Division of Clinical Ultrasound, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.
From the Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.
Pediatr Emerg Care. 2023 Feb 1;39(2):e35-e40. doi: 10.1097/PEC.0000000000002843. Epub 2022 Sep 14.
As point-of-care ultrasound (POCUS) continues to evolve in pediatric emergency medicine (PEM), new protocols and curricula are being developed to help establish the standards of practice and delineate training requirements. New suggested guidelines continue to improve, but a national standard curriculum for training and credentialing PEM providers is still lacking. To understand the barriers and perception of curriculum implementation for PEM providers, we created an ultrasound program at our institution and observed attitudes and response to training.
Fourteen PEM-fellowship-trained faculty with limited to no previous experience with POCUS underwent training within a 12-month time frame using a modified practice-based training that included didactics, knowledge assessment, and hands-on practice. As part of the curriculum, the faculty completed a 3-phase survey before, after, and 6 months after completion of the curriculum.
There was a 100%, 78.6%, and 71.4% response rate for the presurvey, postsurvey, and 6 months postsurvey, respectively. Lack of confidence with using POCUS went from 100% on the presurvey to 57% on the postsurvey and down to 30% on the 6th month postsurvey. All other barriers also decreased from precurriculum to postcurriculum, except for length of time to perform POCUS. Participants rated the curriculum highly, with a mean Likert score and standard error of the mean at 3.9 ± 0.73, respectively. The average rating for whether POCUS changed clinical practice was low (2.6 ± 1.34).
These results show that a simplified structured curriculum can improve perception of POCUS and decrease barriers to usage while helping to understand obstacles for implementation of POCUS among PEM-fellowship-trained faculty.
随着即时超声（POCUS）在儿科急诊医学（PEM）中的不断发展，新的方案和课程正在开发中，以帮助建立实践标准并划定培训要求。新的建议指南在不断完善，但仍缺乏针对 PEM 提供者培训和认证的国家标准课程。为了了解 PEM 提供者实施课程的障碍和认知，我们在机构内创建了一个超声项目，并观察他们对培训的态度和反应。
14 名接受过儿科急诊医学 fellowship 培训且之前很少或没有接触过 POCUS 的教员在 12 个月的时间内接受了培训，培训采用了基于实践的修改方法，包括教学、知识评估和实践操作。作为课程的一部分，教员在课程开始前、结束后和结束后 6 个月完成了 3 阶段调查。
预调查、后调查和 6 个月后调查的回复率分别为 100%、78.6%和 71.4%。对使用 POCUS 的信心不足从预调查的 100%下降到后调查的 57%，再下降到 6 个月后调查的 30%。除了执行 POCUS 的时间长短外，其他所有障碍也从前课程到后课程都有所减少。参与者对课程的评价很高，平均 Likert 得分和均数标准误分别为 3.9 ± 0.73。POCUS 是否改变临床实践的平均评分较低（2.6 ± 1.34）。
这些结果表明，简化的结构化课程可以提高对 POCUS 的认知，减少使用障碍，同时帮助了解 PEM fellowship 培训教员实施 POCUS 的障碍。
