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European Journal of Trauma and Emergency Surgery

Erschienen in:

17.03.2016 | Original Article

Tailored ultrasound learning for acute care surgeons: a review of the MUSEC (Modular UltraSound ESTES Course) project

verfasst von: M. Zago, I. Martinez Casas, J. Pereira, D. Mariani, A. R. Silva, A. Casamassima, E. Barbosa, F. Ferreira, M. Ruesseler, G. A. Bass, L. Ponchietti, F. Butti, M. Marconi, L. F. Pinheiro

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2016

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Abstract

Purpose

The European Society for Trauma and Emergency Surgery (ESTES) identified the need for general and trauma surgeons involved in the management of critically ill surgical patients to embrace and learn both basic and advanced US skills. A steering group was created to address this deficit.

Methods

Modular UltraSound ESTES Course (MUSEC) is a modular blended-learning course. It incorporates pre-test/post-test examinations, pre-course online materials, didactic and interactive lectures, interactive case scenarios discussion with pathological US clips, hands-on practice on healthy volunteer models, and on original phantoms for simulating both pathological US findings and practicing US-guided interventional maneuvers. Four independent modules were provided. Surgical decision-making didactics were also included in the course curriculum. Learning gain (Δ of the rating of pre-test and post-test) was calculated for each module. An anonymous post-course satisfaction survey was also administered (16 questions with a Likert’s 5-point scale of evaluation).

Results

Twenty-three MUSEC Courses were run in a 30 months period, training 416 doctors from 29 countries. A total of 52 modules were delivered. The mean pre-test and post-test grades were 8.3/12 and 10.7/12, respectively, yielding a significant mean learning gain of 28.9 % (p = 0.001). Post-course satisfaction survey got an overall ranking of 4.5/5.

Conclusions

MUSEC is an effective and original educational format, enjoyed by candidates, that fills an educational gap for tailored US education as a procedural skill to acute care surgeons. Ongoing revisions should reduce the current limitations and increase the educational value, in terms of number of modules and post-course credentialing.

Chan BK, Wiseberg-Firtell JA, Jois RH, Jensen K. Audisio RA Localization techniques for guided surgical excision of non-palpable breast lesions. Cochrane Database Syst Rev. 2015;12:CD009206. doi:10.1002/14651858.CD009206.pub2.PubMed

Tsao GJ, Orloff LA. Clinician-performed thyroid ultrasound-guided fine-needle aspiration. Otolaryngol Clin North Am. 2014;47(4):509–18.CrossRefPubMed

Torzilli G, editor. US-guided liver surgery. Berlin: Springer; 2014.

Rozycki GS, Ochsner MG, Jaffin JH, Champion HR. Prospective evaluation of surgeons’ use of ultrasound in the evaluation of trauma patients. J Trauma. 1993;34(4):516–26.CrossRefPubMed

Kirkpatrick AW, Sirois M, Laupland KB, Liu D, Rowan K, Ball CG, Hameed SM, Brown R, Simons R, Dulchavsky SA, et al. Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment With Sonography For Trauma (EFAST). J Trauma. 2004;57(2):288–95.CrossRefPubMed

Scalea TM, Rodriguez A, Chiu WC, Brenneman FD, Fallon WF Jr, Kato K, McKenney MG, Nerlich ML, Ochsner MG, Yoshii H. Focused Assessment with Sonography for Trauma (FAST): results from an international consensus conference. J Trauma. 1999;46(3):466–72.CrossRefPubMed

Martínez Casas I, Casamassima A, Mariani D, Pereira J, Silva R, Pinheiro LF, Zago M. US ESTES Survey. Resultados de una encuesta europea sobre la utilización de la ecografía “point of care” en cirugía de urgencias y trauma. Cir Esp. 2014;92:231–2.

Melniker LA, Leibner E, McKenney MG, Lopez P, Briggs WM, Mancuso CA. Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial. Ann Emerg Med. 2006;48(3):227–35.CrossRefPubMed

Neri L, Storti E, Lichtenstein D. Toward an ultrasound curriculum for critical care medicine. Crit Care Med. 2007;35(5 Suppl):S290–304.CrossRefPubMed

10.

Zago M. Time for a comprehensive ultrasound-enhanced trauma management. Eur J Trauma Emerg Surg. 2009;35:339–40.CrossRefPubMed

11.

Stawicki SP, Bahner DP. Modern sonology and the bedside practitioner: evolution of ultrasound from curious novelty to essential clinical tool. Eur J Trauma Emerg Surg. 2015;41:457–60.CrossRefPubMed

12.

