title: Assessment of knowledge retention and the value of proctored ultrasound exams after the introduction of an emergency ultrasound curriculum.
abstract: BACKGROUND
  Optimal training required for proficiency in bedside ultrasound is unknown. In addition, the value of proctored training is often assumed but has never been quantified.
  
  
  METHODS
  To compare different training regimens for both attending physicians and first year residents (interns), a prospective study was undertaken to assess knowledge retention six months after an introductory ultrasound course. Eighteen emergency physicians and twelve emergency medicine interns were assessed before and 6 months after an introductory ultrasound course using a standardized, image-based ultrasound test. In addition, the twelve emergency medicine interns were randomized to a group which received additional proctored ultrasound hands-on instruction from qualified faculty or to a control group with no hands-on instruction to determine if proctored exam training impacts ultrasound knowledge. Paired and unpaired estimates of the median shift in test scores between groups were made with the Hodges-Lehmann extension of the Wilcoxon-Mann-Whitney test.
  
  
  RESULTS
  Six months after the introductory course, test scores (out of a 24 point test) were a median of 2.0 (95% CI 1.0 to 3.0) points higher for residents in the control group, 5.0 (95% CI 3.0 to 6.0) points higher for residents in the proctored group, and 2.5 (95% CI 1.0 to 4.0) points higher for the faculty group. Residents randomized to undergo proctored ultrasound examinations exhibited a higher score improvement than their cohorts who were not with a median difference of 3.0 (95% CI 1.0 to 5.0) points.
  
  
  CONCLUSIONS
  We conclude that significant improvement in knowledge persists six months after a standard introductory ultrasound course, and incorporating proctored ultrasound training into an emergency ultrasound curriculum may yield even higher knowledge retention.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit St., Boston, Massachusetts, USA. vnoble@partners.org
authors.forename: Vicki E
authors.initials: VE
authors.lastname: Noble
authors.forename: Bret P
authors.initials: BP
authors.lastname: Nelson
authors.forename: A Nicholas
authors.initials: AN
authors.lastname: Sutingco
authors.forename: Keith A
authors.initials: KA
authors.lastname: Marill
authors.forename: Hilarie
authors.initials: H
authors.lastname: Cranmer
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital / Q000592:standards*; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency; D019095:Point-of-Care Systems / Q000592:standards*; D015397:Program Evaluation; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States