Point-of-Care Ultrasound and Modernization of the Bedside Assessment

Maw, Anna; Huebschmann, Amy G.; Mould‐Millman, Nee‐Kofi; Soni, Nilam J.

doi:10.4300/jgme-d-20-00216.1

Cited by 23 publications

(25 citation statements)

References 37 publications

(48 reference statements)

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“…Among potential barriers to POCUS minor risks associated with ultrasound. 6 Our findings mirror previous needs assessments performed in internal medicine and family medicine in which program leaders were also supportive of POCUS training for their residents. 15,23 Still, a third of respondents in our study felt that POCUS training should be limited to residents who will use POCUS in subspeciality fields that regularly use POCUS.…”

Section: Current Pocus Training In Pediatric Residencysupporting

confidence: 86%

“…As ultrasound migrates out of traditional imaging fields, graduate medical training programs must balance the desire to incorporate the potential benefits of POCUS with the risk of harm caused by improper training, supervision, and use. 6 For the field of pediatrics, POCUS is an especially appealing imaging modality, given improved acoustic windows in children compared with adults and the lack of ionizing radiation or need for sedation. Although POCUS for procedural guidance has the largest evidence base for benefit in children, many other diagnostic POCUS applications, including management of soft tissue infections, evaluation of dehydration, and diagnosis of pneumonia, have also revealed promise.…”

mentioning

confidence: 99%

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Point-of-Care Ultrasound Training in Pediatric Residency: A National Needs Assessment

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O'Hara

Ziniel

et al. 2021

Hospital Pediatrics

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BACKGROUND AND OBJECTIVES As point-of-care ultrasound (POCUS) evolves into a standard tool for the care of children, pediatric residency programs need to develop POCUS training programs. Few POCUS training resources exist for pediatric residents, and little is known about POCUS training in pediatric residencies. We aim to describe pediatric residency leadership perspectives regarding the value of POCUS and to elucidate the current state of POCUS training in pediatric residency programs. METHODS A group of pediatric educators and POCUS experts developed a novel survey followed by cognitive interviews to establish response-process validity. The survey was administered electronically to pediatric residency associate program directors between December 2019 and April 2020. Program characteristics, including region, setting, and size, were used to perform poststratification for analyses. We performed comparative analyses using program and respondent characteristics. RESULTS We achieved a 30% (58 of 196) survey response rate. Although only a minority of respondents (26%) used POCUS in clinical practice, a majority (56%) indicated that all pediatric residents should be trained in POCUS. A majority of respondents also considered 8 of 10 POCUS applications important for pediatric residents. Only 37% of programs reported any POCUS training for residents, primarily informal bedside education. Most respondents (94%) cited a lack of qualified instructors as a barrier to POCUS training. CONCLUSIONS Most pediatric residency programs do not provide residents with POCUS training despite its perceived value and importance. Numerous POCUS applications are considered important for pediatric residents to learn. Future curricular and faculty development efforts should address the lack of qualified POCUS instructors.

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Section: Current Pocus Training In Pediatric Residencysupporting

confidence: 86%

mentioning

confidence: 99%

Point-of-Care Ultrasound Training in Pediatric Residency: A National Needs Assessment

Good

O'Hara

Ziniel

et al. 2021

Hospital Pediatrics

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“…The findings on POCUS adoption by a health system and its clinicians captured in the present study mirror professional society conversations around this topic currently [ 8 , 15 ]. As the evidence for the utility of POCUS has grown with multiple studies demonstrating improved accuracy [ 34 ], expedited diagnoses [ 2 ], and an associated reduction in additional testing and overall costs [ 32 , 33 , 35 ], there is now an increasingly recognized need for guidelines in training standards and quality assurance to guide implementation [ 13 , 14 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center

et al. 2021

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There is growing interest from multiple specialties, including internal medicine, to incorporate diagnostic point of care ultrasound (POCUS) into standard clinical care. However, few internists currently use POCUS. The objective of this study was to understand the current determinants of POCUS adoption at both the health system and clinician level at a U.S. academic medical center from the perspective of multi-level stakeholders. We performed semi-structured interviews of multi-level stakeholders including hospitalists, subspecialists, and hospital leaders at an academic medical center in the U.S. Questions regarding the determinants of POCUS adoption were asked of study participants. Using the framework method, team-based analysis of interview transcripts were guided by the contextual domains of the Practical Robust Implementation and Sustainability Model (PRISM). Thirty-one stakeholders with diverse roles in POCUS adoption were interviewed. Analysis of interviews revealed three overarching themes that stakeholders considered important to adoption by clinicians and health systems: clinical impact, efficiency and cost. Subthemes included two that were deemed essential to high-fidelity implementation: the development of credentialing policies and robust quality assurance processes. These findings identify potential determinants of system and clinician level adoption that may be leveraged to achieve high-fidelity implementation of POCUS applications that result in improved patient outcomes.

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“…

e read with great enthusiasm the article ''Point-of-Care Ultrasound and Modernization of the Bedside Assessment'' by Maw et al 1 We support and thank the authors for highlighting point-of-care ultrasound (POCUS) as a diagnostic tool and for pointing out the challenges inherent to POCUS curriculum development in graduate medical education.We surveyed attitudes on POCUS from the incoming intern class (2021-2022) of our university-based family medicine residency program. On a scale of 1 to 10, with 10 representing the most excitement and interest in POCUS education and application, the incoming intern class (n ¼ 10) was both ''very excited'' (9.8, range 8-10) for formal POCUS education and ''very interested'' in applying POCUS to patient care during (9.1, range 8-10) and following (9.3, range 8-10) residency.

…”

mentioning

confidence: 99%

“…e read with great enthusiasm the article ''Point-of-Care Ultrasound and Modernization of the Bedside Assessment'' by Maw et al 1 We support and thank the authors for highlighting point-of-care ultrasound (POCUS) as a diagnostic tool and for pointing out the challenges inherent to POCUS curriculum development in graduate medical education.…”

mentioning

confidence: 99%

To the Editor: Re: Point-of-Care Ultrasound and Modernization of the Bedside Assessment

Siebert

Evans

2021

Journal of Graduate Medical Education

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e read with great enthusiasm the article ''Point-of-Care Ultrasound and Modernization of the Bedside Assessment'' by Maw et al. 1 We support and thank the authors for highlighting point-of-care ultrasound (POCUS) as a diagnostic tool and for pointing out the challenges inherent to POCUS curriculum development in graduate medical education.We surveyed attitudes on POCUS from the incoming intern class (2021-2022) of our university-based family medicine residency program. On a scale of 1 to 10, with 10 representing the most excitement and interest in POCUS education and application, the incoming intern class (n ¼ 10) was both ''very excited'' (9.8, range 8-10) for formal POCUS education and ''very interested'' in applying POCUS to patient care during (9.1, range 8-10) and following (9.3, range 8-10) residency. Eight of 10 residents reported some degree of POCUS exposure during medical school, including 4 residents who completed a full formal course. One resident reported utilizing ultrasound for patient care during medical school between 21 and 50 times, while the remaining 9 residents used it 10 times or less.These limited data are subject to a number of potential biases and confounders but nonetheless lend themselves to the following conclusions:

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Point-of-Care Ultrasound and Modernization of the Bedside Assessment

Cited by 23 publications

References 37 publications

Point-of-Care Ultrasound Training in Pediatric Residency: A National Needs Assessment

Point-of-Care Ultrasound Training in Pediatric Residency: A National Needs Assessment

Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center

To the Editor: Re: Point-of-Care Ultrasound and Modernization of the Bedside Assessment

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