Young Allison C, Butts Christine, deBoisblanc Bennett P, Tejedor Richard S, Kantrow Stephen P, Lammi Matthew R
Louisiana State University School of Medicine, New Orleans, Louisiana.
Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
ATS Sch. 2022 Jan 28;3(1):125-134. doi: 10.34197/ats-scholar.2021-0120OC. eCollection 2022 Mar.
The use of point-of-care ultrasound as a diagnostic and interventional tool is rapidly becoming standard of care in critical care medicine; a standardized training curriculum is needed to ensure provider proficiency.
This study aimed to describe a longitudinal critical care ultrasound (CCUS) curriculum in a pulmonary critical care medicine (PCCM) fellowship training program. It evaluated the curriculum's impact on fellows' knowledge, skills, and self-reported confidence and retention of these attributes.
We conducted a prospective observational study of a longitudinal CCUS training program within a single PCCM fellowship training program. Knowledge, skills, and confidence of 22 fellows were assessed at baseline; after initial training; and at 6, 12, and 18 months in five domains (ultrasound basics, vascular, lung/pleural, abdomen, and cardiac). We quantified changes in CCUS knowledge, confidence, and skills by fellowship class and assessed for longitudinal retention of these three attributes. The difference in scores between new first-year fellows undergoing formal training and second-year fellows with previous informal training was compared at matched time points.
After the initial formal training, there was a significant increase in knowledge, skills, and confidence scores, which were maintained or continued to increase up to 18 months. Fellows with 1 year of formal training also had a higher level of knowledge and skills than fellows with 1 year of informal training, although they had similar levels of self-reported confidence in their skills.
A formal, longitudinal CCUS curriculum implemented in a PCCM fellowship program improves trainees' knowledge and skills in various ultrasound domains in addition to their confidence in using ultrasound for patient care. A longitudinal curriculum results in retention of all three attributes and appeared to be more effective than an informal training program based on teaching during rounds, but this needs to be replicated in a larger cohort.
即时超声作为一种诊断和介入工具，在重症医学中迅速成为标准治疗手段；需要标准化培训课程以确保医疗人员熟练掌握。
本研究旨在描述一项在肺重症医学（PCCM）专科培训项目中的纵向重症超声（CCUS）课程。它评估了该课程对学员知识、技能以及自我报告的这些属性的信心和保持情况的影响。
我们在一个单一的PCCM专科培训项目中对纵向CCUS培训项目进行了前瞻性观察研究。在基线、初始培训后以及6个月、12个月和18个月时，对22名学员在五个领域（超声基础、血管、肺/胸膜、腹部和心脏）的知识、技能和信心进行评估。我们按学员班级量化CCUS知识、信心和技能的变化，并评估这三个属性的纵向保持情况。在匹配的时间点比较接受正规培训的新一年级学员和有过非正规培训的二年级学员的分数差异。
经过初始正规培训后，知识、技能和信心分数显著提高，并在18个月内保持或持续提高。接受1年正规培训的学员在知识和技能水平上也高于接受1年非正规培训的学员，尽管他们在自我报告的技能信心水平上相似。
在PCCM专科培训项目中实施的正式纵向CCUS课程，除了提高学员使用超声进行患者护理的信心外，还提高了他们在各个超声领域的知识和技能。纵向课程导致这三个属性都得以保持，并且似乎比基于查房教学的非正规培训项目更有效，但这需要在更大的队列中进行重复验证。
