Graduating Surgical Residents Lack Competence in Critical Care Ultrasound

Tripu, Renuka; Lauerman, Margaret H.; Haase, Daniel; Fatima, Syeda; Glaser, Jacob; Cardarelli, Cassandra; Scalea, Thomas M.; Murthi, Sarah B.

doi:10.1016/j.jsurg.2017.09.022

Cited by 9 publications

(20 citation statements)

References 11 publications

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“…Our study further supports the notion that general surgery residents' perception of their training is higher than their actual performance and observed competence . This is suggested by the fact that the 10 residents who felt a high level of confidence in performing the E‐FAST still demonstrated a statistically significant increase in their post‐training comfort levels.…”

Section: Discussionsupporting

confidence: 85%

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Interdisciplinary approach to enhance trauma residents education of Extended‐Focused Assessment for Sonography in Trauma in the emergency department

Haney

Graglia

Schleifer

et al. 2020

ANZ Journal of Surgery

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Background Despite the utilization of point‐of‐care ultrasound (POCUS) by trauma surgeons, formal POCUS requirements do not exist for general surgery residents. We sought to evaluate surgery resident comfort with performing and interpreting of Extended‐Focused Assessment for Sonography in Trauma (E‐FAST) scans after a brief educational session. Methods A pre‐survey, sent to PGY‐2 and ‐3 surgical residents before their trauma rotation, evaluated comfort with eight components of the E‐FAST. Residents were then required to watch a 15‐min online video and attend a 1‐h bedside training session moderated by emergency medicine ultrasound fellows during which residents practised E‐FAST image acquisition and interpretation. After the rotation, residents completed a post‐survey evaluating their comfort with the E‐FAST. Results All 27 residents rotating on the trauma service during the 2017–2018 academic year were eligible and, therefore, approached by the study team. Twenty‐one (77.78%) residents completed the pre‐survey, training and post‐survey. Initially, only 52% (13/25) of residents reported feeling confident in performing the E‐FAST. After the session, all (100%) reported feeling confident in their training in E‐FAST. Self‐reported mean comfort with each of the eight components of the E‐FAST showed a statistically significant (P < 0.01) increase from pre–post survey for all residents. Isolating only the residents who initially reported feeling confident in E‐FAST still showed a statistically significant (P < 0.01) increase in mean comfort. Conclusion A single POCUS training programme has been shown to improve surgical residents' comfort in performing and interpreting the E‐FAST. This interdisciplinary approach can enhance collaboration and bridge gaps between emergency medicine and surgery residency programmes.

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Section: Discussionsupporting

confidence: 85%

“…Yet curricular US education for surgery residents has not been established. Surgery residency guidelines do not currently require US training and there is no formalized POCUS education for the majority of surgical residency programmes in the USA …”

Section: Introductionmentioning

confidence: 99%

Interdisciplinary approach to enhance trauma residents education of Extended‐Focused Assessment for Sonography in Trauma in the emergency department

Haney

Graglia

Schleifer

et al. 2020

ANZ Journal of Surgery

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“…A follow‐up study in 2010 showed that 64% of emergency medicine residency programs required more than 150 ultrasound examinations for competency, which was a considerable improvement from previous reports before the American College of Emergency Physicians statement . Recent literature regarding general surgery training calls for an urgent need for a standardized ultrasound curriculum such as inclusion in the Accreditation Council for Graduate Medical Education Milestones Project . Currently, most residents who are exposed to diagnostic or interventional ultrasound in otolaryngology do not log or track these procedures in a formal way.…”

Section: Discussionmentioning

confidence: 99%

“…6 Recent literature regarding general surgery training calls for an urgent need for a standardized ultrasound curriculum such as inclusion in the Accreditation Council for Graduate Medical Education Milestones Project. 7,8 Currently, most residents who are exposed to diagnostic or interventional ultrasound in otolaryngology do not log or track these procedures in a formal way. Encouragement of such a mechanism may be vital to legitimize and potentially credential our trainees as competent in performing ultrasound procedures.…”

Section: Discussionmentioning

confidence: 99%

Current Experience of Ultrasound Training in Otolaryngology Residency Programs

Meister

Vila

Bonilla‐Velez

et al. 2018

J of Ultrasound Medicine

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“…These procedures such as chest tube placement and central line cannulation have intrinsic risk, and can be morbid or mortal if done improperly. However, there are no current minimum number of procedures that a trainee needs to perform and no clear‐cut guidelines exist for assessing bedside procedure competency 4‐7 . There is limited instruction from faculty on these procedures, often resulting in instruction from resident to resident instead 8,9 …”

Section: Introductionmentioning

confidence: 99%

Resident perception of standardization and credentialing for high‐risk bedside procedures in cardiothoracic surgery: Results from an institutional pilot study

Okusanya

Bartow

Aranda‐Michel

et al. 2020

Journal of Cardiac Surgery

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Objectives: Though clear-guidelines are set by the American Board of Thoracic Surgery (ABTS) for the operative cases that cardiothoracic surgery residents must perform to be board-eligible, no such recommendations exist to assess competency for the wide range of high-risk bedside procedures. Our department created and implemented a multidisciplinary course designed to standardize common high-risk bedside procedures and credential our trainees. The aim of this study was to survey the attitudes of residents towards and query the efficacy of such a course. Methods: The course was designed with the goal of standardizing endotracheal intubation, arterial line insertion (radial and femoral), central venous line insertion, pigtail tube thoracostomy, thoracentesis and nasogastric tube placement. The course consisted of an online module followed by a 4-hour hands-on simulation session. Knowledge-based pre-and post-evaluations were administered as well as a Likert-based survey regarding multiple aspects of the residents′ perceptions of the course and the procedures. Results: Twenty-three (7 traditional and 16 integrated) cardiothoracic surgical residents participated in the course. Residents reported that 48% of the time, bedside procedures were historically taught by other trainees rather than by faculty. All residents endorsed increased standardization of all procedures after the course. Likewise, residents showed increased confidence in all procedures except for pigtail tube thoracostomy, thoracentesis as well as nasogastric tube placement. 43.5% of the participants demonstrated improvement in the pretest and posttest knowledgebased evaluations. Conclusion: Cardiothoracic residents have favorable attitudes towards standardization and credentialing for high-risk bedside procedures and utilizing such courses may help standardize procedural techniques.

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Graduating Surgical Residents Lack Competence in Critical Care Ultrasound

Cited by 9 publications

References 11 publications

Interdisciplinary approach to enhance trauma residents education of Extended‐Focused Assessment for Sonography in Trauma in the emergency department

Interdisciplinary approach to enhance trauma residents education of Extended‐Focused Assessment for Sonography in Trauma in the emergency department

Current Experience of Ultrasound Training in Otolaryngology Residency Programs

Resident perception of standardization and credentialing for high‐risk bedside procedures in cardiothoracic surgery: Results from an institutional pilot study

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