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（由适用提供）：越来越多的医师在没有接受心脏病学或放射学培训的情况下采用护理超声（POCU）。为了避免诊断错误，有必要确保他们不仅具有图像获取和解释中的必要技能，而且还必须了解构成诊断图像质量（DIQ）的构成，以便他们可以确定其获得的图像是否足够“足够好”，以便为给定患者的临床表现做出诊断。本提案的目的是开发1）用于量化现场患者获得图像的诊断质量的标题，以及2）一种安全的pocus工具，该工具实现了技能评估系统（SAS）的标题，这是华盛顿大学开发的模拟器，用于培训和评估超声波技能。我们将从心脏超声波开始，但该技术将适用于其他器官的超声波。 DIQ的评估桥接仅教导图像获取和图像解释的程序中的差距。拟议的专栏和安全登机工具将在DIQ中有效培训，这是一项基本技能，对于医生来说很难从缩写的Pocus Trainin计划中学习。标准视图的DIQ不仅包含加权标准，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，一种新颖的教学工具，以直观地向医生展示如何操纵传感器和调整设备设置有助于实现DIQ。我们将在SAS上开发一门课程，以教授和评估DIQ的技能。然后，我们将通过比较没有DIQ培训的医生与未经DIQ培训的能力正确区分适当的医疗保健图像与医疗保健益处的能力来评估DIQ课程对患者安全的影响：这项研究对患者的安全有很大的影响：因为在诊断质量的诊断质量和有限的患者中，诊断质量的诊断和虚假诊断的能力很重要，并在诊断质量上降低了有限的诊断和限制的效果，并有限地降低了限制的诊断，并在限制的诊断方面有限地进行了有限的能力，并有限地降低了有限的能力，并在诊断质量上有限地降低了效果，并在诊断质量上有限地降低了效果，并有限地降低了限制的诊断能力。超声检查的实践。