■目的是开发一种创新的方法来培训急诊医学(EM)住院医师,以执行HINTS的头部脉冲测试(HIT)组件(头部脉冲测试,眼球震颤,倾斜测试)使用视频眼图(VOG)设备反馈进行检查。
■使用运动学习理论的原理和爱立信的专业知识框架,我们开发了一种利用VOG设备反馈的培训创新,以教授HIT所需的头部转动程度(10°-20°)和速度(>100°/s)。我们评估了参与者使用VOG设备执行HIT的技术能力,没有反馈,计算之前20次尝试中成功的HIT数量,紧接着,和2周后的培训创新。参与者在训练前和训练后2周以1至5李克特量表对他们的信心进行评分。
■大多数参与者(14人中的11人,占78%)在训练前的20次尝试中甚至无法进行一次成功的HIT,尽管有关头部转动参数的简短口头和视觉指导。然而,大多数参与者取得了不止一个成功,事实上,至少有五次成功,训练后立即(14个中的13个,93%),训练后2周再次(11个中的9个,82%)。基线测试期间成功HIT的中位数(四分位距)为0(0,平均0.79),7.5(5.8)培训后立即,和10(8.0)训练后2周(p<0.01,Kruskal-Wallis)。中位置信度等级从基线测试前的1.5(1)增加到随访测试后的3(1.5)(p=0.02,Mann-WhitneyU)。
■在运动训练之前,大多数参与者未能正确执行HIT。利用VOG设备的反馈训练可以促进正确执行HIT所需的技能的发展。需要进一步的研究来评估训练HIT和HINTS检查的其他组成部分的解释性方面的能力。
UNASSIGNED: The objective was to develop an innovative method of training emergency medicine (EM) resident physicians to perform the head impulse test (HIT) component of the HINTS (head impulse test, nystagmus, test of skew) examination using video-oculography (VOG) device feedback.
UNASSIGNED: Using principles from motor learning theory and Ericsson\'s framework for expertise, we developed a training innovation utilizing VOG device feedback to teach the degree (10°-20°) and velocity (>100°/s) of head turn required for the HIT. We assessed the technical ability of participants to perform the HIT using the VOG device, without feedback, to count the number of successful HITs out of 20 attempts before, immediately after, and 2 weeks after the training innovation. Participants rated their confidence on a 1 to 5 Likert scale before and 2 weeks after training.
UNASSIGNED: Most participants (11 of 14, 78%) were unable to perform even one successful HIT in 20 attempts before training despite brief verbal and visual instruction regarding the head turn parameters. However, most participants achieved more than one success, in fact, all with at least five successes, immediately after training (13 of 14, 93%) and again 2 weeks after training (nine of 11, 82%). The median (interquartile range) number of successful HITs was 0 (0, mean 0.79) during baseline testing, 7.5 (5.8) immediately after training, and 10 (8.0) 2 weeks after training (p < 0.01, Kruskal-Wallis). The median confidence rating increased from 1.5 (1) before baseline testing to 3 (1.5) after follow-up testing (p = 0.02, Mann-Whitney U).
UNASSIGNED: Prior to motor training, most participants failed to properly perform the HIT. Feedback training with VOG devices may facilitate development of the skills required to properly perform the HIT. Further study is needed to assess the ability to train the interpretive aspect of the HIT and other components of the HINTS examination.