PDF(Pubmed)
Abstract：
BACKGROUND: Point-of-care ultrasound (POCUS) is steadily growing in use in prehospital emergency medicine. While currently used primarily by emergency physicians, POCUS could also be employed by paramedics to support diagnosis and decision-making. Yet to date, no paramedicine-targeted POCUS curricula exist in Germany. Furthermore, given time and resource constraints in paramedic training, it is unclear whether paramedics could feasibly learn POCUS for prehospital deployment. Hence, this study outlines the development and implementation of a comprehensive POCUS curriculum for paramedics. Through this curriculum, we investigate whether paramedics can attain proficiency in POCUS comparable to other user groups.
METHODS: In this prospective observational study, we first developed a blended learning-based POCUS curriculum specifically for paramedics, focusing on basic principles, the RUSH-Protocol and ultrasound guided procedures. Participants underwent digital tests to measure their theoretical competence before (T1) and after the digital preparation phase (T2), as well as at the end of the on-site phase (T3). At time point T3, we additionally measured practical competence using healthy subjects and simulators. We compared the theoretical competence and the practical competence on a simulator with those of physicians and medical students who had also completed ultrasound training. Furthermore, we carried out self-assessment evaluations, as well as evaluations of motivation and curriculum satisfaction.
RESULTS: The paramedic study group comprised n = 72 participants. In the theoretical test, the group showed significant improvement between T1 and T2 (p < 0.001) and between T2 and T3 (p < 0.001). In the practical test on healthy subjects at T3, the group achieved high results (87.0% ± 5.6). In the practical test on a simulator at T3, paramedics (83.8% ± 6.6) achieved a lower result than physicians (p < 0.001), but a comparable result to medical students (p = 0.18). The results of the study group\'s theoretical tests (82.9% ± 9.2) at time point T3 were comparable to that of physicians (p = 0.18) and better than that of medical students (p < 0.01). The motivation and attitude of paramedics towards the prehospital use of POCUS as well as their self-assessment significantly improved from T1 to T3 (p < 0.001). The overall assessment of the curriculum was positive (92.1 ± 8.5).
CONCLUSIONS: With our tailored curriculum, German paramedics were able to develop skills in POCUS comparable to those of other POCUS learners. Integration of POCUS into paramedics\' training curricula offers opportunities and should be further studied.
METHODS: In this prospective observational study, we first developed a blended learning-based POCUS curriculum specifically for paramedics, focusing on basic principles, the RUSH-Protocol and ultrasound guided procedures. Participants underwent digital tests to measure their theoretical competence before (T1) and after the digital preparation phase (T2), as well as at the end of the on-site phase (T3). At time point T3, we additionally measured practical competence using healthy subjects and simulators. We compared the theoretical competence and the practical competence on a simulator with those of physicians and medical students who had also completed ultrasound training. Furthermore, we carried out self-assessment evaluations, as well as evaluations of motivation and curriculum satisfaction.
RESULTS: The paramedic study group comprised n = 72 participants. In the theoretical test, the group showed significant improvement between T1 and T2 (p < 0.001) and between T2 and T3 (p < 0.001). In the practical test on healthy subjects at T3, the group achieved high results (87.0% ± 5.6). In the practical test on a simulator at T3, paramedics (83.8% ± 6.6) achieved a lower result than physicians (p < 0.001), but a comparable result to medical students (p = 0.18). The results of the study group\'s theoretical tests (82.9% ± 9.2) at time point T3 were comparable to that of physicians (p = 0.18) and better than that of medical students (p < 0.01). The motivation and attitude of paramedics towards the prehospital use of POCUS as well as their self-assessment significantly improved from T1 to T3 (p < 0.001). The overall assessment of the curriculum was positive (92.1 ± 8.5).
CONCLUSIONS: With our tailored curriculum, German paramedics were able to develop skills in POCUS comparable to those of other POCUS learners. Integration of POCUS into paramedics\' training curricula offers opportunities and should be further studied.
摘要：
背景：在院前急诊医学中，护理点超声（POCUS）的使用正在稳步增长。虽然目前主要由急诊医生使用，护理人员也可以使用POCUS来支持诊断和决策。到目前为止,德国不存在以辅助医学为目标的POCUS课程。此外，考虑到护理人员培训的时间和资源限制，目前尚不清楚护理人员是否可以合理地学习POCUS进行院前部署.因此，本研究概述了护理人员综合POCUS课程的开发和实施.通过这个课程，我们调查护理人员是否可以达到与其他用户群体相当的POCUS水平.
方法：在这项前瞻性观察研究中，我们首先为护理人员开发了一个基于混合学习的POCUS课程，注重基本原则，RUSH协议和超声引导程序。参与者在数字准备阶段之前（T1）和之后（T2）进行了数字测试，以衡量他们的理论能力，以及在现场阶段（T3）结束时。在时间点T3，我们还使用健康的受试者和模拟器测量了实际能力。我们将模拟器上的理论能力和实践能力与也完成了超声培训的医生和医学生的能力进行了比较。此外，我们进行了自我评估，以及动机和课程满意度的评估。
结果：护理人员研究组包括n=72名参与者。在理论测试中,该组在T1和T2之间（p<0.001）以及T2和T3之间（p<0.001）显着改善。在T3时对健康受试者的实际测试中，该组取得了很高的结果（87.0％±5.6）。在T3的模拟器上进行的实际测试中，护理人员（83.8％±6.6）的结果低于医生（p<0.001）。但结果与医学生相当(p=0.18)。研究组在T3时间点的理论测试结果（82.9％±9.2）与医师相当（p=0.18），优于医学生（p<0.01）。从T1到T3，护理人员对院前使用POCUS的动机和态度以及他们的自我评估显着改善（p<0.001）。课程的总体评估为阳性（92.1±8.5）。
结论：通过我们量身定制的课程，德国护理人员能够发展与其他POCUS学习者相当的POCUS技能。将POCUS纳入护理人员培训课程提供了机会，应进一步研究。
方法：在这项前瞻性观察研究中，我们首先为护理人员开发了一个基于混合学习的POCUS课程，注重基本原则，RUSH协议和超声引导程序。参与者在数字准备阶段之前（T1）和之后（T2）进行了数字测试，以衡量他们的理论能力，以及在现场阶段（T3）结束时。在时间点T3，我们还使用健康的受试者和模拟器测量了实际能力。我们将模拟器上的理论能力和实践能力与也完成了超声培训的医生和医学生的能力进行了比较。此外，我们进行了自我评估，以及动机和课程满意度的评估。
结果：护理人员研究组包括n=72名参与者。在理论测试中,该组在T1和T2之间（p<0.001）以及T2和T3之间（p<0.001）显着改善。在T3时对健康受试者的实际测试中，该组取得了很高的结果（87.0％±5.6）。在T3的模拟器上进行的实际测试中，护理人员（83.8％±6.6）的结果低于医生（p<0.001）。但结果与医学生相当(p=0.18)。研究组在T3时间点的理论测试结果（82.9％±9.2）与医师相当（p=0.18），优于医学生（p<0.01）。从T1到T3，护理人员对院前使用POCUS的动机和态度以及他们的自我评估显着改善（p<0.001）。课程的总体评估为阳性（92.1±8.5）。
结论：通过我们量身定制的课程，德国护理人员能够发展与其他POCUS学习者相当的POCUS技能。将POCUS纳入护理人员培训课程提供了机会，应进一步研究。
