Rocic Petra, Garrison Ryan, Stitle Kyle, Reynolds Austin, Andrews-Dickert Rebecca
Department of Physiology and Pharmacology, College of Osteopathic Medicine, Sam Houston State University, 925 City Central Ave, Conroe, TX, 77304, USA.
BMC Med Educ. 2024 Dec 19;24(1):1493. doi: 10.1186/s12909-024-06513-9.
As Point-of-Care Ultrasound (POCUS) education is increasingly incorporated in undergraduate medical education (UME), evaluation of the effectiveness of various ultrasound-related curricula is a developing field. The Extended Focused Assessment with Sonography (EFAST) is a POCUS exam widely used in emergency medicine. This project examines third-year osteopathic medical (OMS III) students' perceptions of the impact of a focused introduction to EFAST training curriculum on their performance ability and utilization of EFAST during third-year clinical rotations. Furthermore, we assessed student perceptions of barriers to the use of POCUS during third-year clinical rotations.
The introduction to EFAST curriculum was developed using competency-based backward design and was delivered in July 2022 to incoming OMS III students. The curriculum involved didactics, hands-on ultrasound practice with standardized patients, and a comprehensive OSCE assessment, where students performed the EFAST exam. In July/August 2023, curriculum participants were anonymously surveyed regarding the effectiveness of the EFAST curriculum and perceived barriers to EFAST and POCUS utilization during their third-year clerkships. Descriptive and thematic analyses were performed on quantitative and qualitative data.
Twenty-one of 69 (30.4%) participants responded to the survey, with 17 (24.6%) participants completing the entire survey. Respondents reported increased knowledge and confidence in performing and interpreting EFAST, with 82.4% indicating increased likelihood of performing EFAST and POCUS in general. 76.4% performed EFAST at least once during third-year clerkships, with 11.8% performing it 15 times or more. Students reported valuing the safe simulated learning environment of the EFAST training, and identified lack of patients with indications for EFAST, time constraints, lack of ultrasound machine availability and clinician comfort level as barriers to EFAST utilization.
This study presents the implementation of a focused EFAST curriculum developed through competency-based deliberate backward design based on professional guidelines and the anticipated educational needs of our institution and community. Student perceptions provided valuable insight into access and barriers to EFAST and POCUS use in subsequent clinical clerkships, indicating student perception of POCUS curriculum effectiveness may provide insight to continual curriculum improvement.
随着床旁超声(POCUS)教育越来越多地纳入本科医学教育(UME),评估各种超声相关课程的有效性是一个不断发展的领域。超声扩展聚焦评估(EFAST)是一种在急诊医学中广泛使用的POCUS检查。本项目研究了三年级整骨医学学生(OMS III)对EFAST培训课程的集中介绍对其在三年级临床轮转期间的操作能力和EFAST使用情况的影响的看法。此外,我们评估了学生对三年级临床轮转期间使用POCUS的障碍的看法。
EFAST课程介绍采用基于能力的逆向设计开发,并于2022年7月提供给即将入学的OMS III学生。该课程包括教学、与标准化患者进行超声实践操作,以及一项综合客观结构化临床考试(OSCE),学生在其中进行EFAST检查。2023年7月/8月,对课程参与者进行了匿名调查,询问EFAST课程的有效性以及他们在三年级实习期间对EFAST和POCUS使用的感知障碍。对定量和定性数据进行了描述性和主题分析。
69名参与者中有21名(30.4%)回复了调查,其中17名(24.6%)参与者完成了整个调查。受访者表示在进行和解读EFAST方面的知识和信心有所增加,82.4%的人表示总体上进行EFAST和POCUS的可能性增加。76.4%的学生在三年级实习期间至少进行了一次EFAST检查,11.8%的学生进行了15次或更多次。学生们表示重视EFAST培训的安全模拟学习环境,并指出缺乏有EFAST指征的患者、时间限制、超声设备可用性不足以及临床医生的舒适度是EFAST使用的障碍。
本研究介绍了通过基于专业指南以及我们机构和社区预期教育需求的基于能力的精心逆向设计开发的集中式EFAST课程的实施情况。学生的看法为后续临床实习中EFAST和POCUS的使用机会和障碍提供了有价值的见解,表明学生对POCUS课程有效性的看法可能为课程持续改进提供参考。