Point of care ultrasound training for internal medicine: a Canadian multi-centre learner needs assessment study

Watson, Kathryn; Lam, Ada; Arishenkoff, Shane; Halman, Samantha; Gibson, Neil; Yu, Jeffrey; Myers, Kathryn A.; Mintz, Marcy

doi:10.1186/s12909-018-1326-8

Cited by 30 publications

(61 citation statements)

References 33 publications

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“…This might suggest that, when it comes to lower extremity exam for DVT, our residents probably need more training on image acquisition skills more than image interpretation using the compressibility criteria. Interestingly, residents’ low confidence levels for DVT exam was also reported in other study in Canada 29. Image acquisition generally seems to be more challenging than image interpretation 7…”

Section: Discussionsupporting

confidence: 56%

<p>Internal medicine residents’ point-of-care ultrasound skills and need assessment and the role of medical school training</p>

Elhassan¹,

Gandhi²,

Sandhu³

et al. 2019

AMEP

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Introduction: Point-of-care-ultrasound (POCUS) as a useful bedside tool is growing. Few studies have examined residents’ attitude towards POCUS or compared POCUS image interpretation skills between residents with and without POCUS training in medical school. Material and Methods: We distributed an anonymous survey and image interpretation test to assess residents’ attitude towards POCUS, confidence, and skills in interpreting POCUS images and videos. Using independent samples t-tests, we compared mean confidence levels and test scores between residents with and without prior POCUS training. Results: Fifty-two residents responded to survey (response rate 68%) and 59 took the image interpretation test (77%). Most residents (90%) reported being interested in POCUS. Residents with prior POCUS training (n=13) were either PGY-1 (9) or PGY-2 (4). No PGY-3 resident had prior training. Most residents (83%) thought POCUS could be extremely useful in the inpatient setting compared to 29% for outpatient setting. PGY-1 residents with prior training had a higher mean confidence level than PGY-1 residents without prior training, but the difference was not statistically significant (3.26 vs 2.64; p =0.08). PGY-1 with prior training had a mean confidence level that was close to that of PGY-3 residents. PGY-1 residents with prior training scored significantly higher than PGY-1 residents without prior training in image interpretation test (10.25 vs 7; p =0.01). Residents felt most confident in interpreting inferior vena cava images (mean 3.7; max. 5), which also had the highest score in image interpretation test (correct response rate of 88%). Conclusion: Our residents seem very interested in POCUS. PGY-1 residents with prior POCUS training in medical school seem to have higher confidence in their POCUS skills than PGY-1 residents without prior training and outperformed them in image interpretation test. The study is very instructive in building our future POCUS curriculum for residents.

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Section: Discussionsupporting

confidence: 56%

<p>Internal medicine residents’ point-of-care ultrasound skills and need assessment and the role of medical school training</p>

Elhassan¹,

Gandhi²,

Sandhu³

et al. 2019

AMEP

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“…Studies describing the applications of POCUS and the competencies required for its safe practice were reviewed [1,3,[10][11][12][13]16,23,24]. Drawing on this knowledge, two researchers with expertise in medical education, POCUS, and survey design (RR and AH) developed a validated questionnaire to investigate interns' perceptions of POCUS.…”

Section: Questionnaire Developmentmentioning

confidence: 99%

“…). Data are presented as mean ±standard deviation POCUS: point-of-care ultrasound; DVT: deep vein thrombosis; JVP: jugular venous pressure; IVC: inferior vena cava; LV: left ventricle; RV: right ventricleThe Canadian IM residents reported the lowest level of skill in the use of POCUS to detect deep vein thrombosis (DVT; mean skill level: 1.7 ±0.8), hydronephrosis (mean: 1.7 ±0.8), and interstitial syndrome (mean: 1.8 ±0.9)[13]. For comparison, our sample reported the following mean skill levels: DVT mean skill level: 2.5 ±1.2; hydronephrosis mean skill level: 2.5 ±1.1; and interstitial syndrome mean skill level: 2.2 ±1.1.While the self-reported proficiency in our sample was statistically significantly higher than that of the Canadian IM residents, the differences were small and clinically insignificant.…”

mentioning

confidence: 99%

Point-of-Care Ultrasound Training: An Assessment of Interns’ Needs and Barriers to Training

