Clinical utilization of point-of-care ultrasound by junior emergency medicine residents.

IF 1.8 4区医学 Q2 ACOUSTICS

Medical Ultrasonography Pub Date : 2022-08-31 Epub Date: 2022-01-19 DOI:10.11152/mu-3425

Wan-Ching Lien, Chih-Heng Chang, Kah-Meng Chong, Meng-Che Wu, Cheng-Yi Wu, Hsiu-Po Wang

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引用次数: 0

Abstract

Aim: Little is known regarding the actual utilization of point-of-care ultrasound (PoCUS) after training. This study aims to investigate the clinical utilization of PoCUS by first post-graduate year (PGY-1) residents after training.

Material and methods: This prospective study was conducted at the emergency department (ED). A PoCUS curriculum was implemented and the objective structured clinical examination (OSCE) scores were obtained after training. The sonographic examinations performed by the residents were collected. The primary outcomes were the numbers, imaging quality, and accuracy of the sonographic examinations after the curriculum, compared with those before the curriculum.

Results: Two hundred and thirtynine residents participated with the median OSCE score of 4 (IQRs, 4-5) and 170 (71%) used PoCUS during clinical practice. The number that each resident performed increased [before vs. after, 0 (0-1) vs. 3 (0-5), p<0.0001], the image quality was better [before vs. after, 3 (2-3) vs. 3 (3), p<0.0001] and the accuracy improved (before vs. after, 117/129 vs. 730/772, p<0.0001) after the curriculum. The residents were categorized into 4 groups based on the utilization: group 1 performed PoCUS before and after the curriculum; group 2 performed only after the curriculum; group 3 performed only before the curriculum; the last did not use. No significant differences existed in the OSCE score between the 4 groups. Group 1 performed more examinationswith better image quality and groups 1 and 2 used ≥2 applications after the curriculum. However, nearly 30% of residents did not use PoCUS, and "chose other imaging priorities" (40/69, 58%) was the main feedback.

Conclusions: A PoCUS training had a positive impact on the clinical utilization by the novice residents. More than 70% of residents integrated PoCUS into clinical practice and used self-formatted US techniques. The OSCE scores could not predict further utilization.

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初级急诊住院医师对即时超声的临床应用。

目的:关于培训后点护理超声(PoCUS)的实际应用知之甚少。本研究旨在了解研究生一年级(PGY-1)住院医师经过培训后对PoCUS的临床应用情况。材料和方法:本前瞻性研究在急诊科(ED)进行。实施PoCUS课程，培训后获得客观结构化临床检查(OSCE)分数。收集住院医师的超声检查结果。主要观察结果为课程后超声检查的数量、成像质量和准确性，与课程前比较。结果:有239名住院医师参与，其中OSCE评分中位数为4 (IQRs, 4-5)， 170名(71%)住院医师在临床实践中使用PoCUS。每位住院医师的临床应用次数增加了[前后相比，0 (0-1)vs. 3(0-5)]。结论:PoCUS培训对新住院医师的临床应用有积极影响。超过70%的住院医师将PoCUS纳入临床实践，并使用自格式化的US技术。欧安组织的分数不能预测进一步的利用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Ultrasonography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.20

自引率

5.90%

发文量

期刊介绍： The journal aims to promote ultrasound diagnosis by publishing papers in a variety of categories, including editorial letters, original papers, review articles, pictorial essays, technical developments, case reports, letters to the editor or occasional special reports (fundamental, clinical as well as methodological and educational papers). The papers published cover the whole spectrum of the applications of diagnostic medical ultrasonography, including basic science and therapeutic applications. The journal hosts information regarding the society''s activities, scheduling of accredited training courses in ultrasound diagnosis, as well as the agenda of national and international scientific events.