Piro Kevin M, Carney Patricia A, Smith Christopher J
Division of Hospital Medicine, Division of General Internal Medicine, Oregon Health & Science University, School of Medicine Portland, OR USA.
School of Medicine, Division of Hospital Medicine, Oregon Health & Science University Portland, OR USA.
POCUS J. 2024 Nov 15;9(2):93-101. doi: 10.24908/pocus.v9i2.17635. eCollection 2024.
Point of care ultrasound (POCUS) is a complex psychomotor skill that requires scaffolded support for skill acquisition. However, the effect of spaced curricular elements on learner POCUS behaviors are not clearly understood. Using a multi-site observational cross-sectional survey study, we measured resident baseline POCUS use, behaviors, and attitudes and then implemented POCUS workflow and just-in-time POCUS curricula during internal medicine resident ward rotations and assessed changes. Self-reported personal and team POCUS use and documentation habits all improved between baseline and the just-in-time teaching. Personal POCUS use correlated with team POCUS use (ρ=0.431; p<0.001) and co-resident POCUS use (ρ=0.242; p=0.035). Attending POCUS use correlated with team POCUS use (ρ=0.523; p< 0.001), but not personal use. Overall, we found moderate, but statistically significant, improvements in reported resident and team performance of POCUS and documentation habits, suggesting that just-in-time interventions may promote POCUS use. Co-learning also appears to be a key influencer for POCUS use.
床旁超声检查（POCUS）是一项复杂的心理运动技能，需要有支架式支持来帮助技能习得。然而，课程元素间隔对学习者POCUS行为的影响尚不清楚。我们采用多地点观察性横断面调查研究，测量住院医师的POCUS基线使用情况、行为和态度，然后在内科住院医师病房轮转期间实施POCUS工作流程和即时POCUS课程，并评估变化情况。自我报告的个人和团队POCUS使用情况以及记录习惯在基线和即时教学之间均有所改善。个人POCUS使用情况与团队POCUS使用情况相关（ρ=0.431；p<0.001），与同组住院医师POCUS使用情况相关（ρ=0.242；p=0.035）。上级医师POCUS使用情况与团队POCUS使用情况相关（ρ=0.523；p<0.001），但与个人使用情况无关。总体而言，我们发现住院医师和团队在POCUS报告表现及记录习惯方面有适度但具有统计学意义的改善，这表明即时干预可能会促进POCUS的使用。共同学习似乎也是POCUS使用的一个关键影响因素。
