麻醉住院期间经食道超声心动图教育的评估。

S. Goldstein, D. Feierman, G. Samayoa, R. Roth, E. Delphin, Yuriy A. Gubenko, Malka Stohl, J. Rimal, Andrei Botea, Ronit Zweig, N. Skubas
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摘要

背景经食道超声心动图可以在非心脏手术期间对患有合并症和/或正在接受与重大血液动力学变化相关的手术的患者进行有用的监测。本研究的目的是调查在麻醉住院期间是否可以获得经食道超声心动图相关知识。方法在机构审查委员会批准后,在两个麻醉学住院项目中进行前瞻性观察性研究。在41周的经食道超声心动图教育课程后,将住院医师的考试成绩与基线进行比较。教育工作者的检查与美国国家超声心动图委员会的晚期围术期经食管超声心动图特殊能力检查进行了验证。结果在41周的疗程后,临床麻醉(CA)-3检查分数比基线增加了12%(P=0.03),CA-2分增加了29%(P=0.007),CA-1成绩提高了25%(P=0.002)。教育工作者考试成绩与特殊能力考试百分位排名之间的Pearson相关系数为0.69(P=0.006)。教育者考试成绩与特种能力考试量表成绩之间的Peason相关系数为0.71(P=0.045)CA类。虽然麻醉学住院医师可以在培训期间学习教学知识,但这需要大量的时间和精力。重要的是对住院患者进行超声心动图方面的教育,为他们进行委员会检查做好准备,并照顾日益老龄化和病情加重的患者群体。需要做进一步的工作来确定提供这种教育的最佳方法。
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Assessment of Didactic Transesophageal Echocardiography Education During Anesthesia Residency.
Background Transesophageal echocardiography can be a useful monitor during noncardiac surgery, in patients with comorbidities and/or undergoing procedures associated with substantial hemodynamic changes. The goal of this study was to investigate if transesophageal-echocardiography-related knowledge could be acquired during anesthesia residency. Methods After institutional review board approval, a prospective observational study was performed in two anesthesiology residency programs. After a 41-week didactic transesophageal-echocardiography-education curriculum residents' exam scores were compared to baseline. The educators' examination was validated against the National Board of Echocardiography's Examination of Special Competence in Advanced Perioperative Transesophageal Echocardiography. Results After the 41-week course, clinical anesthesia (CA)-3 exam scores increased 12% compared to baseline (P = .03), CA-2 scores increased 29% (P = .007), and CA-1 scores increased 25% (P = .002). Pearson correlation coefficient between the educators' exam score and the special competence exam percentile rank was 0.69 (P = .006). Pearson correlation coefficient between the educators' exam score and the special competence exam scaled score was 0.71 (P = .0045). Conclusions The 41-week course resulted in significant increases in exam scores in all 3 CA-classes. While didactic knowledge can be learned by anesthesiology residents during training, it requires significant time and effort. It is important to educate residents in echocardiography, to prepare them for board examinations and to care for the increasingly older and sicker patient population. Further work needs to be done to determine optimal methods to provide such education.
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