Premium
Monitoring Personalized Learning Curves for Emergency Ultrasound With Risk‐adjusted Learning‐curve Cumulative Summation Method
Author(s) -
Peyrony Olivier,
Legay Léa,
Morra Ivonne,
Verrat Anne,
Milacic Hélène,
Franchitti Jessica,
Amami Jihed,
Gillet Ariane,
Azarnoush Kouchiar,
Elezi Arben,
Bragança Adélia,
Taboulet Pierre,
Bourrier Pierre,
Fontaine JeanPaul,
RescheRigon Matthieu
Publication year - 2018
Publication title -
aem education and training
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 9
ISSN - 2472-5390
DOI - 10.1002/aet2.10073
Subject(s) - cusum , learning curve , medicine , inferior vena cava , radiology , medical physics , computer science , statistics , mathematics , operating system
Abstract Background Ultrasound ( US ) has been a regular practice in emergency departments for several decades. Thus, train our students to US is of prime interest. Because US image acquisition ability can be very different from a patient to another (depending on image quality), it seems relevant to adapt US learning curves ( LC s) to patient image quality using tools based on cumulative summation ( CUSUM ) as the risk‐adjusted LC CUSUM ( RLC ). Objectives The aim of this study was to monitor LC of medical students for the acquisition of abdominal emergency US views and to adapt these curves to patient image quality using RLC . Methods We asked medical students to perform abdominal US examinations with the acquisition of 11 views of interest on emergency patients after a learning session. Emergency physicians reviewed the student examinations for validation. LC s were plotted and the student was said proficient for a specific view if his LC reached a predetermined limit fixed by simulation. Results Seven students with no previous experience in US were enrolled. They performed 19 to 50 examinations of 11 views each. They achieve proficiency for a median of 9 (6–10) views. Aorta and right pleura views were validated by seven students; inferior vena cava, right kidney, and bladder by six; gallbladder and left kidney by five; portal veins and portal hilum by four; and subxyphoid and left pleura by three. The number of US examinations required to reach proficiency ranged from five to 41 depending on the student and on the type of view. LC showed that students reached proficiency with different learning speeds. Conclusions This study suggests that, when monitoring LC s for abdominal emergency US , there is some heterogeneity in the learning process depending on the student skills and the type of view. Therefore, rules based on a predetermined number of examinations to reach proficiency are not satisfactory.