Christopher J Smith, Abdulrahman Morad, Christopher Balwanz, Elizabeth Lyden, Tabatha Matthias
{"title":"Prospective evaluation of cardiac ultrasound performance by general internal medicine physicians during a 6-month faculty development curriculum.","authors":"Christopher J Smith, Abdulrahman Morad, Christopher Balwanz, Elizabeth Lyden, Tabatha Matthias","doi":"10.1186/s13089-018-0090-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Point-of-care (POCUS) education is rapidly expanding within medical schools and internal medicine residency programs, but lack of trained faculty is a major barrier. While POCUS training can improve short-term outcomes, knowledge and skills rapidly decay without deliberate practice and feedback. The purpose of this study was to evaluate the performance of focused cardiac ultrasound (FCU) by volunteer general internal medicine (GIM) faculty participating in a longitudinal POCUS curriculum.</p><p><strong>Methods: </strong>Participants: Nine GIM clinician-educators participated in a 6-month POCUS curriculum. Faculty performance was compared to three cardiology fellows. Three diagnostic cardiac sonographers (DCS) were also evaluated and served as the gold standard.</p><p><strong>Evaluation: </strong>the primary outcome was a FCU efficiency score, calculated by dividing image quality score by exam duration. FCU exams were conducted on three standardized patients after completion of an introductory workshop, at 3 months, and at 6 months. Two blinded cardiologists scored the exams.</p><p><strong>Analysis: </strong>mean efficiency scores were compared using a linear mixed effects model, followed by pairwise comparisons using Tukey's test.</p><p><strong>Results: </strong>GIM faculty's FCU efficiency scores were maintained over the 6-month period (2.2, SE 1.0 vs. 3.8, SE 1.0, p = 0.076). Their scores at each session were similar to cardiology fellows (p > 0.69), but inferior to DCSs (p < 0.0001).</p><p><strong>Conclusion: </strong>GIM faculty participating in a POCUS curriculum maintained their FCU performance over 6 months with efficiency scores comparable to experienced cardiology fellows.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"10 1","pages":"9"},"PeriodicalIF":3.6000,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-018-0090-7","citationCount":"8","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Ultrasound Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s13089-018-0090-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 8
Abstract
Background: Point-of-care (POCUS) education is rapidly expanding within medical schools and internal medicine residency programs, but lack of trained faculty is a major barrier. While POCUS training can improve short-term outcomes, knowledge and skills rapidly decay without deliberate practice and feedback. The purpose of this study was to evaluate the performance of focused cardiac ultrasound (FCU) by volunteer general internal medicine (GIM) faculty participating in a longitudinal POCUS curriculum.
Methods: Participants: Nine GIM clinician-educators participated in a 6-month POCUS curriculum. Faculty performance was compared to three cardiology fellows. Three diagnostic cardiac sonographers (DCS) were also evaluated and served as the gold standard.
Evaluation: the primary outcome was a FCU efficiency score, calculated by dividing image quality score by exam duration. FCU exams were conducted on three standardized patients after completion of an introductory workshop, at 3 months, and at 6 months. Two blinded cardiologists scored the exams.
Analysis: mean efficiency scores were compared using a linear mixed effects model, followed by pairwise comparisons using Tukey's test.
Results: GIM faculty's FCU efficiency scores were maintained over the 6-month period (2.2, SE 1.0 vs. 3.8, SE 1.0, p = 0.076). Their scores at each session were similar to cardiology fellows (p > 0.69), but inferior to DCSs (p < 0.0001).
Conclusion: GIM faculty participating in a POCUS curriculum maintained their FCU performance over 6 months with efficiency scores comparable to experienced cardiology fellows.
背景:即时护理(POCUS)教育在医学院和内科住院医师项目中迅速扩展,但缺乏训练有素的教师是一个主要障碍。虽然POCUS培训可以改善短期效果,但如果没有刻意的练习和反馈,知识和技能会迅速衰退。本研究的目的是评估参与纵向POCUS课程的志愿普通内科(GIM)教师聚焦心脏超声(FCU)的性能。方法:参与者:9名GIM临床教育工作者参加了为期6个月的POCUS课程。教员的表现与三位心脏病学研究员进行了比较。三个诊断心脏超声仪(DCS)也被评估并作为金标准。评价:主要结果是FCU效率评分,由图像质量评分除以检查时间计算。在完成介绍性讲习班后、3个月和6个月对3名标准化患者进行FCU检查。两位盲眼心脏病专家为这些考试打分。分析:平均效率评分采用线性混合效应模型比较,两两比较采用Tukey检验。结果:GIM教师的FCU效率得分在6个月内保持不变(2.2,SE 1.0 vs. 3.8, SE 1.0, p = 0.076)。他们在每次会议上的得分与心脏病学研究员相似(p > 0.69),但低于dcs (p结论:参加POCUS课程的GIM教师在6个月内保持其FCU表现,效率得分与经验丰富的心脏病学研究员相当。