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评估一种新的针对第一年儿科住院医师的即时超声课程。

Evaluation of a Novel Point-of-Care Ultrasound Curriculum for First-Year Pediatric Residents.

机构信息

From the Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT.

Department of Emergency Medicine, Queen's University, Kingston, Canada.

出版信息

Pediatr Emerg Care. 2022 Nov 1;38(11):605-608. doi: 10.1097/PEC.0000000000002853. Epub 2022 Oct 17.

Abstract

OBJECTIVE

The aim of the study is to evaluate a novel point-of-care ultrasound (POCUS) educational curriculum for pediatric residents.

METHODS

The cohort study in graduate medical education was completed from January 2017 to March 2019. Postgraduate year 1 (PGY1) pediatric residents attended the educational curriculum that consisted of 3 half-day sessions over a 3-month period. Each session consisted of a lecture (introduction, extended focused assessment with sonography for trauma, soft tissue/musculoskeletal, cardiac, and resuscitative applications) followed by supervised hands-on scanning sessions. Group ratio was 3 learners to 1 machine/expert instructor. Main outcome measures included pre- and post-written test scores, as well as objective structured clinical examination (OSCE) scores.

RESULTS

Forty-nine PGY1 residents (78% women) completed the curriculum. The mean (SD) pretest score was 68% (8.5), and the mean posttest score was 83% (8.3) with a difference of 15 (95% confidence interval, 12.5-17.6; P < 0.001). Mean (SD) focused assessment with sonography for trauma OSCE score after the curriculum was 88.7% (11.9). The number of PGY1 pediatric residents that were comfortable performing POCUS examinations increased from pretraining to posttraining for soft tissue/musculoskeletal (14%-61%, P < 0.001), extended focused assessment with sonography for trauma (24%-90%, P < 0.001), and cardiac (18%-86%, P < 0.001). All participants found the curriculum useful, and 42 of 49 (86%) stated the curriculum increased their ability to acquire and interpret images.

CONCLUSIONS

Postgraduate year 1 pediatric residents learned the basics of POCUS through 3 brief educational sessions. The increase in posttest scores demonstrated improved POCUS knowledge, and the high OSCE score demonstrated their ability to acquire ultrasound images. Point-of-care ultrasound guidelines are needed for pediatric residency programs.

摘要

目的

本研究旨在评估一种新的即时超声(POCUS)教育课程在儿科住院医师中的应用效果。

方法

这是一项研究生医学教育中的队列研究,完成于 2017 年 1 月至 2019 年 3 月期间。一年级儿科住院医师(PGY1)参加了为期 3 个月的 3 次半天课程教育。每次课程包括讲座(介绍、扩展创伤超声重点评估、软组织/肌肉骨骼、心脏和复苏应用),随后是监督的现场扫描课程。学习者与机器/专家讲师的比例为 3:1。主要观察指标包括预测试和后测试的书面分数,以及客观结构化临床考试(OSCE)分数。

结果

共有 49 名 PGY1 住院医师(78%为女性)完成了该课程。平均(SD)预测试分数为 68%(8.5),平均后测试分数为 83%(8.3),差异为 15(95%置信区间,12.5-17.6;P<0.001)。课程结束后,创伤超声重点评估 OSCE 分数的平均值为 88.7%(11.9)。PGY1 儿科住院医师进行 POCUS 检查的舒适度从培训前到培训后有了提高,在软组织/肌肉骨骼(14%-61%,P<0.001)、扩展创伤超声重点评估(24%-90%,P<0.001)和心脏(18%-86%,P<0.001)方面。所有参与者都认为该课程很有用,49 名参与者中有 42 名(86%)表示该课程提高了他们获取和解释图像的能力。

结论

PGY1 儿科住院医师通过 3 次简短的教育课程学习了 POCUS 的基础知识。后测试分数的增加表明 POCUS 知识有所提高,而高 OSCE 分数表明他们有获取超声图像的能力。儿科住院医师培训项目需要制定即时超声指南。

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