Jarwan¹,

Alshamrani²,

Alghamdi³

et al. 2020

Cureus

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Background and objective The use of point-of-care ultrasound (POCUS) is generally on the rise worldwide. However, as the epidemiology of diseases and the approach to their management vary internationally, POCUS may not be universally applicable. The resources available for medical education are generally limited. Thus, when considering the development of a training program during the internship year, we sought to determine interns' perceptions of the applicability of POCUS to clinical practice, the current skill gaps, and barriers to training. Methods A validated questionnaire was distributed to the interns of the College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh to determine their proficiency in POCUS, and their opinions on its applicability on a 5-point Likert scale. Each skill gap was calculated by subtracting selfreported proficiency in POCUS from its perceived applicability. Results Of the 300 total interns (male: 200, female: 100), 229 participated [response rate: 76%; male: 136 (68%), female: 93 (93%)]. The use of POCUS to detect abdominal free fluid was perceived to be the most applicable use (mean: 3.9 ±1.1); scanning for consolidation was the least applicable (mean: 3.0 ±1.2). Knowledge and proficiency among the sample were generally poor. The skill gap was greatest for the assessment of inferior vena cava collapsibility (mean: 1.4 ±1.3) and least for the identification of pneumothorax (mean: 0.5 ±1.5). Although three-quarters of the participants (170) agreed that POCUS was an essential skill, 36 (16%) stated that they had no interest in it, and nearly half (101) believed that they did not have time to learn POCUS. Conclusions While POCUS is applicable to medical interns in Saudi Arabia, significant skill gaps exist. However, our sample's perception of the applicability of POCUS was less favorable than that of internal medicine (IM) residents in Canada. Thus, initiating POCUS training during the internship year may yield suboptimal results. Interns must prioritize medical licensing examinations and applications for residency training. Indeed, many interns believe that they do not have enough time to learn POCUS. Thus, prioritizing the training of residents in POCUS may be a more effective use of the finite resources available for medical education.

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“…To meet the rapid growth of POCUS utilization, several professional societies have published guidelines, consensus statements, or expert opinions detailing recommendations for POCUS application in both adults and children 10‐17 . However, incorporation of these guidelines into GME training programs is variable and limited 18‐21 . Furthermore, many providers completed their GME training prior to incorporation of POCUS educational goals into GME program requirements yet still desire POCUS training.…”

Section: Introductionmentioning

confidence: 99%

Point of care ultrasound for all by all: A multidisciplinary survey across a large quaternary care medical system

Wenger

Steinbach

Carlbom

et al. 2020

J of Clinical Ultrasound

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Purpose We sought to understand current POCUS practices and comfort as well as assess opinions about POCUS across our medical system via a survey to guide program development. Methods This study was conducted as a 19 question RedCap survey with multiple parts. Respondents were queried for demographics as well as experience with, attitudes toward, and clinical use of POCUS in common critical care scenarios. Results The survey was completed by 343 individuals, a response rate of 30%. Most respondents “agreed” that POCUS is a needed skill and helped them provide safer care (78% and 86% agreement). Most faculty and trainees reported some POCUS training (62% and 88%) and at least weekly use. Trainees rated themselves more comfortable than faculty for most exam types. The majority of faculty rated their POCUS education as inadequate while trainees had mixed responses. Conclusions POCUS is a frequently used tool, yet users are less confident in their skills than expected. POCUS applications are viewed as needed for future practice but there is a substantial need for improved education among faculty and trainees. Pooling resources and sharing educational initiatives across multiple specialties may help improve POCUS implementation.

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Point of care ultrasound training for internal medicine: a Canadian multi-centre learner needs assessment study

Cited by 30 publications

References 33 publications

<p>Internal medicine residents’ point-of-care ultrasound skills and need assessment and the role of medical school training</p>

<p>Internal medicine residents’ point-of-care ultrasound skills and need assessment and the role of medical school training</p>

Point-of-Care Ultrasound Training: An Assessment of Interns’ Needs and Barriers to Training

Point of care ultrasound for all by all: A multidisciplinary survey across a large quaternary care medical system

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