Leidi Antonio, Krauer Juliette, Soret Guillaume, Parent Thibault, Marti Christophe, Meyer Philippe, Juillerat André, Bex Stijn, Suh Noémie, Rouyer Frédéric, Siegenthaler Nils, Grosgurin Olivier
Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.
J Ultrasound. 2025 Mar;28(1):1-9. doi: 10.1007/s40477-024-00968-8. Epub 2024 Dec 3.
In recent years, point-of-care ultrasonography (POCUS) has been integrated into internal medicine practice with most curricula composed of a single course. Despite competency acquisition during the course, a significant decline in proficiency occurs in the subsequent weeks due to a lack of regular practice and training. This study aims to evaluate the impact of a structured POCUS tutoring, on POCUS use and skills retention at 6 months.
In this randomized controlled trial, internal medicine residents were enrolled after completing a practical course focused on heart and lung ultrasonography. Residents assigned to the intervention group were paired with a tutor, and time slots were scheduled for bedside direct supervision over the following 6 months. The primary outcome was the proportion of residents who successfully completed at least 25 POCUS examinations six months after inclusion. Secondary outcomes included self- and blinded-expert-assessed POCUS competency skills.
Between January and May 2022, 23 residents were included in the study. The intervention significantly increased the proportion of participants reaching the primary outcome (70% versus 0%; p < 0.001) with a median of 27 (interquartile range, IQR, 6 to 44) supervised examinations performed versus 0 (IQR 0 to 0) in intervention and control arm respectively; p < 0.001. After 6 months, proficiency was higher for most heart imaging but not for lung imaging, as assessed through self-assessment by participants or independently by blinded experts.
Structured POCUS supervision significantly enhances the number of POCUS examinations and proficiency at 6-months, particularly in applications requiring greater visuospatial skills.
近年来，即时超声检查（POCUS）已被纳入内科实践，大多数课程仅由一门课程组成。尽管在课程期间获得了相应能力，但由于缺乏定期练习和培训，在随后的几周内熟练程度会显著下降。本研究旨在评估结构化POCUS辅导对6个月时POCUS使用情况和技能保持的影响。
在这项随机对照试验中，内科住院医师在完成一门专注于心肺超声检查的实践课程后入组。分配到干预组的住院医师与一名导师配对，并安排在接下来的6个月里进行床边直接监督。主要结局是入组6个月后成功完成至少25次POCUS检查的住院医师比例。次要结局包括自我评估和由不知情专家评估的POCUS能力技能。
2022年1月至5月期间，23名住院医师纳入研究。干预显著提高了达到主要结局的参与者比例（70%对0%；p<0.001），干预组和对照组分别进行的监督检查中位数为27次（四分位间距，IQR，6至44）和0次（IQR 0至0）；p<0.001。6个月后，通过参与者自我评估或不知情专家独立评估发现，大多数心脏成像的熟练程度较高，但肺部成像的熟练程度并非如此。
结构化POCUS监督显著提高了6个月时POCUS检查的次数和熟练程度，尤其是在需要更高视觉空间技能的应用中。
