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家庭医学住院医师和执业医师对床旁超声的态度、障碍及当前使用情况

Point-of-Care Ultrasound Attitudes, Barriers, and Current Use Among Family Medicine Residents and Practicing Physicians.

作者信息

Ludden-Schlatter Alicia, Kruse Robin L, Mahan Reiana, Stephens Luke

机构信息

University of Missouri Department of Family and Community Medicine, Columbia, MO.

University of Missouri Department of Family and Community Medicine, Ashland, MO.

出版信息

PRiMER. 2023 Apr 26;7:13. doi: 10.22454/PRiMER.2023.967474. eCollection 2023.

Abstract

INTRODUCTION

Point-of-care ultrasound (POCUS) has high interest among learners and educators, but many barriers inhibit training and clinical use. Interest and barriers may differ between educators, trainees, and practicing physicians. This study investigates interest in POCUS, confidence in POCUS skills, and barriers to POCUS use for residents, academic family physicians, and community providers.

METHODS

Online surveys sent to current residents, faculty, and graduates of an academic family medicine residency compared current use, comfort, training, perceived importance, barriers, and interest in future use of POCUS.

RESULTS

Most participants (95.6%) agreed that POCUS was somewhat or extremely important to family medicine. Most participants also reported interest in all POCUS indications, other than obstetrics. Very few (5.4%) reported being extremely comfortable using POCUS. Most residents were somewhat comfortable, whereas most faculty and graduates were not at all comfortable. A majority in each group reported inexperience with equipment and interpreting images as a barrier. One-third of faculty and graduates reported "not billable" as a barrier. Statistically significant differences were found between groups' reports of prior training, current use, and interest in POCUS for obstetrics.

CONCLUSIONS

Family medicine residents, faculty, and community physicians reported high perceived importance of and interest in nonobstetric POCUS, but low comfort level in performing POCUS. Resident and faculty barriers may vary according to practice environment and differing time constraints. Senior faculty may have less POCUS training and comfort using POCUS than residents, highlighting the importance of continuing faculty education.

摘要

引言

即时超声检查(POCUS)在学习者和教育工作者中备受关注,但诸多障碍限制了其培训和临床应用。教育工作者、学员和执业医师对其的兴趣和面临的障碍可能有所不同。本研究调查了住院医师、学术家庭医生和社区医疗服务提供者对POCUS的兴趣、对POCUS技能的信心以及POCUS使用的障碍。

方法

向一所学术家庭医学住院医师培训项目的现任住院医师、教员和毕业生发送在线调查问卷,比较他们对POCUS的当前使用情况、操作舒适度、培训情况、感知重要性、障碍以及对未来使用POCUS的兴趣。

结果

大多数参与者(95.6%)认为POCUS对家庭医学 somewhat 或极其重要。大多数参与者还表示对除产科外的所有POCUS适应症感兴趣。很少有人(5.4%)报告使用POCUS极其舒适。大多数住院医师 somewhat 舒适,而大多数教员和毕业生则完全不舒适。每组中的大多数人报告称设备使用经验不足和图像解读是障碍。三分之一的教员和毕业生报告“无法计费”是障碍。在各组关于POCUS的既往培训、当前使用情况以及对产科POCUS的兴趣报告之间发现了统计学上的显著差异。

结论

家庭医学住院医师、教员和社区医生报告称,非产科POCUS具有较高的感知重要性和兴趣,但执行POCUS的舒适度较低。住院医师和教员面临的障碍可能因实践环境和不同的时间限制而有所不同。资深教员接受的POCUS培训可能比住院医师少,使用POCUS的舒适度也较低,这凸显了持续开展教员教育的重要性。

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本文引用的文献

1
Current State of Point-of-Care Ultrasound Use Within Family Medicine.家庭医学中即时超声的使用现状。
J Am Board Fam Med. 2022 Jul-Aug;35(4):809-813. doi: 10.3122/jabfm.2022.04.220019.
2
Point-of-Care Ultrasound Use by Primary Care Physicians.基层医疗机构医生的即时超声使用情况。
J Am Board Fam Med. 2021 Jul-Aug;34(4):859-860. doi: 10.3122/jabfm.2021.04.200619.

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