Evaluating a Web-based Point-of-care Ultrasound Curriculum for the Diagnosis of Intussusception.

Autor: Lin-Martore M; Department of Emergency Medicine and Pediatrics University of California San Francisco CA USA., Olvera MP; School of Medicine University of California San Francisco CA USA., Kornblith AE; Department of Emergency Medicine and Pediatrics University of California San Francisco CA USA., Zapala M; Department of Radiology and Biomedical Imaging School of Medicine University of California San Francisco CA USA., Addo N; Department of Emergency Medicine University of California San Francisco CA USA., Lin M; Department of Emergency Medicine University of California San Francisco CA USA., Werner HC; Department of Emergency Medicine and Pediatrics University of California San Francisco CA USA.
Jazyk: angličtina
Zdroj: AEM education and training [AEM Educ Train] 2020 Sep 23; Vol. 5 (3), pp. e10526. Date of Electronic Publication: 2020 Sep 23 (Print Publication: 2021).
DOI: 10.1002/aet2.10526
Abstrakt: Objectives: Intussusception is a pediatric medical emergency that can be difficult to diagnose. Radiology-performed ultrasound is the diagnostic study of choice but may lead to delays due to lack of availability. Point-of-care ultrasound for intussusception (POCUS-I) studies have shown excellent accuracy and reduced lengths of stay, but there are limited POCUS-I training materials for pediatric emergency medicine (PEM) providers.
Methods: We performed a prospective cohort study assessing PEM physicians undergoing a primarily Web-based POCUS-I curriculum. We developed the POCUS-I curriculum using Kern's six-step model. The curriculum included a Web-based module and a brief, hands-on practice that was developed with a board-certified pediatric radiologist. POCUS-I technical skill, knowledge, and confidence were determined by a direct observation checklist, multiple-choice test, and a self-reported Likert-scale survey, respectively. We assessed participants immediately pre- and postcourse as well as 3 months later to assess for retention of skill, knowledge, and confidence.
Results: A total of 17 of 17 eligible PEM physicians at a single institution participated in the study. For the direct observation skills test, participants scored well after the course with a median (interquartile range [IQR]) score of 20 of 22 (20-21) and maintained high scores even after 3 months (20 [20-21]). On the written knowledge test, there was significant improvement from 57.4% (95% CI = 49.8 to 65.2) to 75.3% (95% CI = 68.1 to 81.6; p < 0.001) and this improvement was maintained at 3 months at 81.2% (95% CI = 74.5 to 86.8). Physicians also demonstrated improved confidence with POCUS-I after exposure to the curriculum, with 5.9% reporting somewhat or very confident prior to the course to 76.5% both after the course and after 3 months (p < 0.001).
Conclusion: After a primarily Web-based curriculum for POCUS-I, PEM physicians performed well in technical skill in POCUS-I and showed improvement in knowledge and confidence, all of which were maintained over 3 months.
(© 2020 by the Society for Academic Emergency Medicine.)
Databáze: MEDLINE
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