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      Implementation and assessment of a pediatric point-of-care ultrasound training course in Japan: a pilot study

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          Abstract

          Purpose

          The popularity of point-of-care ultrasound (POCUS) has led to the creation of educational guidelines for its use. In Japan, however, a comprehensive training course for POCUS use in pediatric emergency medicine has yet to be developed. The present study aimed to implement a pilot course for pediatric POCUS training in Japan and to compare participants’ self-efficacy level before and after the course.

          Methods

          A half-day training course in pediatric POCUS was implemented at a meeting of the Japan Society of Point-of-Care Ultrasound. A standardized training course, including pre-learning materials, live lectures, and hands-on sessions, was developed based on the US consensus educational guidelines. Physicians interested in pediatric POCUS were recruited for participation and completed a self-evaluation survey before and after the course to access their background, self-efficacy in performing selected ultrasound procedures before and after the course, and their overall satisfaction with the course.

          Results

          In total, 31 physicians participated. Of these, 25 completed the survey. Ten participants were in post-graduate year (PGY) 1–2, 13 were in PGY 3–5, and eight were in PGY 6 or higher. The post-training self-efficacy score was significantly higher than the pre-course assessment score (86.0 [standard deviation (SD): 19.2] vs. 35.6 [SD 17.6], p =  < 0.05, mean difference: 49.6 [95% confidence interval 39.6–61.2]). Furthermore, overall satisfaction with the course was high at 8.6 (SD 1.8).

          Conclusion

          The present study implemented a pilot training course in pediatric POCUS and found the participants’ self-efficacy level to be significantly higher after the course.

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          Most cited references28

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          Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study

          Summary Background Although CT scans are very useful clinically, potential cancer risks exist from associated ionising radiation, in particular for children who are more radiosensitive than adults. We aimed to assess the excess risk of leukaemia and brain tumours after CT scans in a cohort of children and young adults. Methods In our retrospective cohort study, we included patients without previous cancer diagnoses who were first examined with CT in National Health Service (NHS) centres in England, Wales, or Scotland (Great Britain) between 1985 and 2002, when they were younger than 22 years of age. We obtained data for cancer incidence, mortality, and loss to follow-up from the NHS Central Registry from Jan 1, 1985, to Dec 31, 2008. We estimated absorbed brain and red bone marrow doses per CT scan in mGy and assessed excess incidence of leukaemia and brain tumours cancer with Poisson relative risk models. To avoid inclusion of CT scans related to cancer diagnosis, follow-up for leukaemia began 2 years after the first CT and for brain tumours 5 years after the first CT. Findings During follow-up, 74 of 178 604 patients were diagnosed with leukaemia and 135 of 176 587 patients were diagnosed with brain tumours. We noted a positive association between radiation dose from CT scans and leukaemia (excess relative risk [ERR] per mGy 0·036, 95% CI 0·005–0·120; p=0·0097) and brain tumours (0·023, 0·010–0·049; p<0·0001). Compared with patients who received a dose of less than 5 mGy, the relative risk of leukaemia for patients who received a cumulative dose of at least 30 mGy (mean dose 51·13 mGy) was 3·18 (95% CI 1·46–6·94) and the relative risk of brain cancer for patients who received a cumulative dose of 50–74 mGy (mean dose 60·42 mGy) was 2·82 (1·33–6·03). Interpretation Use of CT scans in children to deliver cumulative doses of about 50 mGy might almost triple the risk of leukaemia and doses of about 60 mGy might triple the risk of brain cancer. Because these cancers are relatively rare, the cumulative absolute risks are small: in the 10 years after the first scan for patients younger than 10 years, one excess case of leukaemia and one excess case of brain tumour per 10 000 head CT scans is estimated to occur. Nevertheless, although clinical benefits should outweigh the small absolute risks, radiation doses from CT scans ought to be kept as low as possible and alternative procedures, which do not involve ionising radiation, should be considered if appropriate. Funding US National Cancer Institute and UK Department of Health.
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            Is Open Access

            Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

            The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers.  To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations.  Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.
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              Evaluating training programs, the four levels

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                Author and article information

                Contributors
                takaakimori001019@gmail.com
                Journal
                J Med Ultrason (2001)
                J Med Ultrason (2001)
                Journal of Medical Ultrasonics (2001)
                Springer Singapore (Singapore )
                1346-4523
                1613-2254
                22 October 2021
                : 1-9
                Affiliations
                [1 ]GRID grid.417084.e, ISNI 0000 0004 1764 9914, Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, , Tokyo Metropolitan Children’s Medical Center, ; 2-8-29 Musashidai, Fuchu, Tokyo 183-8561 Japan
                [2 ]GRID grid.257016.7, ISNI 0000 0001 0673 6172, Department of Emergency and Disaster Medicine, , Hirosaki University, ; 5 Zaifu-cho, Hirosaki, Aomori 035-8562 Japan
                [3 ]GRID grid.415413.6, ISNI 0000 0000 9074 6789, Department of Emergency Medicine, , Hyogo Prefectural Kobe Children’s Hospital, ; 1-6-7 Minatojimaminamicho, Chuo-ku, Kobe, 650-0047 Japan
                [4 ]GRID grid.413713.3, ISNI 0000 0004 0378 7726, Department of Pediatrics, , Hyogo Prefectural Awaji Medical Center, ; 1-1-137 Shioya, Sumoto, Hyogo 656-0021 Japan
                [5 ]GRID grid.415020.2, ISNI 0000 0004 0467 0255, Department of Pediatrics, , Jichi Medical University Saitama Medical Center, ; 1-847 Amanuma-cho, Ohmiya-ku, Saitama, 330-8503 Japan
                Author information
                http://orcid.org/0000-0003-0824-3632
                Article
                1155
                10.1007/s10396-021-01155-6
                8532428
                34677709
                52660fd5-c89d-411d-9f81-982ca4fe2c75
                © The Author(s), under exclusive licence to The Japan Society of Ultrasonics in Medicine 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 15 June 2021
                : 17 August 2021
                Categories
                Original Article–Pediatrics

                Radiology & Imaging
                ultrasonography,education,child
                Radiology & Imaging
                ultrasonography, education, child

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