SESSION TYPE: Teaching of Procedures
PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM
PURPOSE: Focused bedside ultrasound is rapidly becoming a standard of care to decrease the risk of complications related to invasive procedures.The purpose of this study was to assess whether adding to the curriculum of junior internal medicine residents an educational intervention combining web-based e-learning and hands-on training using human models and simulators would improve residents’ proficiency in different clinical applications of bedside ultrasound as compared to using the traditional apprenticeship teaching method alone.
METHODS: A prospective cohort study was conducted using two groups of internal medicine residents from two levels of training. A group of junior residents (n=39) were provided with two educational interventions (one on central and peripheral vessels and one on pleural space and lung). Each intervention consisted of a combination of web-based e-learning curriculum and bedside hands-on training. A group of senior residents (n=15) were the traditionally trained group and were not provided with the educational interventions. Knowledge, skills and attitudes were measured between the two groups and used as markers of residents’ competency.
RESULTS: After the educational intervention, performance of the junior residents on the practical tests was dramatically superior to the performance of the senior residents. This was true for the vascular assessment (94%±5 vs 68%±15, unpaired student t test: p<0.0001, mean difference: 26 (95%CI: 20-31)) and also for the pleural assessment (92%±9 vs 57%±25, unpaired student t test: p<0.0001, mean difference: 35 (95%CI: 23-44)). The junior residents also had a significantly higher success rate in performing ultrasound-guided needle insertion compared to senior residents for both the transverse (95% vs 60%, Fisher's exact test p=0.0048) and longitudinal views (100% vs 73%, Fisher's exact test p=0.0055).
CONCLUSIONS: Our study demonstrated that a structured curriculum combining web-based education, hands-on training and simulation integrated early in the training of junior residents can lead to better proficiency in performing ultrasound-guided techniques compared to the traditional apprenticeship model.
CLINICAL IMPLICATIONS: Potential major impact on training of residents and on patient safety.
DISCLOSURE: The following authors have nothing to disclose: Yanick Beaulieu, Jean-Victor Patenaude, Robert Thivierge, Pierre Drolet, Réjean Laprise, Andre Denault, Karim Serri, Martin Albert, Alain Lamontagne, Marc Belliveau
No Product/Research Disclosure InformationHôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada