Bansbach Joachim, Bentele Michael, Bollinger Matthias, Bentele Stefanie, Langenhan Ronny, Gerber Bianka, Trifunovic-Koenig Milena, Bushuven Stefan
Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Training Center for Emergency Medicine (NOTIS e.V), Engen, Germany.
BMC Emerg Med. 2024 Dec 18;24(1):235. doi: 10.1186/s12873-024-01154-z.
Learning motivation is essential to obtain and maintain ultrasound competencies in emergency medicine. One's competencies herein and the need for ongoing training are best evaluated by self-assessment. This may be flawed by overconfidence effects - the belief to be better than others or better than tests reveal. This study aims to clarify the underinvestigated interaction of learning motivation and self-assessment in emergency point-of-care-ultrasound (POCUS).
In this cross-sectional multicenter project, physicians assessed their own and others' competence and learning motivation using the Situational Motivation Scale comprising intrinsic motivation, external and identified regulation, and amotivation. In addition, we presented eight ultrasound loops of different pathologies to emergency physicians of various specialties.
Overall, the motivation to learn was high, while self-assessment showed no significant overconfidence in POCUS. The rate of correct diagnoses based on the loops was relatively low. As a result, we did not detect overconfidence effects in participants who completed questions (n = 86) and tests (n = 56). Overplacing oneself above peers negatively correlated with intrinsic learning motivation and identified regulation and positively correlated to amotivation. Further analyses indicated that learning motivation was associated with the interactions of the physicians' risk perception, speciality, and self-assessment.
The absence of overconfidence effects, the complexity of learning motivation and their interaction show that prior findings in other contexts may not be easily transferable to POCUS and could be highly context-sensitive. In conclusion, this study highlights high levels of learning motivation but relatively low diagnostic accuracy in POCUS, which suggests the need for ongoing education and assessment. Ensuring that physicians continue to receive objective feedback and opportunities to refine their skills is critical for maintaining high standards of care. Despite the small sample size and other limitations of the study, the results primarily served to generate hypotheses for future research on emergency ultrasound education.
学习动机对于在急诊医学中获得并保持超声技能至关重要。通过自我评估能最好地评估一个人在此方面的技能以及持续培训的需求。这可能会受到过度自信效应的影响——即认为自己比他人更好或比测试结果显示的更好。本研究旨在阐明在急诊即时超声检查（POCUS）中学习动机与自我评估之间未得到充分研究的相互作用。
在这个横断面多中心项目中，医生使用情境动机量表评估自己和他人的技能及学习动机，该量表包括内在动机、外部调节和认同调节以及无动机。此外，我们向不同专业的急诊医生展示了八个不同病理情况的超声影像循环。
总体而言，学习动机较高，而自我评估显示在POCUS方面没有显著的过度自信。基于这些影像循环的正确诊断率相对较低。因此，我们在完成问题（n = 86）和测试（n = 56）的参与者中未发现过度自信效应。将自己置于同龄人之上与内在学习动机和认同调节呈负相关，与无动机呈正相关。进一步分析表明，学习动机与医生的风险感知、专业和自我评估之间的相互作用有关。
不存在过度自信效应、学习动机的复杂性及其相互作用表明，其他背景下的先前研究结果可能不易转移到POCUS，并且可能对背景高度敏感。总之，本研究突出了POCUS中较高的学习动机，但诊断准确性相对较低，这表明需要持续的教育和评估。确保医生持续获得客观反馈并获得提升技能的机会对于维持高标准的医疗护理至关重要。尽管本研究样本量小且存在其他局限性，但结果主要用于为未来急诊超声教育研究生成假设。
