非専門家ユーザーに対する心肺ケア時点超音波検査の仮想カリキュラムと遠隔相談モデルを用いたトレーニング：多施設共同研究

Disparities in access to postgraduate cardiopulmonary point-of-care ultrasound (POCUS) training have limited uptake by nonspecialists in remote care centres. This multicentre pre-post study evaluated the skill improvement of learners after they participated in a longitudinal and virtual POCUS training program.

Nonexpert POCUS users were recruited at urban teaching hospitals and geographically remote hospitals/nursing stations across 4 Canadian provinces. The 3-week educational program consisted of e-learning, independent imaging practice, and point-of-care tele-ultrasound (tele-POCUS) consultations with experts during clinical encounters. Standardized assessments were used to evaluate skill improvement in image acquisition, image quality, and image interpretation for cardiac and lung/pleura POCUS (as measured on a 5-point Likert scale) after program completion and receipt of remotely delivered guidance via tele-POCUS.

Among 29 learners, 17 (41% female) completed the training program, of whom 7 practiced in remote hospitals/nursing stations. For cardiac POCUS, pre- and post-training assessments revealed improvements in image acquisition (mean scores: 3.02 to 4.48, P < 0.01), quality (2.49 to 4.06, P < 0.01), and interpretation (3.03 to 4.44, P < 0.01). Improvements in image acquisition (3.27 to 4.63, P < 0.01), quality (3.25 to 4.53, P < 0.01), and interpretation (3.35 to 4.65, P < 0.01) also occurred for lung/pleura POCUS. A total of 153 tele-POCUS consultations (77 cardiac and 76 lung/pleura) were performed. Image acquisition improved after remote guidance was provided to learners using tele-POCUS (all P < 0.01). Results were similar in analyses stratified by geographic setting.

Cardiopulmonary POCUS can be taught successfully to learners in diverse geographic settings using a virtual training format and tele-POCUS.