Gram Pernille, Purup Thomas, Eriksen Emilie Marie, Søbye Stina, Wielandt Simone Kjaergaard, Astorp Kasper, Jensen Martin Bach, Andersen Camilla Aakjaer
Center for General Practice, Aalborg University, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark.
Institute for Clinical Medicine, Aalborg University Hospital, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark.
BMC Med Educ. 2024 Dec 18;24(1):1489. doi: 10.1186/s12909-024-06510-y.
Point-of-care ultrasound is increasingly used across medical specialties, calling for timely and relevant ultrasound education in specialty training. To enable customizing such education, we aimed to explore medical interns' received ultrasound education during medical school and internship, perceived scanning competencies, evaluation of received education, future expectations for using ultrasound, and tendencies for perceiving ultrasound competence.
This was a national cross-sectional study. We developed a questionnaire based on a theoretical conceptual model, individual interviews with medical interns and focus groups with medical students, followed by pilot testing. The questionnaire was distributed to all medical interns in Denmark (N = 1231). Data were summarized with descriptive statistics. Differences between universities and tendencies for perceiving ultrasound competence were analyzed with Fisher's exact tests and modified Poisson regression, respectively.
Responses from 420 (34.1%) interns were included. Although varying across medical schools, 95.7% received formal ultrasound training and 86.0% encountered ultrasound examinations through clinical rotation. During internship, 44.2% received formal training, while 68.5% had to pursue it independently. Ultrasound examinations during clinical work were observed by 73.2% and performed by 47.6%. Common ultrasound usage barriers were insufficient scanning routine, supervision, knowledge, confidence and mental surplus. Ultrasound competence gain from medical school and internship was reported by 75.2% and 55.3%, respectively, but mainly to lesser/some extent. Most desired more training, expected to use ultrasound in the future (71.0%) and considered it a core competence (73.0%). Perceived ultrasound competence was significantly associated with receiving practical (RR: 4.08) or both practical and theoretical education (RR: 4.34) in medical school, and practical training on patients (RR: 1.09), required number of performed scans (RR: 1.06), competence test(s) (RR: 1.07), and/or consulting books/encyclopedia (RR:1.07) during internship.
Ultrasound training is part of medical school curricula but varies in type and extent. While most encounter and many use ultrasound during internships, formal training is less integrated. Most desire more training and attitudes towards future ultrasound usage are positive. Filled curricula pose dilemmas for prioritization and several barriers prevail for using ultrasound, representing missed opportunities for competence development and maintenance. Training governance and scaffolding continuous learning may be needed.
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床旁超声在各个医学专业中的应用越来越广泛，这就要求在专业培训中提供及时且相关的超声教育。为了能够定制此类教育，我们旨在探讨医学实习生在医学院校学习期间和实习期间接受的超声教育、感知到的扫描能力、对所接受教育的评价、对未来使用超声的期望以及感知超声能力的倾向。
这是一项全国性横断面研究。我们基于一个理论概念模型开发了一份问卷，对医学实习生进行了个人访谈，并与医学生进行了焦点小组讨论，随后进行了预试验。问卷被分发给丹麦所有的医学实习生（N = 1231）。数据用描述性统计进行总结。分别用Fisher精确检验和修正泊松回归分析了不同大学之间的差异以及感知超声能力的倾向。
纳入了420名（34.1%）实习生的回复。尽管不同医学院校情况各异，但95.7%的实习生接受过正规的超声培训，86.0%的实习生通过临床轮转接触过超声检查。在实习期间，44.2%的实习生接受了正规培训，而68.5%的实习生不得不自行学习。73.2%的实习生在临床工作中观察过超声检查，47.6%的实习生进行过超声检查。常见的超声使用障碍包括扫描常规不足、监督不够、知识欠缺、信心不足和精力过剩。分别有75.2%和55.3%的实习生表示在医学院校学习期间和实习期间获得了超声能力，但大多是在较小/一定程度上获得的。大多数实习生希望接受更多培训，预计未来会使用超声（71.0%），并认为超声是一项核心能力（73.0%）。感知到的超声能力与在医学院校接受实践培训（相对风险：RR：4.08）或实践与理论教育（RR：4.34）、在实习期间对患者进行实践培训（RR：1.09）、所需的超声扫描次数（RR：1.06）、能力测试（RR：1.07）和/或查阅书籍/百科全书（RR：1.07）显著相关。
超声培训是医学院校课程的一部分，但在类型和程度上存在差异。虽然大多数实习生在实习期间接触过超声且许多人使用过超声，但正规培训的整合程度较低。大多数实习生希望接受更多培训，对未来使用超声的态度积极。课程安排满导致在优先级确定方面存在困境，并且超声使用存在一些障碍，这意味着在能力发展和维持方面错失了机会。可能需要培训管理和搭建持续学习的框架。
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