Remote Mentoring of Point‐of‐Care Ultrasound Skills to Inexperienced Operators Using Multiple Telemedicine Platforms: Is a Cell Phone Good Enough?

Smith, Andrew H.; Addison, Reuben; Rogers, Peter; Stone-McLean, Jordan; Boyd, Sarah; Hoover, Kristopher; Pollard, Megan; Dubrowski, Adam; Parsons, Mike

doi:10.1002/jum.14609

Cited by 27 publications

(43 citation statements)

References 16 publications

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“…Programs to teach POCUS, in-person, have demonstrated to be effective [10], but have a high cost and can be difficult to repeat/grow. The use of real-time video conferencing has demonstrated to be effective for remote POCUS guidance and training [11,12]. The application of such a remote guidance and telecommunication system has demonstrated a positive clinical impact.…”

Section: Discussionmentioning

confidence: 99%

“…Kolbe et al reported a change in management in 48% of patients in a rural village in Nicaragua after the implementation of a remote guidance and telecommunication system between expert sonographers around the world and local practitioners [13]. The application of smartphone-based video conference platforms also has proven clinical utility [12]. Robertson et al demonstrated successful communication between intensivists at a tertiary care center and non-physician health care providers in a low-income country, which demonstrated successful ability to both educate POCUS image acquisition techniques as well as allow for appropriate image quality for remote clinical interpretation [14].…”

Section: Discussionmentioning

confidence: 99%

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Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

et al. 2019

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Reports on the use of various smartphone-based video conference applications to guide point-of-care ultrasound (POCUS) examinations in resource-limited settings have been described. However, the use of an augmented reality-enabled smartphone video conference application in this same manner has not been described. Presented is a case in which such as application was used to remotely guide a point of care ultrasound examination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

et al. 2019

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“…As teleultrasound continues to grow, exploration of how this concept can be applied using low-cost, commercially available products have recently been explored. Multiple studies have demonstrated the utility of smartphone-based video conferencing platforms to remotely instruct POCUS examinations [10,16,29]. Images obtained from these platforms are noninferior to those obtained directly from the ultrasound device [18].…”

Section: Discussionmentioning

confidence: 99%

Feasibility Evaluation of Commercially Available Video Conferencing Devices to Technically Direct Untrained Nonmedical Personnel to Perform a Rapid Trauma Ultrasound Examination

Ramsingh

et al. 2019

Diagnostics

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Introduction: Point-of-care ultrasound (POCUS) is a rapidly expanding discipline that has proven to be a valuable modality in the hospital setting. Recent evidence has demonstrated the utility of commercially available video conferencing technologies, namely, FaceTime (Apple Inc, Cupertino, CA, USA) and Google Glass (Google Inc, Mountain View, CA, USA), to allow an expert POCUS examiner to remotely guide a novice medical professional. However, few studies have evaluated the ability to use these teleultrasound technologies to guide a nonmedical novice to perform an acute care POCUS examination for cardiac, pulmonary, and abdominal assessments. Additionally, few studies have shown the ability of a POCUS-trained cardiac anesthesiologist to perform the role of an expert instructor. This study sought to evaluate the ability of a POCUS-trained anesthesiologist to remotely guide a nonmedically trained participant to perform an acute care POCUS examination. Methods: A total of 21 nonmedically trained undergraduate students who had no prior ultrasound experience were recruited to perform a three-part ultrasound examination on a standardized patient with the guidance of a remote expert who was a POCUS-trained cardiac anesthesiologist. The examination included the following acute care POCUS topics: (1) cardiac function via parasternal long/short axis views, (2) pneumothorax assessment via pleural sliding exam via anterior lung views, and (3) abdominal free fluid exam via right upper quadrant abdominal view. Each examiner was given a handout with static images of probe placement and actual ultrasound images for the three views. After a brief 8 min tutorial on the teleultrasound technologies, a connection was established with the expert, and they were guided through the acute care POCUS exam. Each view was deemed to be complete when the expert sonographer was satisfied with the obtained image or if the expert sonographer determined that the image could not be obtained after 5 min. Image quality was scored on a previously validated 0 to 4 grading scale. The entire session was recorded, and the image quality was scored during the exam by the remote expert instructor as well as by a separate POCUS-trained, blinded expert anesthesiologist. Results: A total of 21 subjects completed the study. The average total time for the exam was 8.5 min (standard deviation = 4.6). A comparison between the live expert examiner and the blinded postexam reviewer showed a 100% agreement between image interpretations. A review of the exams rated as three or higher demonstrated that 87% of abdominal, 90% of cardiac, and 95% of pulmonary exams achieved this level of image quality. A satisfaction survey of the novice users demonstrated higher ease of following commands for the cardiac and pulmonary exams compared to the abdominal exam. Conclusions: The results from this pilot study demonstrate that nonmedically trained individuals can be guided to complete a relevant ultrasound examination within a short period. Further evaluation of using telemedicine technologies to promote POCUS should be evaluated.

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“…Faculty could review their hand positioning and images using an online virtual platform (e.g., FaceTime, Zoom). [32][33][34][35] Software-based guidance instruction can assist POCUS users in obtaining and optimizing sonographic views (e.g., Caption Health) and can even perform autointerpretation of images (e.g., Butterfly IQ, GE Healthcare, Phillips). Some handheld POCUS machines even have built-in feedback options.…”

Section: Simulationmentioning

confidence: 99%

Rethinking Residency Conferences in the Era of COVID‐19

Gottlieb

Landry

Egan

et al. 2020

AEM Education and Training

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The COVID-19 pandemic requires a substantial change to the traditional approach to conference didactics. Switching to a virtual medium for conference sessions presents several challenges, particularly with regard to aspects that rely heavily on in-person components (e.g., simulation, ultrasound). This paper will discuss the challenges and strategies to address them for conference planning in the era of COVID-19.

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Remote Mentoring of Point‐of‐Care Ultrasound Skills to Inexperienced Operators Using Multiple Telemedicine Platforms: Is a Cell Phone Good Enough?

Abstract: Remote US skills can be taught equally effectively by using a variety of telemedicine technologies. Smartphones represent a viable option for US training in resource-challenged settings.

Cited by 27 publications

References 16 publications

Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

Feasibility Evaluation of Commercially Available Video Conferencing Devices to Technically Direct Untrained Nonmedical Personnel to Perform a Rapid Trauma Ultrasound Examination

Rethinking Residency Conferences in the Era of COVID‐19

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