Padalino P, Bomben F, Chiara O, Montagnolo G, Marini A, Zago M, Rebora P. Healing of blunt liver injuries after non-operative management: role of ultrasonography follow-up. Eur J Trauma Emerg Surg. 2009;35:364–70.CrossRefPubMed

13.

Zago M, Mariani D, Casamassima A, Turconi MG, Kurihara H, Luzzana F. Chest XRay can be safely skipped if thoracic US (EFAST) is included in trauma protocol. A prospective study. Eur J Trauma Emerg Surg. 2008;34:55.CrossRef

14.

Zago M, editor. Essential ultrasound for trauma: E-FAST. Ultrasound for acute care surgeons series—first volume. Berlin: Springer; 2014. doi:10.1007/978-88-470-5274-1.

15.

Pereira J, Afonso AC, Constantino J, Matos A, Henriques C, Zago M, Pinheiro LF. Accuracy of ultrasound in the diagnosis of acute cholecystitis with coexistent acute pancreatitis. Eur J Trauma Emerg Surg. 2016. doi:10.1007/s00068-015-0619-4.PubMed

16.

El Sayed MJ, Zaghrini E. Prehospital emergency ultrasound: a review of current clinical applications, challenges, and future implications. Emerg Med Int. 2013;2013:531674.CrossRefPubMedPubMedCentral

17.

Via G, Storti E, Spreafico A, Melniker L, Neri L. Point of care ultrasound for sepsis management in resource-limited settings: time for a new paradigm for global health care. Intensive Care Med. 2012;38(8):1405–7.CrossRefPubMed

18.

Royall NA, et al. Ultrasound-assisted musculoskeletal procedures: a practical overview of current literature. World J Orthop. 2011;2(7):57–66.CrossRefPubMedPubMedCentral

19.

Al-Kadi AS, Gillman LM, Ball CG, Panebianco NL, Kirkpatrick AW. Resuscitative long-bone sonography for the clinician: usefulness and pitfalls of focused clinical ultrasound to detect long-bone fractures during trauma resuscitation. Eur J Trauma Emerg Surg. 2009;35(4):357–63.CrossRefPubMed

20.

Stawicki SP, Adkins EJ, Eiferman DS, Evans DC, Ali NA, Njoku C, Lindsey DE, Cook CH, Balakrishnan JM, Valiaveedan S, Galwankar SC, Boulger CT, Springer AN, Bahner DP. Prospective evaluation of intravascular volume status in critically ill patients: does inferior vena cava collapsibility correlate with central venous pressure? J Trauma Acute Care Surg. 2014;76(4):956–63.CrossRefPubMed

21.

Kelly N, Esteve R, Papadimos TJ, Sharpe RP, Keeney SA, DeQuevedo R, Portner M, Bahner DP, Stawicki SP. Clinician-performed ultrasound in hemodynamic and cardiac assessment: a synopsis of current indications and limitations. Eur J Trauma Emerg Surg. 2015;41(5):469–80.CrossRefPubMed

22.

Frankel HL, Kirkpatrick AW, Elbarbary M, Blaivas M, Desai H, Evans D, Summerfield DT, Slonim A, Breitkreutz R, Price S, Marik PE, Talmor D, Levitov A. Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically Ill patients-part I: general ultrasonography. Crit Care Med. 2015;43(11):2479–502.CrossRefPubMed

23.

Flament JB, Delattre JF, Palot JP, Avisse C, Burde A. Ultrasound-guided percutaneous drainage of intra- peritoneal fluid collections. An experience of a surgical team with 205 patients. Chirurgie. 1991;117(4):298–310.PubMed

24.

Dalziel PJ, Noble VE. Bedside ultrasound and the assessment of renal colic: a review. Emerg Med J. 2013;30(1):3–8.CrossRefPubMed

25.

Gaspari RJ, Dickman E, Blehar D. Learning curve of bedside ultrasound of the gallbladder. J Emerg Med. 2009;37:51–6CrossRefPubMed

26.

Theodoro D, Blaivas M, Duggal S, Snyder G, Lucas M. Real- time B-mode ultrasound in the ED saves time in the diagnosis of deep vein thrombosis (DVT). Am J Emerg Med. 2004;22:197–200.CrossRefPubMed

27.

Ünlüer EE, Yavasi Ö, Eroğlu O, Yilmaz C, Akarca FK. Ultra-sonography by emergency medicine and radiology residents for the diagnosis of small bowel obstruction. Eur J Emerg Med. 2010;17:260–4.CrossRefPubMed

28.

Scheiermann P, Seeger FH, Breitkreutz R. Ultrasound-guided central venous access in adults and children: procedure and pathological findings. Anaesthesist. 2010;59(1):53–61.CrossRefPubMed

29.

