跳过内容
开放导航
672A7139.jpg 672A7139.jpg

未来的听诊器?

Article

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

本文中,我们讨论了“ Pare Point Ultrasound”的应用,以及为什么您可能要考虑将其集成到现有的模拟中。


POCUS: The Need to Know

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

人口可以帮助加强核心解剖学和生理概念,说明病理和疾病过程,并促进体格检查的掌握。由于这些原因,从美国急诊医学学院到美国医学超声研究所的组织都提倡Pocus作为本科医学教育的重要因素。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.

其次,当今的超声培训通常缺乏强调批判性思维和决策组成部分 - 在紧急和重症监护环境中至关重要。

History Repeats Itself…Even in Simulation

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.

直到1990年代,麻醉居民在保持患者安全的同时,在实现临床能力方面面临挑战。理想情况下,通过练习和经验而不是传统的讲座来获得许多麻醉练习所需的许多技术和非技术技能 - 从难以实现的气道管理和肺部分离到有效的团队合作。

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.5其他研究人员报告了更好的心肺复苏性能6, reduction in costs and complications related to central catheter insertion7, higher scores in cardiopulmonary bypass weaning and superior non-technical skills in simulation training groups.

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

•可作为现场患者的替代品。
• Is experiential learning-based.
• Offers varying levels of fidelity.
•增加参与度并最大化保留率。
•允许汇报。
• Improves teamwork.

Adding Vitality to Your Ultrasound Training

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

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.10在护理学校中,有87%的人将基于模拟的培训与课程中的高或中等模特融合在一起。11

许多学校可以使用模拟设备 - 在超声波上,其用途根本没有达到满足。这意味着,当今的主要居民和临床主管中的大多数人没有在自己的超声培训中亲身体验模拟的价值,也可能无法认识到它提供的机会来优化这种临床技能的教学。

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.

With team training solutions such as theLaerdal SonoSim Ultrasound Solution现在可用的是,当前使用Laerdal模拟器的程序可能会发现可以扩展到包括Pocus培训功能。

SimMan 3G PLUS dark manikin.jpg
与Simman®3GPlus一起为学习者做好准备,为现实世界中的活动做准备,这是一个完全明确的患者模拟器设计的... 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®3GPlus

lsus-2-hero.jpg
将模拟器转换为负担得起的超声准备就绪培训解决方案,该解决方案提供了增强的用户体验... 变换你的模拟器变成一个负担得起的,超sound-ready training solution that offers an enhanced user experience integrating real ultrasound images and pathologic findings.
SimMom MB_.jpg
Get the best out of your simulation by combining SimMom and MamaBirthie. Put together in one impactful simulation... Get the best out of your simulation by combining SimMom and MamaBirthie. Put together in one impactful simulation toolkit, this solution can be used at different stages of the Circle of Learning to support a complete learning experience....

References

1美国急诊医学学院。AAEM临床实践委员会声明:超声检查应纳入本科医学教育课程。J Emerm Med。2015;49(1):89-90。doi:10.1016/j.jemermed.2014.12.092
2 Goldstein Sr。“总统的信:“具有医学教育超声波的感染热情”。美国超声医学研究所。http://www.aium.org/soundwaves/article.aspx?aid=785&iid=20140626。2014年6月26日发布。2017年9月1日访问。
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, Brand R. Does training on an anaesthesia simulator lead to improvement in performance? Br J Anaesth 1994; 73: 293-7.
5 Wayne DB, Didwania A, Feinglass J, Fudala MJ, Barsuk JH, McGaghie WC. Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study. Chest 2008; 133: 56-61
6 Barsuk 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, 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.超声检查在钝性腹部创伤中的作用:一项前瞻性研究。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. Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US); 2000. 2, Errors in Health Care: A Leading Cause of Death and Injury. Available from: https://www.ncbi.nlm.nih.gov/books/NBK225187

Baidu