German Emily R, Hogge Katelyn A, Reese Brooke L, Lindsey Tom
Medicine, Edward Via College of Osteopathic Medicine (VCOM) Carolinas, Spartanburg, USA.
Surgery, Edward Via College of Osteopathic Medicine (VCOM) Carolinas, Spartanburg, USA.
Cureus. 2022 Nov 21;14(11):e31722. doi: 10.7759/cureus.31722. eCollection 2022 Nov.
Introduction Medical students are trained using anatomical landmarks in order to perform many procedures, such as knee aspirations. With the growing popularity and use of ultrasound, the question arises whether training students with ultrasound instead of landmarks increases their skill. Previous research has shown increased accuracy and confidence in residents who trained with ultrasound compared to landmarks only. No studies to date have analyzed the effect of ultrasound learning versus landmark learning in medical students. Objective The purpose of this study is to analyze the confidence and accuracy of medical students when taught knee aspiration using ultrasound training compared to students taught with landmarks only. Methods The project was deemed exempt by the Edward Via College of Osteopathic Medicine (VCOM) Institutional Review Board (IRB) because it falls under the quality improvement category (IRB number 1806802-1). Subjects were randomized into two groups: one trained in ultrasound and one trained in landmarks for performing knee aspirations. Both groups were tested for accuracy by the ability to aspirate fluid from the model and the number of attempts; each student was given a maximum of three attempts. Documentation included the number of attempts for each student or "no fluid" for those exceeding three attempts. They were then surveyed for confidence. The study took place in an educational setting at VCOM-Carolinas. A total of 42 first-year medical students participated in this study. Results Fisher's exact test showed statistically significant results for confidence (p<0.001) between the ultrasound group (N=22) and non-ultrasound group (N=20) with a power of 0.285. The accuracy of aspirating fluid was not found to be statistically significant (p=0.4805). Conclusions Although no significant differences in the accuracy of knee aspirations at short term were seen, there was a clear improvement in student confidence and perceived capability of the skill. Those students who learned using ultrasound-guided techniques were more confident in their ability to accurately perform the technique when compared to their peers.
引言 医学生通过使用解剖标志进行培训，以便执行许多操作，如膝关节穿刺。随着超声的日益普及和应用，出现了一个问题，即使用超声而非解剖标志对学生进行培训是否能提高他们的技能。先前的研究表明，与仅使用解剖标志培训的住院医师相比，使用超声培训的住院医师准确性和信心有所提高。迄今为止，尚无研究分析超声学习与解剖标志学习对医学生的影响。目的 本研究的目的是分析与仅接受解剖标志教学的学生相比，接受超声培训进行膝关节穿刺教学的医学生的信心和准确性。方法 该项目被爱德华·维亚骨科医学院（VCOM）机构审查委员会（IRB）认定为豁免项目，因为它属于质量改进类别（IRB编号1806802 - 1）。受试者被随机分为两组：一组接受超声培训，另一组接受解剖标志培训以进行膝关节穿刺。两组均通过从模型中抽吸液体的能力和尝试次数来测试准确性；每个学生最多有三次尝试机会。记录包括每个学生的尝试次数，对于超过三次尝试的学生记录为“无液体”。然后对他们进行信心调查。该研究在VCOM - 卡罗莱纳分校的教育环境中进行。共有42名一年级医学生参与了本研究。结果 费舍尔精确检验显示，超声组（N = 22）和非超声组（N = 20）之间在信心方面具有统计学显著结果（p < 0.001），检验效能为0.285。未发现抽吸液体的准确性具有统计学显著性（p = 0.4805）。结论 虽然短期内膝关节穿刺准确性未见显著差异，但学生的信心和技能感知能力有明显提高。与同龄人相比，那些使用超声引导技术学习的学生对自己准确执行该技术的能力更有信心。