Copetti R, Soldati G, Copetti P. Chest sonography: a useful tool to differentiate acute cardiogenic pulmonary edema from acute respiratory distress syndrome. Cardiovasc Ultrasound. 2008;6:16.CrossRefPubMedPubMedCentral

30.

Rippey J, Gawthrope I. Creating thoracic phantoms for diagnostic and procedural ultrasound training. AJUM. 2012;15(2):43–54.

31.

Knowles MS. The modern practice of adult education: from pedagogy to andragogy. 2nd ed. New York: Cambridge Books; 1980.

32.

Heinze A, Procter C. Reflection on the use of blended learning education in a changing environment. In Proceedings of the 2nd international education in a changing environment (ECE) conference, Salford: Education development Unit, University of Salford; 2004. http://www.ece.salford.ac.uk/proceedings/papers/ah_04.rtf.

33.

Hadley J, Kulier R, Zamora J, Coppus SF, Weinbrenner S, Meyerrose B, Decsi T, Horvath AR, Nagy E, Emparanza JI, Arvanitis TN, Burls A, Cabello JB, Kaczor M, Zanrei G, Pierer K, Kunz R, Wilkie V, Wall D, Mol BW, Khan KS. Effectiveness of an e-learning course in evidence-based medicine for foundation (internship) training. J R Soc Med. 2010;103(7):288–94.CrossRefPubMedPubMedCentral

34.

Kulier R, Coppus SF, Zamora J, Hadley J, Malick S, Das K, Weinbrenner S, Meyerrose B, Decsi T, Horvath AR, Nagy E, Emparanza JI, Arvanitis TN, Burls A, Cabello JB, Kaczor M, Zanrei G, Pierer K, Stawiarz K, Kunz R, Mol BW. Khan KS The effectiveness of a clinically integrated e-learning course in evidence-based medicine: a cluster randomised controlled trial. BMC Med Educ. 2009;9:21. doi:10.1186/1472-6920-9-21.CrossRefPubMedPubMedCentral

35.

Cuca C, Scheiermann P, Hempel D, Via G, Seibel A, Barth M, Hirche TO, Walcher F, Breitkreutz R. Assessment of a new e-learning system on thorax, trachea, and lung ultrasound. Emerg Med Int. 2013;2013:145361.CrossRefPubMedPubMedCentral

36.

Röhrig S, Hempel D, Stenger T, Armbruster W, Seibel A, Walcher F, Breitkreutz R. Which learning methods are expected for ultrasound training? Blend learning on trial. Anaesthesist. 2014;63(10):745–52.CrossRef

37.

Lane N, Lahham S, Joseph L, Bahner DP, Fox JC. Ultrasound in medical education: listening to the echoes of the past to shape a vision for the future. Eur J Trauma Emerg Surg. 2015;41(5):461–7.CrossRefPubMed

38.

Villamaria CY, Eliason JL, Napolitano L, Stansfield RB, Spencer JR, Rasmussen TE. Endovascular Skills for Trauma And Resuscitative Surgery (ESTARS) course: curriculum development, content validation, and program assessment. J Trauma Acute Care Surg. 2014;76:929–36.CrossRefPubMed

39.

Sisley AC, Johnson SB, Ericson W, Fortune JB. Use of an Objective Standardized Clinical Examination (OSCE) for assessment of physician performance in the ultrasound evaluation of trauma. J Trauma. 1999;47(4):627–31.CrossRefPubMed

40.

Ziesmann MT, Park J, Unger BJ, Kirkpatrick AW, Vergis A, Logsetty S, Pham C, Kirschner D, Gillman LM. Validation of the quality of ultrasound imaging and competence (QUICk) score as an objective assessment tool for the FAST examination. J Trauma Acute Care Surg. 2015;78(5):1008–13.CrossRefPubMed

41.

Ziesmann MT, Park J, Unger B, Kirkpatrick AW, Vergis A, Pham C, Kirschner D, Logestty S. Gillman LM. Validation of hand motion analysis as an objective assessment tool for the Focused Assessment with Sonography for Trauma examination. J Trauma Acute Care Surg. 2015;79:631–7.

Titel: Tailored ultrasound learning for acute care surgeons: a review of the MUSEC (Modular UltraSound ESTES Course) project
verfasst von: M. Zago
I. Martinez Casas
J. Pereira
D. Mariani
A. R. Silva
A. Casamassima
E. Barbosa
F. Ferreira
M. Ruesseler
G. A. Bass
L. Ponchietti
F. Butti
M. Marconi
L. F. Pinheiro
Publikationsdatum: 17.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 2/2016
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-016-0651-z

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