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未来的听诊器?

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Why You May Want to Include Point-of-Care Ultrasound in Your Simulations

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

Pocus发现充当诊断难题的一大部分,通常表明了护理途径的下一步。

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.

历史重复……即使在模拟中

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,降低与中央导管插入有关的成本和并发症7,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.
•是基于体验的学习。
•提供不同水平的忠诚度。
• Increases engagement and maximizes retention.
• Allows for debriefing.
• Improves teamwork.

为您的超声培训增添活力

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.

随着Point Pare-Pare Ultrasound快速成为临床检查的扩展,基于模拟的教育是满足新兴教育需求的首选工具,并最终改善了患者的安全性和结果。

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.

Prepare your learners for real-world events with SimMan® 3G PLUS, a fully articulating patient simulator designed... 使用Simman®3GPlus为学习者准备现实世界活动,这是一个完全明确的患者模拟器,设计用于沉浸式培训。具有可互换的面部皮肤,现实的患者处理以及与...一起训练的能力

SimMan® 3G PLUS

Designed to integrate diagnostic ultrasound into simulations. Designed to integrate diagnostic ultrasound into simulations.
通过将Simmom和Mamabirthie结合起来,从模拟中获得最佳状态。放在一个有影响力的模拟中... 通过将Simmom和Mamabirthie结合起来,从模拟中获得最佳状态。将该解决方案放在一个有影响力的模拟工具包中,可以在学习圈的不同阶段使用以支持完整的学习体验。

参考

1American Academy of Emergency Medicine. AAEM clinical practice committee statement: Ultrasound should be integrated into undergraduate medical education curriculum. J Emerg Med. 2015; 49(1):89-90. doi: 10.1016/j.jemermed.2014.12.092
2 Goldstein SR. "President's letter: "Contagious enthusiasm" for ultrasound in medical education." American Institute of Ultrasound Medicine. http://www.aium.org/soundwaves/article.aspx?aId=785&iId=20140626. Published June 26, 2014. Accessed September 1, 2017.
3公园等。医学学习者能否使用高保真超声模拟器来实现Point Pare的超声波能力?:一项试点研究。关键超声杂志2013 5:9
4 Chopra V,Gesink BJ,De Jong J,Bovill JG,Spierdijk J,BrandR。是否培训麻醉模拟器会改善性能?Br J Anaesth 1994;73:293-7。
5 Wayne DB,Didwania A,Feinglass J,Fudala MJ,Barsuk JH,McGaghie WC。基于模拟的教育改善了在学术教学医院的心脏骤停团队回应期间的护理质量:一项病例对照研究。胸2008;133:56-61
6Barsuk JH, McGaghie WC, Cohen ER, O'Leary KJ, Wayne DB. Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Crit Care Med 2009; 37: 2697-701.
7 Bruppacher HR,Alam SK,Leblanc VR,后者D,Naik VN,Savoldelli GL等。基于模拟的培训可改善医生在心脏手术的高风险临床环境中的患者护理方面的表现。麻醉学2010;112:985-92。
8 Abu-Zidan FM, Zayat I, Sheikh M, Mousa I, Behbehani A. Role of ultrasonography in blunt abdominal trauma: A prospective study. Eur J Surg. 1996;162:361–5.[PubMed: 8781916]
9 Passiment M,Sacks H,Huang G.医学教育中的医学模拟:AAMC调查的结果。华盛顿特区;2011年。https://www.aamc.org/download/259760/data/medicalsimulationinmedicaleducationanaamcsurvey.pdf。2017年9月1日访问。
10 Hayden J.在护理教育中使用模拟:国家调查结果。J护士管制。2010; 1(3):52-57。
11. Lewiss,Resa&Hoffmann,Beatrice&Beaulieu,Yanick&Phelan,Mary Beth。(2014)。Point Pare Ultrasound Education模拟和多媒体资源的越来越多的作用。超声医学杂志:美国超声医学研究所官方杂志。doi 33. 27-32。10.7863/Ultra.33.1.27。
12.美国医疗质量委员会(美国);Kohn LT,Corrigan JM,Donaldson MS,编辑。错误是人类:建立更安全的卫生系统。华盛顿(华盛顿特区):国家科学院出版社(美国);2000. 2,《医疗保健错误:死亡和伤害的主要原因》。可从:https://www.ncbi.nlm.nih.gov/books/nbk225187获得

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