Development and Assessment of the Point-of-Care Ultrasound (PoCUS) Teleeducation Curriculum for Hospital-at-home Care: Using Near-Peer Training, Remote Supervision, and High-Fidelity Simulation
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- OSCE total and subscale scores on EPA-based PoCUS
研究概览
简要总结
Since July 2024, the National Health Insurance Administration (NHIA) has been implementing a pilot Hospital-at-Home (HAH) Acute Care Program to curb hospital admissions. Point-of-Care Ultrasound (PoCUS) is considered the most promising imaging tool for this model. Replicating the hospital's familiar environment-its staffing patterns, diagnostic workflows, and medication protocols-in a patient's home or nursing facility is almost impossible, posing a major challenge to care teams. Medical-simulation training offers a solution, yet current PoCUS courses remain organ-based and lack scenario-based simulations that prepare physicians for HAH practice.
This two-year study will create a PoCUS curriculum and outcome-assessment tools tailored to HAH, adapting previously validated Entrustable Professional Activities (EPA) instruments to three HAH scenarios: pneumonia, urinary tract infection, and soft-tissue infection. Year 1 will develop scenario-based simulation courses and matching EPA tools, and train peer instructors who receive full PoCUS instruction for the three scenarios. Year 2 will randomly assign learners to compare two teaching models-peer training with remote supervision and scenario simulation versus traditional PoCUS training-evaluated with an Objective Structured Clinical Examination (OSCE) scored by EPA forms across multiple domains.
The project aims to establish normative standards for PoCUS training and assessment in HAH, confirm the feasibility of peer training with remote supervision, and provide a platform to train HAH medical teams nationwide, including those in rural areas.
详细描述
Background
PoCUS has evolved from hospital-based imaging to bedside diagnostic support, enabling rapid, problem-oriented assessments across trauma, shock, dyspnea, and resuscitation scenarios as portable devices matured in image quality and accessibility.
Recent medical education trends emphasize competency-based medical education (CBME), milestones, and EPAs, requiring structured assessment of indications, image acquisition, interpretation, and integration into management for skill-intensive technologies such as ultrasound.
Near-peer training can scale instruction without loss of effectiveness compared with faculty-led teaching, while remote supervision and simulation address logistical limits. However, online environments can attenuate nonverbal cues, underscoring the need for purposeful instructional design and validated evaluation tools.
Taiwan's National Health Insurance (NHI) launched a HAH pilot program in July 2024 focusing on acute infections-pneumonia, urinary tract infection (UTI), and soft tissue infection-where portable diagnostics and PoCUS can substitute or complement in-hospital imaging for timely home-based decisions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •■ PGY, internal medicine, and family medicine residents at National Taiwan University Hospital.
排除标准
- •■Unwillingness to participate in the study.
研究组 & 干预措施
Remote supervision + Simulation
This group will experience didactics plus near-peer hands-on with remote supervision and scenario simulation (lecture + on-site near-peer instructor hands-on + simulation). The PoCUS teacher will not be physically present but will supervise remotely via video conferencing to monitor and communicate in real-time.
干预措施: Remote supervision + simulation (Other)
Control
This group will follow the conventional teaching model, didactics plus on-site faculty-supervised hands-on (lecture + on-site teacher supervised hands-on).
结局指标
主要结局
OSCE total and subscale scores on EPA-based PoCUS
时间窗: 1 month
The effectiveness of the curriculum will be evaluated approximately one month after completing the PoCUS course for both the experimental and control groups, using OSCE assessments incorporating EPA constructs. The OSCE will be evaluated independently by two reviewers(on site and remote), with the final score calculated as the average of their individual assessments. Students' performance will be analyzed based on their total OSCE scores as well as their scores for each construct of the EPA.
次要结局
- Technology Acceptance Model (TAM) questionnaire total and subscale scores(1 month)
- Post-OSCE survey score(1 month)
- Inter-rater reliability of EPA-based OSCE ratings(1 month)
研究者
National Taiwan University Clinical Trial Center
Attending physician, National Taiwan University Hospital
National Taiwan University Hospital