Tailored ultrasound learning for acute care surgeons: a review of the MUSEC (Modular UltraSound ESTES Course) project.

PURPOSE: The European Society for Trauma and Emergency Surgery (ESTES) identified the need for general and trauma surgeons involved in the management of critically ill surgical patients to embrace and learn both basic and advanced US skills. A steering group was created to address this deficit. METHODS: Modular UltraSound ESTES Course (MUSEC) is a modular blended-learning course. It incorporates pre-test/post-test examinations, pre-course online materials, didactic and interactive lectures, interactive case scenarios discussion with pathological US clips, hands-on practice on healthy volunteer models, and on original phantoms for simulating both pathological US findings and practicing US-guided interventional maneuvers. Four independent modules were provided. Surgical decision-making didactics were also included in the course curriculum. Learning gain (Δ of the rating of pre-test and post-test) was calculated for each module. An anonymous post-course satisfaction survey was also administered (16 questions with a Likert's 5-point scale of evaluation). RESULTS: Twenty-three MUSEC Courses were run in a 30 months period, training 416 doctors from 29 countries. A total of 52 modules were delivered. The mean pre-test and post-test grades were 8.3/12 and 10.7/12, respectively, yielding a significant mean learning gain of 28.9 % (p = 0.001). Post-course satisfaction survey got an overall ranking of 4.5/5. CONCLUSIONS: MUSEC is an effective and original educational format, enjoyed by candidates, that fills an educational gap for tailored US education as a procedural skill to acute care surgeons. Ongoing revisions should reduce the current limitations and increase the educational value, in terms of number of modules and post-course credentialing.

Energy cost and efficiency of riding aerodynamic bicycles.

Traction resistance (Rt) was determined by towing two cyclists in fully dropped posture on bicycles with an aerodynamic frame with lenticular wheels (AL), an aerodynamic frame with traditional wheels (AT), or a traditional frame with lenticular wheels (TL) in calm air on a flat wooden track at constant speed (8.6-14.6 m.s-1). Under all experimental conditions, Rt increased linearly with the square of air velocity (v2a); r2 equal to greater than 0.89. The constant k = delta Rt/delta v2a was about 15% lower for AL and AT (0.157 and 0.155 N.s2 x m-2) than for TL bicycles (0.184 N.s2 x m-2). These data show firstly, that in terms of mechanical energy savings, the role of lenticular wheels is negligible and, secondly, that for TL bicycles, the value of k was essentially equal to that found by others for bicycles with a traditional frame and traditional wheels (TT). The energy cost of cycling per unit distance (Cc, J.m-1) was also measured for AT and TT bicycles from the ratio of the O2 consumption above resting to speed, in the speed range from 4.7 to 11.1 m.s-1. The Cc also increased linearly with v2a, as described by: Cc = 30.8 + 0.558 v2a and Cc = 29.6 + 0.606 v2a for AT and TT bicycles. Thus from our study it would seem that AT bicycles are only about 5% more economical than TT at 12.5 m.s-1 the economy tending to increase slightly with the speed.(ABSTRACT TRUNCATED AT 250 WORDS)