KISA BİR EĞİTİM MODÜLÜ KULLANILARAK ACİL TIP ASİSTANLARI TARAFINDAN SOL VENTRIKÜL DUVAR HAREKET ANORMALLİKLERİNİN BELİRLENMESİ

Abstract

Giriş: Duvar hareket anormalliklerinin acil servis hekimleri (ASH) tarafından değerlendirilmesi yeni bir konudur ve henüz acil ultrason kılavuzlarına dahil edilmemiştir. Bu çalışmanın amacı, kısa bir eğitim modülünün (STM) ASH'lerin duvar hareketi anormalliklerini tanıma becerisine katkısını değerlendirmektir. Gereç ve Yöntemler: Bu prospektif deneysel çalışma üçüncü basamak bir eğitim ve araştırma hastanesinin acil servisinde yürütülmüştür. Çalışmaya 1-3 yıllık mezuniyet sonrası eğitim programına dahil olan ASH'leri dahil edildi. Çalışma için otuz dakikalık duvar hareket hatası anormalliğini içeren video destekli kısa bir STM oluşturuldu. Normal ve duvar hareket kusuru patolojilerini içeren otuz soruluk bir test hazırlandı. Asistanlar eğitimden önce (ön test), eğitimden hemen sonra (son test) ve bir ay sonra (son test) olmak üzere üç teste tabi tutuldu ve testleri karşılaştırmak için ANOVA kullanıldı. Post-hoc analizlerde, istatistiksel anlamlılık değerini hesaplamak için Bonferroni testi kullanılmıştır (0.05/3=0.016), 0.016 değeri istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: Çalışmaya 23 ASH dahil edilmiştir. Asistanlar eğitim öncesi ön testlerde 90 sorudan ortalama 50±12'sini, son testte 70±12'sini ve bir ay sonra 63±12'sini doğru yanıtlamıştır. Kısa eğitim modelinin asistanların duvar hareket kusurlarını tanıması üzerinde istatistiksel olarak anlamlı bir etkisi vardı (p<0.001). Post-hoc analizinde öntest ve son-test puanları arasında anlamlı bir fark vardı(p<0.001). Sonuç: Tüm duvar hareket kusurlarını ve normal duvar hareketini içeren 30 dakikalık kısa eğitim modeli, ASH'lerin duvar hareket anormalliklerini görsel olarak tanımaları için etkili bir eğitim yöntemi olarak bulundu.

Keywords

• Hasta başı ultrason
• eğitim
• acil tıp
• odaklanmış kardiyak ultrason
• miyokard enfarktüsü

THE DETERMINATION OF LEFT VENTRICULAR WALL MOTION ABNORMALITY BY EMERGENCY MEDICINE RESIDENTS USING A BRIEF TRAINING MODULE

Abstract

Introduction: Evaluation of wall motion abnormalities by emergency physicians (EP) is a new subject and has not yet been included in emergency ultrasound guidelines. This study aims to evaluate the contribution of a short training module (STM) to the ability of EPs to recognize wall motion abnormalities. Material and Methods: This prospective experimental study was conducted in the emergency department of a tertiary training and research hospital. EPs who were included in the 1-3-year postgraduate education program were included in the study. For the study, a short video-supported STM containing the thirty-minute wall motion error abnormality was created. A thirty-question test, including normal and wall motion defects, was prepared. The residents were subjected to three tests before the training (pre-test), immediately after the training (post-test), and one month after (final test). ANOVA was used to compare the tests. In post-hoc analyses, the Bonferroni test was used to calculate the statistical significance value (0.05/3=0.016), a value of 0.016 was considered statistically significant. Results: 23 EMRs were included in the study. The residents answered an average of 50±12 of 90 questions correctly in the pre-tests before the training, 70±12 questions in the post-test, and 63±12 questions one month later. The short training model had a statistically significant effect on residents' recognition of wall motion defects (p<0.001). There was a significant difference between pre-test and post-test scores in post-hoc analysis (p<0.001). Conclusion: The short 30-minute training model, which includes all wall motion defects and normal wall motion, was found to be an effective training method for EPs to visually recognize wall motion abnormalities

Keywords

• Bedside ultrasound
• education
• emergency medicine
• focused cardiac ultrasoun
• myocardial infarction

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