Teaching echoscopy for the early diagnosis of ascites in cirrhosis: assessment of an objective structured clinical examination (OSCE).

Abstract

We assessed the efficacy of a brief, 8-h teaching program, using an objective structured clinical examination (OSCE) for the use of a pocket ultrasound device (echoscope) focused on bed side diagnosis of subclinical ascites in chronic liver disease. Ten cirrhotic patients, five with subclinical ascites and five without, were selected during ultrasound examination performed with a high performance equipment for screening of hepatocellular carcinoma. Five post graduate medical doctors residents in Gastroenterology or Internal Medicine underwent a brief, 8-h theoretical and hands-on examinations training. The methodology to assess the correct competence consisted in two phases defined by actions and answers to questions. The evaluation of the technical efficacy was positive in all five students. The diagnostic efficacy for the ten patients examined consisted in no false positive diagnosis of ascites and one false negative. In this preliminary experience, the use of a pocket ultrasound device (echoscope) for diagnosis of subclinical ascites in the context of a short structured teaching program and examination was efficient.