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The Stethoscope of the Future?

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

超声波不仅仅用于孕产妇保健practices. Having come a long way since its roots in military and industrial settings, today ultrasound is well-established as a crucial technology across a range of diagnostic and therapeutic applications. The uses vary from determining the size and sex of a fetus to boosting the accuracy of a needle biopsy to treating a soft-tissue injury. Further, bedside point-of-care ultrasound (POCUS) has evolved into a valuable addition to an acute care clinician’s toolbox in settings such as emergency and intensive care medicine. It’s fast, improves diagnostic accuracy and informs treatment plans by condensing the list of viable diagnostic etiologies.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: The Need to Know

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

However, there are two caveats. First, POCUS is operator dependent. Confidence and competence in image acquisition and interpretation are essential, as is the ability to incorporate one’s findings into clinical decision-making.4Developing the necessary operator competence in ultrasound often proves problematic, as it currently consists of a “see one, do one” approach that requires patients, standardized patients, commercial training models or cadavers — all at substantial cost.

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

As point-of-care ultrasound becomes an increasingly prevalent imaging modality, medical schools and residency programs are beginning to incorporate more robust ultrasound training into the curricula. Experts can’t help but draw a parallel to the history of anesthesia educators, who turned to simulation in order to train basic skills in a realistic context.

Until the 1990s, anesthesiology residents faced 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.

The emergence of high-fidelity mannequin simulators and simulation-based training effectively addressed these challenges. Anesthesiology residents trained with simulators were found to respond more quickly, perform better and deviate less from accepted procedures.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, higher scores in cardiopulmonary bypass weaning and superior non-technical skills in simulation training groups.

为什么医疗模拟培训如此有效?经验表明模拟…

• 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.
•改善团队合作。

为您的超声培训增添活力

Simulation training is particularly well-suited for mastering point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. It is rapid, accurate, repeatable, cost-effective, noninvasive and without the risk of radiation, and may be used in both stable and unstable patients. It may also be performed parallel to physical examination, resuscitation and stabilization, which can add significant value to medical schools and residency programs’ ultrasound training.9

美国医学院协会的一项调查发现,超过80%的医学院在课程的所有四年内都纳入了基于模拟的教学。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。

With team training solutions such as theLaerdal SonoSim Ultrasound Solutionnow 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... Prepare your learners for real-world events with SimMan® 3G PLUS, a fully articulating patient simulator designed for immersive training. Featuring interchangeable face skins, realistic patient handling, and the ability to train with...

SimMan® 3G PLUS

Designed to integrate diagnostic ultrasound into simulations. Designed to integrate diagnostic ultrasound into simulations.
结合Simmom和Mamabirthie,从模拟中获得最好的模拟。放在一个有影响力的模拟中... 结合Simmom和Mamabirthie,从模拟中获得最好的模拟。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

1 American 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 Parks, et al. Can medical learners achieve point-of-care ultrasound competency using a high-fidelity ultrasound simulator?: a pilot study. Critical Ultrasound Journal 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
6 Barsuk JH,McGaghie WC,Cohen ER,O'Leary KJ,Wayne DB。基于模拟的精通学习可减少医疗重症监护病房中心静脉导管插入过程中的并发症。Crit Care Med 2009;37:2697-701。
7 Bruppacher HR, Alam SK, LeBlanc VR, Latter D, Naik VN, Savoldelli GL, et al. Simulation-based training improves physicians' performance in patient care in high-stakes clinical setting of cardiac surgery. Anesthesiology 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. Medical Simulation in Medical Education: Results of an AAMC Survey. Washington, DC; 2011. https://www.aamc.org/download/259760/data/medicalsimulationinmedicaleducationanaamcsurvey.pdf. Accessed September 1, 2017.
10 Hayden J. Use of simulation in nursing education: national survey results. J Nurs Regul. 2010;1(3):52–57.
11. Lewiss, Resa & Hoffmann, Beatrice & Beaulieu, Yanick & Phelan, Mary Beth. (2014). Point-of-Care Ultrasound Education The Increasing Role of Simulation and Multimedia Resources. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 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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