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      Skills acquisition for novice learners after a point-of-care ultrasound course: does clinical rank matter?

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          Abstract

          Background

          Few studies have compared the effectiveness of brief training courses on point-of-care ultrasound (POCUS) skill acquisition of novice attending physicians vs. trainees. The purpose of this study was to evaluate the change in POCUS image interpretation skills and confidence of novice attending physicians vs. trainees after a 1-day POCUS training course.

          Methods

          A 1-day POCUS training course was held in March 2017 in Japan. A standardized training curriculum was developed that included online education, live lectures, and hands-on training. The pre-course assessment tools included a written examination to evaluate baseline knowledge and image interpretation skills, and a physician survey to assess confidence in performing specific ultrasound applications. The same assessment tools were administered post-course, along with a course evaluation. All learners were novices and were categorized as trainees or attending physicians. Data were analyzed using two-way analysis of variance.

          Results

          In total, 60 learners attended the course, and 51 learners (85%) completed all tests and surveys. The 51 novice learners included 29 trainees (4 medical students, 9 PGY 1–2 residents, 16 PGY 3–5 residents) and 22 attending physicians (6 PGY 6–10 physicians, and 16 physicians PGY 11 and higher). The mean pre- and post-course test scores of novice trainees improved from 65.5 to 83.9% while novice attending physicians improved from 66.7 to 81.5% ( p < 0.001). The post-course physician confidence scores in using ultrasound significantly increased in all skill categories for both groups. Both trainees and attending physicians demonstrated similar improvement in their post-course test scores and confidence with no statistically significant differences between the groups. The course evaluation scores for overall satisfaction and satisfaction with faculty members’ teaching skills were 4.5 and 4.6 on a 5-point scale, respectively.

          Conclusions

          Both novice trainees and attending physicians showed similar improvement in point-of-care ultrasound image interpretation skills and confidence after a brief training course. Although separate training courses have traditionally been developed for attending physicians and trainees, novice learners of point-of-care ultrasound may acquire skills at similar rates, regardless of their ranking as an attending physician or trainee. Future studies are needed to compare the effectiveness of short training courses on image acquisition skills and determine the ideal course design.

          Electronic supplementary material

          The online version of this article (10.1186/s12909-018-1310-3) contains supplementary material, which is available to authorized users.

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          Most cited references28

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          Point-of-care ultrasonography.

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            Guidelines for the Appropriate Use of Bedside General and Cardiac Ultrasonography in the Evaluation of Critically Ill Patients-Part I: General Ultrasonography.

            To establish evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the ICU and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck, and extremities.
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              Medical education in Japan.

              There are 79 medical schools in Japan--42 national, 8 prefectural (i.e., founded by a local government), and 29 private--representing approximately one school for every 1.6 million people. Undergraduate medical education is six years long, typically consisting of four years of preclinical education and then two years of clinical education. High school graduates are eligible to enter medical school. In 36 schools, college graduates are offered admission, but they account for fewer than 10% of the available positions. There were 46,800 medical students in 2006; 32.8% were women. Since 1990, Japanese medical education has undergone significant changes, with some medical schools implementing integrated curricula, problem-based learning tutorials, and clinical clerkships. A model core curriculum was proposed by the government in 2001 that outlined a core structure for undergraduate medical education, with 1,218 specific behavioral objectives. A nationwide common achievement test was instituted in 2005; students must pass this test to qualify for preclinical medical education. It is similar to the United States Medical Licensing Examination step 1, although the Japanese test is not a licensing examination. The National Examination for Physicians is a 500-item examination that is administered once a year. In 2006, 8,602 applicants took the examination, and 7,742 of them (90.0%) passed. A new law requires postgraduate training for two years after graduation. Residents are paid reasonably, and the work hours are limited to 40 hours a week. In 2004, a matching system was started; the match rate was 95.6% (46.2% for the university hospitals and 49.4% for other teaching hospitals). Sustained and meaningful change in Japanese medical education is continuing.
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                Author and article information

                Contributors
                makky0118@yahoo.co.jp
                401-729-2635 , taro_minami@brown.edu
                SoniN@uthscsa.edu
                eijih@jadecom.jp
                hrtakaha@juntendo.ac.jp
                okubo@rd.dnc.ac.jp
                juichi@med.nagoya-u.ac.jp
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                22 August 2018
                22 August 2018
                2018
                : 18
                : 202
                Affiliations
                [1 ]ISNI 0000 0001 0943 978X, GRID grid.27476.30, Department of General Medicine/Family & Community Medicine, , Nagoya University Graduate School of Medicine, ; Nagoya, Aichi Japan
                [2 ]Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba Japan
                [3 ]Division of Pulmonary and Sleep Medicine, Care New England Medical Group, Primary Care and Specialty Services, 111 Brewster Street, Pawtucket, Rhode Island 02860 USA
                [4 ]ISNI 0000 0004 1936 9094, GRID grid.40263.33, Department of Medicine, the Warren Alpert Medical School of Brown University, ; Providence, RI USA
                [5 ]ISNI 0000000121845633, GRID grid.215352.2, Division of General & Hospital Medicine, , University of Texas Health San Antonio, ; San Antonio, TX USA
                [6 ]ISNI 0000 0004 1762 2738, GRID grid.258269.2, Department of General Medicine, , Juntendo University Faculty of Medicine, ; Tokyo, Japan
                [7 ]ISNI 0000 0004 0620 4696, GRID grid.460033.2, Research Division, , The National Center for University Entrance Examinations, ; Tokyo, Japan
                Author information
                http://orcid.org/0000-0001-7373-939X
                Article
                1310
                10.1186/s12909-018-1310-3
                6106885
                30134975
                6f49bc4f-97cc-4e89-9ee2-fff975df8f41
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 November 2017
                : 10 August 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100007181, Quality Enhancement Research Initiative;
                Award ID: HX002263-01A1
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Education
                point-of-care ultrasound,education,effectiveness,trainees,attending physician
                Education
                point-of-care ultrasound, education, effectiveness, trainees, attending physician

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