Mahmood Oria, Jørgensen Rikke, Nielsen Kristina, Konge Lars, Russell Lene
Center of Clinical Education, University of Copenhagen, Copenhagen, Denmark.
CAMES, University of Copenhagen, Kobenhavn, Denmark.
Ultrasound Int Open. 2022 May 3;8(1):E2-E6. doi: 10.1055/a-1795-5138. eCollection 2022 Jan.
Point of care ultrasound (POCUS) is widely used, but the sensitivity and specificity of the findings are highly user-dependent. There are many different approaches to ultrasound training. The aim of this study was to explore the effects of hands-on practice when learning POCUS. Junior doctors with no or limited ultrasound experience were included in the study and divided into three groups. They all completed a Focused Assessment with Sonography for Trauma (FAST) course with different amounts of hands-on practice: 40 minutes (n=67), 60 minutes (n=12), and 90 minutes of hands-on time (n=27). By the end of the course, they all completed a previously validated test. More hands-on time improved the mean test scores and decreased the test time. The scores of the 40-, 60-, and 90-minute groups were 11.6 (SD 2.1), 12.8 (SD 2.5), and 13.7 (SD 2.5), respectively (p<0.001). The 90-minute group completed the test significantly faster than the other two groups (20 versus 26 minutes, p=0.003). A large inter-individual variation was seen. The necessary amount of hands-on training is unknown. This study demonstrates that performance increases with prolonged hands-on time but the inter-individual variation among trainees is very large, thereby making it impossible to define the "optimal" time. This supports the use of the concept of mastery learning where each individual trainee can continue training until proficiency is reached.
床旁超声（POCUS）应用广泛，但检查结果的敏感性和特异性高度依赖于使用者。超声培训有许多不同的方法。本研究的目的是探讨学习POCUS时实践操作的效果。没有或仅有有限超声经验的初级医生被纳入研究并分为三组。他们都完成了不同实践操作时长的创伤超声重点评估（FAST）课程：40分钟（n = 67）、60分钟（n = 12）和90分钟实践时间（n = 27）。课程结束时，他们都完成了一项先前验证过的测试。更多的实践时间提高了平均测试分数并缩短了测试时间。40分钟组、60分钟组和90分钟组的分数分别为11.6（标准差2.1）、12.8（标准差2.5）和13.7（标准差2.5）（p<0.001）。90分钟组完成测试的速度明显快于其他两组（20分钟对26分钟，p = 0.003）。观察到个体间存在很大差异。实践培训的必要时长尚不清楚。本研究表明，随着实践时间延长，表现会提高，但受训者之间的个体差异非常大，因此无法确定“最佳”时间。这支持了掌握学习的概念，即每个受训者可以继续训练直到达到熟练程度。
