Cooper Michael C, Jones Jodi, Pascual Mandy, Field Steven, Rendon Juan M, Kulstad Christine, Dixon Bryant, Pham Tu Kristie, Narayan Aman, Pyle Hunter, Hoang Khiem, Han Anthony, Bahga Dalbir, Pandey Aman, Roppolo Lynn
Department of Pediatrics, Division of Emergency Medicine, University of Texas Southwestern USA.
Department of Emergency Medicine, University of Texas Southwestern USA.
POCUS J. 2022 Apr 21;7(1):171-178. doi: 10.24908/pocus.v7i1.15625. eCollection 2022.
To determine medical student ability to accurately obtain and interpret POCUS exams of varying difficulty in the pediatric population after a short didactic and hands-on POCUS course. Five medical students were trained in four POCUS applications (bladder volume, long bone for fracture, limited cardiac for left ventricular function, & inferior vena cava collapsibility) and enrolled pediatric ED patients. Ultrasound-fellowship-trained emergency medicine physicians reviewed each scan for image quality and interpretation accuracy using the American College of Emergency Physicians' quality assessment scale. We report acceptable scan frequency and medical student vs. Ultrasound-fellowship-trained emergency medicine physician interpretation agreement with 95% confidence intervals (CI). Ultrasound-fellowship-trained emergency medicine physicians graded 51/53 bladder volume scans as acceptable (96.2%; 95% CI 87.3-99.0%) and agreed with 50/53 bladder volume calculations (94.3%; 95% CI 88.1-100%). Ultrasound-fellowship-trained emergency medicine physicians graded 35/37 long bone scans as acceptable (94.6%; 95% CI 82.3-98.5%) and agreed with 32/37 medical student long bone scan interpretations (86.5%; 95% CI 72.0-94.1%). Ultrasound-fellowship-trained emergency medicine physicians graded 116/120 cardiac scans as acceptable (96.7%; 95% CI 91.7-98.7%) and agreed with 111/120 medical student left ventricular function interpretations (92.5%; 95% CI 86.4-96.0%). Ultrasound-fellowship-trained emergency medicine physicians graded 99/117 inferior vena cava scans as acceptable (84.6%; 95% CI 77.0-90.0%) and agreed with 101/117 medical student interpretations of inferior vena cava collapsibility (86.3%; 95% CI 78.9-91.4%). Medical students demonstrated satisfactory ability within a short period of time in a range of POCUS scans on pediatric patients after a novel curriculum. This supports the incorporation of a formal POCUS education into medical school curricula and suggests that novice POCUS learners can attain a measure of competency in multiple applications after a short training course.
为了确定医学生在经过简短的理论和实践相结合的床旁超声课程后，准确获取和解读不同难度的儿科床旁超声检查结果的能力。五名医学生接受了四项床旁超声应用（膀胱容量、长骨骨折、左心室功能的有限心脏检查及下腔静脉塌陷情况）的培训，并纳入了儿科急诊科患者。接受过超声专科培训的急诊医学医生使用美国急诊医师学会的质量评估量表对每次扫描的图像质量和解读准确性进行评估。我们报告了可接受的扫描频率以及医学生与接受过超声专科培训的急诊医学医生解读结果的一致性，并给出95%置信区间（CI）。接受过超声专科培训的急诊医学医生将51/53次膀胱容量扫描评为可接受（96.2%；95%CI 87.3 - 99.0%），并与50/53次膀胱容量计算结果一致（94.3%；95%CI 88.1 - 100%）。接受过超声专科培训的急诊医学医生将35/37次长骨扫描评为可接受（94.6%；95%CI 82.3 - 98.5%），并与32/37次医学生长骨扫描解读结果一致（86.5%；95%CI 72.0 - 94.1%）。接受过超声专科培训的急诊医学医生将116/120次心脏扫描评为可接受（96.7%；95%CI 91.7 - 98.7%），并与111/120次医学生左心室功能解读结果一致（92.5%；95%CI 86.4 - 96.0%）。接受过超声专科培训的急诊医学医生将99/117次下腔静脉扫描评为可接受（84.6%；95%CI 77.0 - 90.0%），并与101/117次医学生下腔静脉塌陷情况解读结果一致（86.3%；95%CI 78.9 - 91.4%）。在经过新的课程培训后，医学生在短时间内对一系列儿科患者的床旁超声扫描表现出了令人满意的能力。这支持将正式的床旁超声教育纳入医学院课程，并表明新手床旁超声学习者在经过短期培训课程后可以在多种应用中达到一定程度的能力。
