Self-reported skills and self-confidence in point-of-care ultrasound: a cross-sectional nationwide survey amongst Finnish emergency physicians

BACKGROUND

The use of point-of-care ultrasound (POCUS) is increasing. Numerous investigators have evaluated the learning curves in POCUS, but there are no published studies on how emergency physicians perceive their own competence level with this skill.

METHODS

A nationwide survey amongst Finnish emergency physicians was conducted. The respondents reported their use of POCUS and how it has affected their clinical decision-making. The number of POCUS examinations performed was compared to the self-assessed skill level with different applications. Cut-off values were determined for the number of examinations required to acquire a good self-assessed skill level in each POCUS application. The correlation between self-confidence and the self-estimated skill level was analyzed. Several different statistical methods were used, such as Student's t-test, Pearson's correlation test, Loess method and ROC curve analysis.

RESULTS

A total of 134 out of 253 Finnish emergency medicine specialists and residents (52%) responded to the survey. The most commonly used POCUS applications were POCUS-assisted procedures, pleural effusion and pneumothorax, inferior vena cava and lower extremity deep venous thrombosis. The initial rate of perceived skill acquisition was very steep with the curve flattening with greater skill and more experience. The number of examinations performed to reach a self-assessed good competence varied from seven to 75 with different applications. The lowest cut-off point for self-assessed good competence was obtained for rapid ultrasound for the shock and hypotension-protocol and the highest for focused cardiac examinations. There was an excellent correlation between self-confidence and the self-assessed skill level.

CONCLUSIONS

The Finnish emergency practitioners' self-assessed development of POCUS skills parallels the previously published learning curves of POCUS. The correlation of self-confidence and the self-assessed skill level was found to be excellent. These findings add information on the development of perceived POCUS skills amongst emergency physicians and could complement a formal performance assessment.

Methods for Simultaneous Robot-World-Hand-Eye Calibration: A Comparative Study

In this paper, we propose two novel methods for robot-world-hand–eye calibration and provide a comparative analysis against six state-of-the-art methods. We examine the calibration problem from two alternative geometrical interpretations, called ‘hand–eye’ and ‘robot-world-hand–eye’, respectively. The study analyses the effects of specifying the objective function as pose error or reprojection error minimization problem. We provide three real and three simulated datasets with rendered images as part of the study. In addition, we propose a robotic arm error modeling approach to be used along with the simulated datasets for generating a realistic response. The tests on simulated data are performed in both ideal cases and with pseudo-realistic robotic arm pose and visual noise. Our methods show significant improvement and robustness on many metrics in various scenarios compared to state-of-the-art methods.

Penetration of nitrogen oxides and particles from outdoor into indoor air and removal of the pollutants through filtration of incoming air

We studied the effect of ventilation and air filtration systems on indoor air quality in a children's day-care center in Finland. Ambient air nitrogen oxides (NO, NO2) and particles (TSP, PM10) were simultaneously measured outdoors and indoors with automatic nitrogen oxide analyzers and dust monitoring. Without filtration nitrogen oxides and particulate matter generated by nearby motor traffic penetrated readily indoors. With chemical filtration 50-70% of nitrogen oxides could be removed. Mechanical ventilation and filtration also reduced indoor particle levels. During holidays and weekends when there was no opening of doors and windows and no particle-generating activity indoors, the indoor particle level was reduced to less than 10% of the outdoor level. At times when outdoor particle concentrations were high during weekdays, the indoor level was about 25% of the outdoor level. Thus, the possible adverse health effects of nitrogen oxides and particles indoors could be countered by efficient filtration. We also showed that inclusion of heat recovery equipment can make new ventilation installations economical.