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首页> 外文期刊>Medical education >Faculty staff-guided versus self-guided ultrasound training for internal medicine residents
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Faculty staff-guided versus self-guided ultrasound training for internal medicine residents

机译：教职员工对内科医师进行超声引导和自我引导超声培训

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Objectives: Ultrasonography is of growing importance within internal medicine (IM), but the optimal method of training doctors to use it is uncertain. In this study, the authors provide the first objective comparison of two approaches to training IM residents in ultrasonography. Methods: In this randomised trial, a simulation-based ultrasound training curriculum was implemented during IM intern orientation at a tertiary care teaching hospital. All 72 incoming interns attended a lecture and were given access to online modules. Interns were then randomly assigned to a 4-hour faculty-guided (FG) or self-guided (SG) ultrasound training session in a simulation laboratory with both human and manikin models. Interns were asked to self-assess their competence in ultrasonography and underwent an objective structured clinical examination (OSCE) to assess their competence in basic and procedurally oriented ultrasound tasks. The primary outcome was the score on the OSCE. Results: Faculty-guided training was superior to self-guided training based on the OSCE scores. Subjects in the FG training group achieved significantly higher OSCE scores on the two subsets of task completion (0.9-point difference, 95% confidence interval [CI] 0.27-1.54; p = 0.008) and ultrasound image quality (2.43-point difference, 95% CI 1.5-3.36; p < 0.001). Both training groups demonstrated an increase in self-assessed competence after their respective training sessions and there was little difference between the groups. Subjects rated the FG training group much more favourably than the SG training group. Conclusions: Both FG and SG ultrasound training curricula can improve the self-reported competence of IM interns in ultrasonography. However, FG training was superior to SG training in both skills acquisition and intern preference. Incorporating mandatory ultrasound training into IM residencies can address the perceived need for ultrasound training, improve confidence and procedural skills, and may enhance patient safety. However, the optimal training method may require significant faculty input.
机译：目的：超声检查在内部医学（IM）中的重要性越来越高，但是培训医生使用超声检查的最佳方法尚不确定。在这项研究中，作者提供了两种在超声检查中训练IM居民的方法的首次客观比较。方法：在该随机试验中，在三级护理教学医院的IM实习生定向期间实施了基于模拟的超声培训课程。所有72名新来的实习生都参加了一次讲座，并获得了在线课程的访问权限。然后，在模拟实验室中将人和人体模型随机分配给实习生进行为时4小时的教师指导（FG）或自我指导（SG）超声培训。要求实习生对自己的超声检查能力进行自我评估，并进行客观的结构化临床检查（OSCE），以评估他们在基本和以程序为导向的超声任务中的能力。主要结果是OSCE的得分。结果：基于OSCE分数，教师指导的培训优于自我指导的培训。 FG训练组的受试者在任务完成的两个子集（差异为0.9点，95％置信区间[CI]为0.27-1.54; p = 0.008）和超声图像质量（差异为2.43点，为95）上获得了显着更高的OSCE分数。 ％CI 1.5-3.36; p ＜0.001）。两个培训小组在各自的培训课程之后均表现出自我评估的能力的提高，并且两组之间的差异很小。与SG培训组相比，受试者对FG培训组的评价更高。结论：FG和SG超声培训课程均可提高IM实习生自我报告的超声检查能力。但是，在技能获取和实习生偏好方面，FG培训优于SG培训。将强制性超声培训纳入IM住院医师可以解决对超声培训的感知需求，提高信心和操作技能，并可以提高患者安全性。但是，最佳培训方法可能需要大量的教职员工投入。

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