Features of the formation of skills in urgent ultrasonography in intern surgeons: experience in diagnosing intestinal obstruction
DOI:
https://doi.org/10.11603/2414-4533.2026.3.16691Keywords:
acute intestinal obstruction, point-of-care ultrasound (POCUS), emergency ultrasonography, surgical residents, postgraduate medical education, learning curve, LC-CUSUM-analysis, diagnosticsAbstract
The aim of the work: to study the features of acquiring practical skills in urgent ultrasonography among surgical residents during the diagnosis of intestinal obstruction and to evaluate the learning curve using LC-CUSUM analysis.
Materials and Methods. A prospective study included 35 first- and second-year surgical residents. The training program consisted of a theoretical module and practical ultrasound examinations performed under the supervision of a mentor. We evaluated the technical quality of scanning, the accuracy of interpreting ultrasound signs of intestinal obstruction, examination time, the number of errors, and the level of independence. LC-CUSUM, regression, correlation, and non-parametric statistical analysis were used to analyze the dynamics of competence formation.
Results. The median number of examinations required to reach an acceptable level of competence was 24. Rapid acquisition of skills was demonstrated by 34.3 % of residents, moderate pace by 48.6 %, and slow by 17.1%. Diagnostic accuracy increased from 58.4% to 93.8%, while the median examination time decreased from 11.5 to 5.8 minutes (p<0.001). The greatest improvement was observed during the first 20–25 examinations, followed by the learning curve plateauing (R²=0.81). The interpretation of indirect signs of ischemia and intestinal strangulation remained the most difficult stage. LC-CUSUM confirmed the achievement of competence in 82.9% of residents and allowed for an objective assessment of individual learning paces.
Conclusion. A structured training program in urgent ultrasonography ensures that the majority of surgical residents achieve a clinically acceptable level of competence after performing approximately 20–30 supervised examinations. The use of LC-CUSUM is an effective tool for objective monitoring of the learning process and can be recommended for individualizing postgraduate training programs and standardizing the assessment of practical competencies in POCUS.
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