Heart and lung point-of-care ultrasonography tutoring in internal medicine: a randomized controlled trial.

Autor: Leidi A; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland. Antonio.Leidi@hug.ch.; Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland. Antonio.Leidi@hug.ch., Krauer J; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland., Soret G; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.; Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland., Parent T; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland., Marti C; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland., Meyer P; Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland., Juillerat A; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland., Bex S; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland., Suh N; Division of Intensive Care, Geneva University Hospitals, Geneva, Switzerland., Rouyer F; Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland., Siegenthaler N; Division of Intensive Care, La Tour Hospital, Geneva, Switzerland., Grosgurin O; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.; Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.
Jazyk: angličtina
Zdroj: Journal of ultrasound [J Ultrasound] 2024 Dec 03. Date of Electronic Publication: 2024 Dec 03.
DOI: 10.1007/s40477-024-00968-8
Abstrakt: Purpose: In recent years, point-of-care ultrasonography (POCUS) has been integrated into internal medicine practice with most curricula composed of a single course. Despite competency acquisition during the course, a significant decline in proficiency occurs in the subsequent weeks due to a lack of regular practice and training. This study aims to evaluate the impact of a structured POCUS tutoring, on POCUS use and skills retention at 6 months.
Methods: In this randomized controlled trial, internal medicine residents were enrolled after completing a practical course focused on heart and lung ultrasonography. Residents assigned to the intervention group were paired with a tutor, and time slots were scheduled for bedside direct supervision over the following 6 months. The primary outcome was the proportion of residents who successfully completed at least 25 POCUS examinations six months after inclusion. Secondary outcomes included self- and blinded-expert-assessed POCUS competency skills.
Results: Between January and May 2022, 23 residents were included in the study. The intervention significantly increased the proportion of participants reaching the primary outcome (70% versus 0%; p < 0.001) with a median of 27 (interquartile range, IQR, 6 to 44) supervised examinations performed versus 0 (IQR 0 to 0) in intervention and control arm respectively; p < 0.001. After 6 months, proficiency was higher for most heart imaging but not for lung imaging, as assessed through self-assessment by participants or independently by blinded experts.
Conclusion: Structured POCUS supervision significantly enhances the number of POCUS examinations and proficiency at 6-months, particularly in applications requiring greater visuospatial skills.
Competing Interests: Declarations. Conflict of interest: The authors have no relevant financial or non-financial interests to disclose. Ethical approval: Exemption from ethical approval was confirmed by the local research ethics committee. Informed consent: Informed consent was obtained from all participants prior study inclusion.
(© 2024. The Author(s).)
Databáze: MEDLINE
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