Gopal Dipika, Baston Cameron, Adusumalli Srinath, Jagasia Dinesh, Prenner Stuart
Division of Cardiovascular Medicine, University of Pennsylvania Perelman School of Medicine Philadelphia, Pennsylvania.
Division of Pulmonary & Critical Care, University of Pennsylvania Perelman School of Medicine Philadelphia, Pennsylvania.
POCUS J. 2021 Apr 22;6(1):29-32. doi: 10.24908/pocus.v6i1.14759. eCollection 2021.
Focused cardiac ultrasound (FCU) is a safe and efficient diagnostic intervention for internal medicine physicians. FCU is a highly teachable skill, but is used in routine cardiac assessment in only 20% of surveyed training programs.We developed an FCU curriculum for internal medicine residents and an assessment tool to evaluate the impact of the curriculum on trainee knowledge and confidence. Internal medicine residents rotating through clinical cardiology services underwent 30 minutes of didactic and 60 minutes of hands-on teaching on acquisition and interpretation of FCU. A 20 item pre and post-curriculum online survey was administered (November 2018-December 2019) to assess confidence and knowledge in FCU. 79 of 116 (68%) residents completed the pre-survey and 50 completed the post-survey, of whom 34 received the curriculum. The mean change in confidence score in those who received versus did not receive the curriculum was 0.99 versus 0.39 (p=0.046) on a 5-point Likert scale. Among 33 residents who had paired pre- and post-surveys the mean change in confidence score was 1.2 versus 0.85 (p<0.001) in those who received versus did not receive the curriculum. The mean increase in knowledge score was 13% versus 7% respectively (p<0.0001). We instituted a novel curriculum for internal medicine residents to gain experience in image acquisition and interpretation. Both confidence and knowledge in FCU improved following the curriculum, indicating that this is a highly teachable skill. Additional analysis of the of the FCU study images will be useful for informing future interventions.
聚焦心脏超声（FCU）对内科医生而言是一种安全且高效的诊断手段。FCU是一项极易传授的技能，但在接受调查的培训项目中，仅有20%将其用于常规心脏评估。我们为内科住院医师开发了一套FCU课程以及一种评估工具，以评估该课程对学员知识和信心的影响。轮转至临床心脏病服务科室的内科住院医师接受了30分钟的理论教学以及60分钟关于FCU采集和解读的实践教学。在2018年11月至2019年12月期间，进行了一项包含20个项目的课程前后在线调查，以评估对FCU的信心和知识。116名住院医师中有79名（68%）完成了课前调查，50名完成了课后调查，其中34名接受了该课程。在5分制李克特量表上，接受课程与未接受课程者的信心得分平均变化分别为0.99和0.39（p = 0.046）。在33名进行了配对课前和课后调查的住院医师中，接受课程与未接受课程者的信心得分平均变化分别为1.2和0.85（p<0.001）。知识得分的平均增幅分别为13%和7%（p<0.0001）。我们为内科住院医师设立了一门新颖的课程，使其获得图像采集和解读方面的经验。课程结束后，住院医师对FCU的信心和知识均有所提高，表明这是一项极易传授的技能。对FCU研究图像的进一步分析将有助于为未来的干预措施提供信息。
