Simulation based Training in Acquiring Images of Diagnostic Quality at the Bedside to Improve Patient Safety

基于模拟的培训，在床边获取诊断质量图像以提高患者安全

• 批准号: 9132178
• 负责人: FLORENCE SHEEHAN
• 金额: $ 25万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9132178
• 关键词: Simulation; based; Training; Acquiring; Images

 DESCRIPTION (provided by applicant): Growing numbers of physicians are adopting point of care ultrasound (POCUS) without having trained in cardiology or radiology. To avoid diagnostic error it is necessary to ensure that they have the requisite skills not only in image acquisition and interpretation, but also in understanding what constitutes diagnostic image quality (DIQ) so that they can identify whether their acquired images are "good enough" to make a diagnosis for a given patient's clinical presentation. The objective of the present proposal is to develop 1) a rubric for quantifying the diagnostic quality of images acquired on live patients, and 2) a safe-POCUS tool that implements the rubric on the Skills Assessment System (SAS), a simulator developed at the University of Washington for training and assessment of ultrasound skill. We will begin with cardiac ultrasound but this technology will be applicable to ultrasound of other organs. The assessment of DIQ bridges the gap in programs that only teach image acquisition and image interpretation. The proposed rubric and safe-POCUS tool will enable efficient training in DIQ, an essential skill that is difficult for physicians to learn from abbreviated POCUS trainin programs. The rubric and safe-POCUS tool will contain weighted criteria not only for DIQ of standard views, but also and more importantly, DIQ required for key diagnoses. We will also develop Dynamic Guidance, a novel instructional tool, to visually demonstrate to physicians how manipulating the transducer and adjusting equipment settings helps achieve DIQ. We will develop a curriculum on the SAS to teach and assess skill in DIQ. We will then assess the impact of the DIQ curriculum on patient safety by comparing the ability of physicians with vs. without DIQ training to correctly distinguish images of adequate vs. inadequate quality for diagnosis. HEALTH CARE BENEFIT: This research is significant for patient safety because competence in acquiring images of diagnostic quality may reduce false negative and false positive diagnoses from POCUS, and help physicians maintain skills over time and on limited patient volumes and thereby enhance the safe and effective utilization of ultrasound in their practices.

 描述(由申请者提供)：越来越多的医生在没有接受过心脏病学或放射学培训的情况下采用了临床点超声(Pocus)。为了避免诊断错误，有必要确保他们不仅在图像采集和解释方面拥有必要的技能，而且在理解什么是诊断图像质量(DIQ)方面也具有必要的技能，以便他们能够确定他们获得的图像是否“足够好”来对给定患者的临床表现做出诊断。本建议的目的是开发1)量化实时患者图像诊断质量的标准，以及2)实施技能评估系统(SAS)标准的安全工具，SAS是华盛顿大学开发的用于培训和评估超声技能的模拟器。我们将从心脏超声开始，但这项技术将适用于其他器官的超声。DIQ的评估弥补了只教授图像获取和图像解释的项目的差距。拟议的评分和安全保护工具将使DIQ方面的培训变得有效，这是一项基本技能，医生很难从简化的Pocus培训计划中学习到。标准和安全保护工具将不仅包含标准视图的DIQ的加权标准，而且更重要的是，关键诊断所需的DIQ。我们还将开发动态指导，这是一种新型的教学工具，向医生直观地演示操作换能器和调整设备设置如何帮助实现DIQ。我们将制定一项关于SAS的课程，以教授和评估DIQ技能。然后，我们将评估DIQ课程对患者安全的影响，方法是比较接受过DIQ培训的医生和没有接受DIQ培训的医生正确区分诊断质量合格和不合格的图像的能力。医疗保健益处：这项研究对患者安全具有重要意义，因为获取诊断质量图像的能力可以减少Pocus的假阴性和假阳性诊断，并帮助医生在有限的患者数量下随着时间的推移保持技能，从而提高超声在临床中的安全和有效利用。