ANIMAL LABORATORY TRAINING IMPROVES LUNG ULTRASOUND PROFICIENCY AND SPEED

作者:Oveland Nils Petter*; Lossius Hans Morten; Aagaard Rasmus; Connolly Jim; Sloth Erik; Knudsen Lars
来源:Journal of Emergency Medicine, 2013, 45(3): E71-E77.
DOI:10.1016/j.jemermed.2013.03.029

摘要

Background: Although lung ultrasound (US) is accurate in diagnosing pneumothorax (PTX), the training requirements and methods necessary to perform US examinations must be defined. Objective: Our aim was to test whether animal laboratory training (ALT) improves the diagnostic competency and speed of PTX detection with US. Methods: Twenty medical students without lung US experience attended a 1-day course. Didactic, practical, and experimental lectures covered the basics of US physics, US machines, and lung US, followed by hands-on training to demonstrate the signs of normal lung sliding and PTX. Each student%26apos;s diagnostic skill level was tested with three subsequent examinations (at day 1, day 2, and 6-month follow-up) using experimentally induced PTX in porcine models. The outcome measures were sensitivity and specificity for US detection of PTX, self-reported diagnostic confidence, and scan time. Results: The students improved their skills between the initial two examinations: sensitivity increased from 81.7% (range 69.1%-90.1%) to 100.0% (range 94.3%-100.0%) and specificity increased from 90.0% (range 82.0%-94.8%) to 98.9% (range 92.3%-100.0%); with no deterioration 6 months later. There was a significant learning curve in choosing the correct answers (p = 0.018), a 1-point increase in the self-reported diagnostic confidence (7.8-8.8 on a 10-point scale; p %26lt; 0.05), and a 1-min reduction in the mean scan time per lung (p %26lt; 0.05). Conclusions: Without previous experience and after undergoing training in an animal laboratory, medical students improved their diagnostic proficiency and speed for PTX detection with US. Lung US is a basic technique that can be used by novices to accurately diagnose PTX.

  • 出版日期2013-9