Limits...
Disaster response team FAST skills training with a portable ultrasound simulator compared to traditional training: pilot study.

Paddock MT, Bailitz J, Horowitz R, Khishfe B, Cosby K, Sergel MJ - West J Emerg Med (2015)

Bottom Line: Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training.For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups.For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between training groups.

View Article: PubMed Central - PubMed

Affiliation: John H. Stroger, Jr. Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois.

ABSTRACT

Introduction: Pre-hospital focused assessment with sonography in trauma (FAST) has been effectively used to improve patient care in multiple mass casualty events throughout the world. Although requisite FAST knowledge may now be learned remotely by disaster response team members, traditional live instructor and model hands-on FAST skills training remains logistically challenging. The objective of this pilot study was to compare the effectiveness of a novel portable ultrasound (US) simulator with traditional FAST skills training for a deployed mixed provider disaster response team.

Methods: We randomized participants into one of three training groups stratified by provider role: Group A. Traditional Skills Training, Group B. US Simulator Skills Training, and Group C. Traditional Skills Training Plus US Simulator Skills Training. After skills training, we measured participants' FAST image acquisition and interpretation skills using a standardized direct observation tool (SDOT) with healthy models and review of FAST patient images. Pre- and post-course US and FAST knowledge were also assessed using a previously validated multiple-choice evaluation. We used the ANOVA procedure to determine the statistical significance of differences between the means of each group's skills scores. Paired sample t-tests were used to determine the statistical significance of pre- and post-course mean knowledge scores within groups.

Results: We enrolled 36 participants, 12 randomized to each training group. Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training. For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups. For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between training groups.

Conclusion: This pilot study of a deployed mixed-provider disaster response team suggests that a novel portable US simulator may provide equivalent skills training in comparison to traditional live instructor and model training. Further studies with a larger sample size and other measures of short- and long-term clinical performance are warranted.

No MeSH data available.


Related in: MedlinePlus

SDOT image acquisition scores across groups.SDOT, standardized direct observation tool; US, ultrasoundData are reported as mean with 95% CI. Images were rated by the evaluator on a 1–5 scale (1 – No information provided by the image, 3 – Adequate image to make a clinical decision, 5 – Textbook quality image).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4380391&req=5

f2-wjem-16-325: SDOT image acquisition scores across groups.SDOT, standardized direct observation tool; US, ultrasoundData are reported as mean with 95% CI. Images were rated by the evaluator on a 1–5 scale (1 – No information provided by the image, 3 – Adequate image to make a clinical decision, 5 – Textbook quality image).

Mentions: The primary endpoints of FAST image acquisition assessment scores between training groups are depicted in Figure 2. In each group, the mean image acquisition skills score was above 3 - acceptable to make a clinical decision. An additional ordinal and dependent analysis of image acquisition scores using a Krukal-Wallis test confirmed similarity between all groups. Likewise, mean image interpretation skills score was similar across groups. The mean (± SD) image interpretation score by group was; Group A. 76 ± 6%, Group B. 77 ± 6%, and Group C. 81 ± 6%. The ANOVA procedure did not demonstrate any statistically significant differences between the training groups’ FAST image acquisition or image interpretation skills scores.


Disaster response team FAST skills training with a portable ultrasound simulator compared to traditional training: pilot study.

Paddock MT, Bailitz J, Horowitz R, Khishfe B, Cosby K, Sergel MJ - West J Emerg Med (2015)

SDOT image acquisition scores across groups.SDOT, standardized direct observation tool; US, ultrasoundData are reported as mean with 95% CI. Images were rated by the evaluator on a 1–5 scale (1 – No information provided by the image, 3 – Adequate image to make a clinical decision, 5 – Textbook quality image).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4380391&req=5

f2-wjem-16-325: SDOT image acquisition scores across groups.SDOT, standardized direct observation tool; US, ultrasoundData are reported as mean with 95% CI. Images were rated by the evaluator on a 1–5 scale (1 – No information provided by the image, 3 – Adequate image to make a clinical decision, 5 – Textbook quality image).
Mentions: The primary endpoints of FAST image acquisition assessment scores between training groups are depicted in Figure 2. In each group, the mean image acquisition skills score was above 3 - acceptable to make a clinical decision. An additional ordinal and dependent analysis of image acquisition scores using a Krukal-Wallis test confirmed similarity between all groups. Likewise, mean image interpretation skills score was similar across groups. The mean (± SD) image interpretation score by group was; Group A. 76 ± 6%, Group B. 77 ± 6%, and Group C. 81 ± 6%. The ANOVA procedure did not demonstrate any statistically significant differences between the training groups’ FAST image acquisition or image interpretation skills scores.

Bottom Line: Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training.For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups.For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between training groups.

View Article: PubMed Central - PubMed

Affiliation: John H. Stroger, Jr. Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois.

ABSTRACT

Introduction: Pre-hospital focused assessment with sonography in trauma (FAST) has been effectively used to improve patient care in multiple mass casualty events throughout the world. Although requisite FAST knowledge may now be learned remotely by disaster response team members, traditional live instructor and model hands-on FAST skills training remains logistically challenging. The objective of this pilot study was to compare the effectiveness of a novel portable ultrasound (US) simulator with traditional FAST skills training for a deployed mixed provider disaster response team.

Methods: We randomized participants into one of three training groups stratified by provider role: Group A. Traditional Skills Training, Group B. US Simulator Skills Training, and Group C. Traditional Skills Training Plus US Simulator Skills Training. After skills training, we measured participants' FAST image acquisition and interpretation skills using a standardized direct observation tool (SDOT) with healthy models and review of FAST patient images. Pre- and post-course US and FAST knowledge were also assessed using a previously validated multiple-choice evaluation. We used the ANOVA procedure to determine the statistical significance of differences between the means of each group's skills scores. Paired sample t-tests were used to determine the statistical significance of pre- and post-course mean knowledge scores within groups.

Results: We enrolled 36 participants, 12 randomized to each training group. Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training. For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups. For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between training groups.

Conclusion: This pilot study of a deployed mixed-provider disaster response team suggests that a novel portable US simulator may provide equivalent skills training in comparison to traditional live instructor and model training. Further studies with a larger sample size and other measures of short- and long-term clinical performance are warranted.

No MeSH data available.


Related in: MedlinePlus