Ferre Robinson M, Russell Frances M, Peterson Dina, Zakeri Bita, Herbert Audrey, Nti Benjamin, Goldman Mitchell, Wilcox James G, Wallach Paul M
Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, USA.
Department of Radiologic Sciences, Indiana University School of Medicine, Indianapolis, USA.
Cureus. 2022 Jul 23;14(7):e27173. doi: 10.7759/cureus.27173. eCollection 2022 Jul.
Objective As point-of-care ultrasound (POCUS) use grows, training in graduate medical education (GME) is increasingly needed. We piloted a multispecialty GME POCUS curriculum and assessed feasibility, knowledge, and comfort with performing POCUS exams. Methods Residents were selected from the following residency programs: internal medicine, family medicine, emergency medicine, and a combined internal medicine/pediatrics program. Didactics occurred through an online curriculum that consisted of five modules: physics and machine operation, cardiac, lung, soft tissue, and extended focused sonography in trauma applications. Residents completed a pre- and post-curriculum questionnaire, as well as knowledge assessments before and after each module. One-hour hands-on training sessions were held for each module. Differences between pre- and post-participation questionnaire responses were analyzed using the Wilcoxon rank sum. Results Of the 24 residents selected, 21 (86%) were post-graduate year two or three, and 16 (65%) were from the internal medicine program. Eighteen (67%) residents reported limited prior POCUS experience. All pre- to post-knowledge assessment scores increased (p<0.05). Statistically significant increases pre- to post-curriculum were found for frequency of POCUS use (p = 0.003), comfort in using POCUS for assessing for abdominal aortic aneurysm, soft tissue abscess detection, undifferentiated hypotension and dyspnea, cardiac arrest and heart failure (p<0.025); and competency in machine use, acquiring and interpreting images and incorporating POCUS into clinical practice (p<0.001). All participants felt the skills learned during this curriculum were essential to their future practice. Conclusions In this pilot, we found using a combination of online and hands-on training to be feasible, with improvement in residents' knowledge, comfort, and use of POCUS.
目的 随着床旁超声(POCUS)的应用日益广泛,研究生医学教育(GME)中的相关培训需求也日益增加。我们开展了一项多专业GME的POCUS课程试点,并评估了其可行性、知识掌握情况以及进行POCUS检查的熟练程度。方法 从以下住院医师培训项目中选拔住院医师:内科、家庭医学、急诊医学以及内科/儿科联合项目。教学通过一个在线课程进行,该课程由五个模块组成:物理与机器操作、心脏、肺部、软组织以及创伤应用中的扩展聚焦超声检查。住院医师在课程前后分别完成一份问卷,并且在每个模块前后进行知识评估。每个模块都进行了一小时的实践培训。使用Wilcoxon秩和检验分析参与前后问卷回复的差异。结果 在选拔的24名住院医师中,21名(86%)为研究生二年级或三年级,16名(65%)来自内科项目。18名(67%)住院医师表示之前的POCUS经验有限。所有知识评估的前后得分均有所提高(p<0.05)。课程前后在POCUS使用频率(p = 0.003)、使用POCUS评估腹主动脉瘤、检测软组织脓肿、鉴别不明原因的低血压和呼吸困难、心脏骤停和心力衰竭方面的舒适度(p<0.025);以及机器使用、获取和解读图像以及将POCUS纳入临床实践的能力(p<0.001)方面均有统计学显著提高。所有参与者都认为在此课程中学到的技能对他们未来的实践至关重要。结论 在本次试点中,我们发现结合在线和实践培训是可行的,住院医师在POCUS的知识、熟练程度和应用方面都有所提高。