title: Thorax, trachea, and lung ultrasonography in emergency and critical care medicine: assessment of an objective structured training concept.
abstract: Background and Study objective. Focused lung ultrasound (LUS) examinations are important tools in critical care medicine. There is evidence that LUS can be used for the detection of acute thoracic lesions. However, no validated training method is available. The goal of this study was to develop and assess an objective structured clinical examination (OSCE) curriculum for focused thorax, trachea, and lung ultrasound in emergency and critical care medicine (THOLUUSE). Methods. 39 trainees underwent a one-day training course in a prospective educational study, including lectures in sonoanatomy and -pathology of the thorax, case presentations, and hands-on training. Trainees' pre- and posttest performances were assessed by multiple choice questionnaires, visual perception tests by interpretation video clips, practical performance of LUS, and identification of specific ultrasound findings. Results. Trainees postcourse scores of correct MCQ answers increased from 56 ± 4% to 82 ± 2% (mean± SD; P < 0.001); visual perception skills increased from 54 ± 5% to 78 ± 3% (P < 0.001); practical ultrasound skills improved, and correct LUS was performed in 94%. Subgroup analysis revealed that learning success was independent from the trainees' previous ultrasound experience. Conclusions. THOLUUSE significantly improves theoretical and practical skills for the diagnosis of acute thoracic lesions. We propose to implement THOLUUSE in emergency medicine training.
authors.affiliation: Frankfurter Institut für Notfallmedizin und Simulationstraining, Fachbereich Medizin der Johann Wolfgang Goethe-Universität, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany ; Zentrale Notaufnahme, Klinikum Frankfurt Höchst, Gotenstaße 6-8, 65929 Frankfurt am Main, Germany.
authors.forename: Raoul
authors.initials: R
authors.lastname: Breitkreutz
authors.affiliation: Frankfurter Institut für Notfallmedizin und Simulationstraining, Fachbereich Medizin der Johann Wolfgang Goethe-Universität, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany ; Klinik für Anaesthesiologie, Operative Intensivmedizin und Schmerztherapie, Klinikum Hanau, 63450 Hanau, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Dutiné
authors.affiliation: Klinik für Anaesthesiologie, Klinikum der Universität München, Campus Großhadern, 81377 München, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Scheiermann
authors.affiliation: II. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, 55131 Mainz, Germany.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Hempel
authors.affiliation: Abteilung Pneumologie/Allergologie, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany.
authors.forename: Sandy
authors.initials: S
authors.lastname: Kujumdshiev
authors.affiliation: Institut für Biostatistik und Mathematische Modellierung, Zentrum der Gesundheitswissenschaften, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany.
authors.forename: Hanns
authors.initials: H
authors.lastname: Ackermann
authors.affiliation: Frankfurter Institut für Notfallmedizin und Simulationstraining, Fachbereich Medizin der Johann Wolfgang Goethe-Universität, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany ; Abteilung Kardiologie, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany.
authors.forename: Florian Hartmut
authors.initials: FH
authors.lastname: Seeger
authors.affiliation: Frankfurter Institut für Notfallmedizin und Simulationstraining, Fachbereich Medizin der Johann Wolfgang Goethe-Universität, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany ; Abteilung Anästhesiologie, Intensiv- und Notfallmedizin, Diakonie Klinikum Siegen, 57074 Siegen, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Seibel
authors.affiliation: Frankfurter Institut für Notfallmedizin und Simulationstraining, Fachbereich Medizin der Johann Wolfgang Goethe-Universität, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany ; Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Walcher
authors.affiliation: Abteilung Pneumologie/Allergologie, Klinikum der Johann Wolfgang Goethe-Universität, 60528 Frankfurt am Main, Germany.
authors.forename: Tim Oliver
authors.initials: TO
authors.lastname: Hirche