Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training.
Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training.
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DOI：
10.1186/s13089-018-0103-6
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发表时间：
2018-09-03
影响因子：
--
通讯作者：
Laursen CB
中科院分区：
文献类型：
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作者：
Pietersen PI;Madsen KR;Graumann O;Konge L;Nielsen BU;Laursen CB
临床肺部超声检查广泛用于呼吸困难或呼吸衰竭患者的初步评估或监测。尽管越来越多地实施，但在教育、能力评估和认证方面没有达成国际共识。今天，培训通常是基于掌握学习的概念，但往往是非结构化的，并受到临床日常生活中忙碌的限制。本系统综述的目的是提供已发表的临床肺部超声学习研究的概述，并为肺部超声教育和认证的未来建议收集证据。根据PRISMA指南，检索了三个数据库（PubMed、Embase、科克伦图书馆），两名评审员检查了结果的合格性。根据牛津循证医学中心和科克伦偏倚风险评估协作工具的指南，对纳入的出版物进行了描述和偏倚风险的证据等级评估。在筛选的7796项研究中，纳入了16项研究。确定了12项前后试验研究、3项描述性研究和1项随机对照试验。七项研究包括基于网络或在线方式，而其余的使用教学或课堂讲座。12项（75%）研究提供了实践课程，其中11项评估了参与者的实践技能。所使用的研究均未验证书面或实际评估。最高证据评分为2分（n = 1），其余评分为4分（n = 15）。16项研究中有11项（68.75%）的偏倚风险被评估为高。所有的教育方法都证明了在超声课程中获得的理论和实践知识的增加，但所纳入的研究在设置，学习和评估方法以及结果测量方面存在实质性差异。根据目前已发表的研究，不可能为临床肺部超声的未来教育和认证制定明确的指导方针，但使用不同的实践培训设施往往有助于学习过程的不同方面。这项系统性审查证明该内容缺乏学习研究，需要进行经过验证的理论和实践测试来进行评估的研究。
Clinical lung ultrasound examinations are widely used in the primary assessment or monitoring of patients with dyspnoea or respiratory failure. Despite being increasingly implemented, there is no international consensus on education, assessment of competencies, and certification. Today, training is usually based on the concept of mastery learning, but is often unstructured and limited by bustle in a clinical daily life. The aim of the systematic review is to provide an overview of published learning studies in clinical lung ultrasound, and to collect evidence for future recommendations in lung ultrasound education and certification. According to PRISMA guidelines, three databases (PubMed, Embase, Cochrane Library) were searched, and two reviewers examined the results for eligibility. Included publications were described and assessed for level of evidence and risk of bias according to guidelines from Oxford Centre for Evidence-Based Medicine and Cochrane Collaboration Tool for Risk of Bias assessment. Of 7796 studies screened, 16 studies were included. Twelve pre- and post-test studies, three descriptive studies and one randomized controlled trial were identified. Seven studies included web-based or online modalities, while remaining used didactic or classroom-based lectures. Twelve (75%) studies provided hands-on sessions, and of these, 11 assessed participants’ hands-on skills. None of the studies used validated neither written nor practical assessment. The highest level of evidence score was 2 (n = 1), remaining scored 4 (n = 15). Risk of bias was assessed high in 11 of 16 studies (68.75%). All educational methods proved increased theoretical and practical knowledge obtained at the ultrasound courses, but the included studies were substantial heterogeneous in setup, learning-, and assessment methods, and outcome measures. On behalf of current published studies, it was not possible to construct clear guidelines for the future education and certification in clinical lung ultrasound, but the use of different hands-on training facilities tends to contribute to different aspects of the learning process. This systematic review proves a lack of learning studies within this content, and research with validated theoretical and practical tests for assessment is desired.