Aggarwal Sunil, Shanmugam Reshma, Knight Thomas, Atkin Catherine, Clare Sarbjit, Smallwood Nicholas, Lasserson Daniel
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Sandwell and West Birmingham Hospitals NHS Foundation Trust, Birmingham, UK.
Ultrasound J. 2023 Mar 21;15(1):16. doi: 10.1186/s13089-023-00314-9.
There is an emerging consensus that point-of-care ultrasound is an essential skill in acute care. This is reflected in recent changes to the Acute Internal Medicine curriculum in the UK. The need to develop and maintain specific ultrasound competencies is now a mandatory component of training. There is a degree of uncertainty as to how existing training infrastructure can best accommodate these changes.
Data were obtained from the latest annual Society for Acute Medicine Benchmarking Audit 2021. All Acute Medical Units in the UK are eligible to participate. Data pertaining to the number of ultrasound machines and number of clinicians that regularly use point of care ultrasound were collected. This was used to develop a series of maps demonstrating variation in provision at the national level.
In total, 123 AMUs responded to the questions related to ultrasound prevalence and numbers of trained clinicians. Of these, 78.9% (97/123) reported having access to at least one ultrasound machine. There was at least one clinician that regularly used ultrasound in 81 responding hospitals (65.9%). There was significant geographic heterogeneity in the use of ultrasound and availability of accredited supervisors. At a regional level, ultrasound expertise is typically concentrated within a relatively small number of hospitals.
Geographic variation in the use of ultrasound and availability of registered supervisors represents a significant challenge to ultrasound training provision at the national level. Targeted interventions in areas with less developed training infrastructure, such as regional training hubs may be required to ensure more equitable access to training opportunities.
目前已逐渐形成一种共识，即床旁超声检查是急性护理中的一项基本技能。这一点在英国急性内科课程的近期变化中得到了体现。培养和维持特定超声技能的需求现已成为培训的一项强制性内容。关于现有培训基础设施如何能最佳适应这些变化，存在一定程度的不确定性。
数据来自2021年急性医学学会最新年度基准审计。英国所有急性医疗单元均有资格参与。收集了与超声机器数量以及定期使用床旁超声的临床医生数量相关的数据。以此绘制了一系列地图，展示全国范围内的配备差异。
共有123个急性医疗单元回答了与超声普及率和经过培训的临床医生数量相关的问题。其中，78.9%（97/123）报告可使用至少一台超声机器。81家回复的医院（65.9%）有至少一名临床医生定期使用超声。超声使用情况和经认可的带教老师的可获得性存在显著的地理差异。在区域层面，超声专业知识通常集中在相对少数的医院。
超声使用情况和注册带教老师可获得性的地理差异对全国范围内的超声培训提供构成了重大挑战。可能需要对培训基础设施欠发达地区进行有针对性的干预，例如设立区域培训中心，以确保更公平地获得培训机会。
