Kuperstein Harry, Gada Kunal, Alam Werda, Ahmad Sahar
Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
StatCare Pulmonary, Knoxville, TN, USA.
BMC Med Educ. 2025 Jan 24;25(1):123. doi: 10.1186/s12909-024-06584-8.
There exists no standardized longitudinal curriculum for teaching bedside ultrasonography (US) in Pulmonary and Critical Care Medicine (PCCM) fellowship programs. Given the importance of mastering bedside US in clinical practice, we developed an integrated year-long US curriculum for first-year PCCM fellows.
11 first-year PCCM fellows completed the entire seven-step Blended Learning Curriculum. We provide results from an evaluation of Step I, the initial training course. Evaluation included a 17-question multiple-choice knowledge test and a hands-on skill exam delivered pre-, immediately post-, and 6 months post-course. Performance on these same evaluation measures was compared between learners who completed a traditionally designed curriculum, which contained a formal in-person didactic course, and learners who completed a blended learning curriculum covering the same learning objectives.
All learners showed a significant improvement immediately after the course in both knowledge (p = 0.007) and skills (p = 0.004) with adequate retention of both knowledge and skills after 6 months. Scores on a multiple-choice knowledge test increased from a median (interquartile range [IQR]) of 24% (15-41%) pre-course to a median of 71% (59-82%) post-course, while scores on a hands-on skill exam increased from a median of 16% (7-45%) pre-course to a median of 87% (74-94%) post-course. There was no difference in learning or retention between those who learned via the blended learning model as compared with a more traditional model. Learners agreed the course was well-designed, with relevant learning topics, sufficient time to learn, and fair evaluation modalities. The blended learning model required 15 fewer faculty-hours than the traditional learning model.
A blended learning model for bedside US education implemented at a single PCCM fellowship performs comparably to a traditional model for both acquisition and retention of knowledge and skills. The incorporation of asynchronous learning mitigates the barrier of insufficient time and quantity of US skilled teaching faculty that many PCCM fellowships face and provides flexibility to both instructors and learners.
在肺与重症医学（PCCM）专科培训项目中，不存在用于教授床旁超声检查（US）的标准化纵向课程。鉴于在临床实践中掌握床旁超声检查的重要性，我们为PCCM专科一年级学员制定了一项为期一年的综合超声课程。
11名PCCM专科一年级学员完成了整个七步混合学习课程。我们提供了对第一步（初始培训课程）评估的结果。评估包括一项17道题的多项选择题知识测试和一项在课程前、课程结束后立即以及课程结束后6个月进行的实践技能考试。比较了完成传统设计课程（包含正式的面对面授课课程）的学习者和完成涵盖相同学习目标的混合学习课程的学习者在这些相同评估指标上的表现。
所有学习者在课程结束后立即在知识（p = 0.007）和技能（p = 0.004）方面都有显著提高，并且在6个月后知识和技能都有充分的保留。多项选择题知识测试的分数从课程前的中位数（四分位间距[IQR]）24%（15 - 41%）提高到课程后的中位数71%（59 - 82%），而实践技能考试的分数从课程前的中位数16%（7 - 45%）提高到课程后的中位数87%（74 - 94%）。与传统模式相比，通过混合学习模式学习的学员在学习或知识技能保留方面没有差异。学员们认为该课程设计良好，学习主题相关，有足够的学习时间，评估方式公平。混合学习模式比传统学习模式所需的教师授课时间少15小时。
在单一PCCM专科培训项目中实施的床旁超声教育混合学习模式在知识和技能的获取与保留方面与传统模式表现相当。异步学习的纳入减轻了许多PCCM专科培训项目面临的超声技能教师时间不足和数量不够的障碍，并为教师和学员都提供了灵活性。
