,但目前未纳入呼吸治疗师(RT)的培训项目。事实上,鉴于其普遍性和临床实用性,加拿大安大略省的呼吸治疗师正在改变其职责范围,将即时超声检查纳入日常患者评估中。因此,我们对文献进行了范围综述,旨在描述即时超声检查培训的现有证据以及针对呼吸治疗师的课程传授方法,以为基于证据的项目设计提供参考。
我们系统检索了从创刊至2020年7月8日的MEDLINE、EMBASE、CINAHL和科学网。我们纳入了所有报告呼吸治疗师即时超声检查培训的研究。文献包括所有研究设计的英文全文报告。标题和摘要筛选、全文审查以及数据提取均独立且重复进行。
七项研究符合我们的纳入标准,包括四项全文和三项摘要;除一项多中心研究外,其余均为前瞻性单中心研究。报告来自九个不同国家。研究描述了心脏、肺部和操作超声检查的应用。大多数研究采用了多种教育方法;讲授式讲座、实践操作课程和实践评估是最常见的方法。一次培训课程的参与者中位数为11人。授课教师为来自重症监护、肺病学和放射学等各个专业的医生。
本次范围综述确定了七篇探讨针对呼吸治疗师的即时超声检查课程不同传授方法的论文。从概述的干预措施来看,向呼吸治疗师传授即时超声检查技能似乎是可行的。然而,需要进一步开展工作,以巩固专门针对呼吸治疗师的即时超声检查课程,并研究其对患者相关结局的影响。