未来的听诊器？

超声不仅用于孕产妇护理实践。自从其扎根于军事和工业环境以来，今天的超声波已成为一系列诊断和治疗应用的重要技术。该用途从确定胎儿的大小和性别来提高针头活检的精度到治疗软组织损伤的准确性不等。此外，床旁的护理超声（POCUS）已演变为在急诊和重症监护医学等环境中的急性护理临床医生工具箱中的宝贵补充。快速，提高诊断准确性，并通过凝结可行的诊断病因清单来为治疗计划提供信息。¹

Herein, we discuss the applications of point-of-care ultrasound as well as why you might want to consider integrating it into your existing simulations.

pocus：需要知道

Acting as one large piece of the diagnostic puzzle, POCUS findings typically indicate the next step in the care pathway.

POCUS can help reinforce core anatomy and physiology concepts, illustrate pathology and disease processes, and facilitate mastery of the physical examination. For these reasons, organizations ranging from the American Academy of Emergency Medicine to the American Institute for Ultrasound in Medicine, have advocated for POCUS as an important element of undergraduate medical education.^{2 3}

但是，有两个警告。首先，Pocus是依赖运营商。对图像获取和解释的信心和能力至关重要，将发现结果纳入临床决策的能力也是如此。⁴在超声波中开发必要的操作员的能力通常被证明是有问题的，因为它目前包括一种需要患者，标准化患者，商业培训模型或尸体的“看一件事，做一种”方法，这些方法都是大笔成本。

Second, today’s ultrasound training typically lacks an emphasis on critical thinking and decision-making components — vital in emergency and intensive care settings.

History Repeats Itself…Even in Simulation

随着现场超声检查成为越来越普遍的成像方式，医学院和居住计划开始将更强大的超声培训纳入课程中。专家不禁要与麻醉教育者的历史相似，他们转向模拟，以便在现实的背景下训练基本技能。

直到1990年代,麻醉学居民面临challenges in achieving clinical competency while maintaining patient safety. Many of the technical and non-technical skills required for anesthesia practice — from difficult airway management and lung separation to effective teamwork — are ideally acquired by exercises and experiences rather than traditional lectures.

高保真模特模拟器和基于模拟的培训的出现有效地解决了这些挑战。发现接受模拟器培训的麻醉居民可以更快地做出反应，表现更好，并且偏离公认的程序。⁵Other researchers reported better cardiopulmonary resuscitation performance⁶, reduction in costs and complications related to central catheter insertion⁷，在模拟培训组中，心肺旁路断奶和卓越的非技术技能的得分较高。

Why is medical simulation training so effective? Experience has shown that simulation…

• Serves as an alternative to a live patient.
• Is experiential learning-based.
• Offers varying levels of fidelity.
• Increases engagement and maximizes retention.
• Allows for debriefing.
• Improves teamwork.

Adding Vitality to Your Ultrasound Training

仿真培训特别适合掌握护理点超声，这是急诊医学和其他专业的核心能力。它是快速，准确，可重复的，具有成本效益，无创的，没有辐射风险，并且可以在稳定和不稳定的患者中使用。它也可以与体格检查，复苏和稳定平行进行，这可以为医学院和居住计划的超声培训增加重要价值。⁹

A survey by the Association of American Medical Colleges found that more than 80% of medical schools had incorporated simulation-based instruction within all four years of their curriculum.¹⁰Among nursing schools, 87% have incorporated simulation-based training with high- or medium-fidelity mannequins within the curriculum.¹¹

Many schools have access to simulation equipment — its use simply has yet to reach full capacity when it comes to ultrasound. That means the majority of today’s chief residents and clinical directors did not experience the value of simulation firsthand in their own ultrasound training, and may not recognize the opportunity it presents to optimize the teaching of this clinical skill.

With point-of-care ultrasound fast becoming an extension of the clinical examination, simulation-based education is the vehicle of choice to meet emerging educational needs, as well as ultimately improving patient safety and outcomes.

通过团队培训解决方案，例如Laerdal Sonosim超声解决方案now available, programs that currently use Laerdal simulators may find they can be expanded to include POCUS training capabilities.