Use of a Pocket-sized Ultrasound Device as an Aid to the Physical Examination for Internal Medicine Residents
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 40
- 试验地点
- 2
- 主要终点
- Comparison of Diagnostic Ability of the Intervention Group's Ultrasound Exam to the Control Group's Physical Exam
研究概览
简要总结
The 40 resident study subjects will be randomized to either receive a training session on use of a pocket-sized ultrasound or to receive training on physical exam skills. Following these sessions the subjects will have the opportunity to practice their skills during clinical rounds at BWH inpatient and outpatient settings. Four weeks after the training session all study subjects will take part in an assessment of their diagnostic skills. During this assessment they will be asked to complete an exam on a patient subject. Those randomized to the ultrasound group will be allowed to use their devices while the control group will use the traditional physical exam. Following the exams, resident study subjects will be asked to indicate whether they detected any of the following abnormalities on their exams: pleural effusion, hepatomegaly, cirrhotic liver, splenomegaly, ascites, aortic stenosis, mitral regurgitation, right atrial pressure, abdominal aortic aneurysm, deep vein thrombosis. Resident study subjects will also complete a questionnaire about the physical exam and use of the ultrasound. Prior to the assessment, all patients will undergo ultrasound by an attending radiologist, and these results will serve as the "gold standard" for our study.
详细描述
II. Specific Aims:
Study population: Internal medicine residents at an academic center
Patient population: A broad population of patients with diverse clinical conditions including cardiac and vascular disease, malignancy, rheumatologic disease, liver disease, renal failure, and others. This population will reflect the diversity of patients seen by internal medicine residents during their training.
Physical findings being studied:
- Abdominal: hepatomegaly, cirrhotic liver, splenomegaly, ascites, abdominal aortic aneurysm
- Lungs: pleural effusion, pneumothorax, paralyzed hemidiaphragm.
- Cardiac: pericardial effusion, mitral regurgitation, tricuspid regurgitation, aortic insufficiency, aortic stenosis, right atrial pressure.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 24 Years 至 35 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •All interns and residents in the BWH internal medicine residency program who responded to a recruitment email and agreed to participate.
排除标准
- •• Radiology Preliminary residents
- •Residents with previous formalized ultrasound training that included a practical component
结局指标
主要结局
Comparison of Diagnostic Ability of the Intervention Group's Ultrasound Exam to the Control Group's Physical Exam
时间窗: one month
The primary outcome is a comparison of the diagnostic ability of the intervention group as recorded after performing an ultrasound exam and the control group using traditional physical examination techniques. We compared the two groups using the average physical findings correctly identified as present or absent as reflected by a "Present Score" (average # of findings identified out of 17 possible findings) and "Absent Score" (average # of findings identified out of 95 possible). The former is a gauge of a resident's ability to correctly identify present abnormalities while the latter is an assessment of correctly identifying a normal examination when findings are absent. The residents used a examination form to indicate whether or not they felt the physical abnormality was present or absent and how confident he or she was in their answer. This was compared with the gold standard which was presence or absence of the abnormality on professional ultrasound.
次要结局
- Improvement in Diagnostic Ability Within the Intervention Group(one month)
研究者
Maria Yialamas
Assistant Professor
Brigham and Women's Hospital