Resident Training in Emergency Ultrasound: Consensus Recommendations from the 2008 Council of Emergency Medicine Residency Directors Conference

Abstract

Over the past 25 years, research performed by emergency physicians (EPs) demonstrates that bedside ultrasound (US) can improve the care of emergency department (ED) patients. At the request of the Council of Emergency Medicine Residency Directors (CORD), leaders in the field of emergency medicine (EM) US met to delineate in consensus fashion the model ''US curriculum'' for EM residency training programs. The goal of this article is to provide a framework for providing US education to EM residents. These guidelines should serve as a foundation for the growth of resident education in EM US. The intent of these guidelines is to provide minimum education standards for all EM residency programs to refer to when establishing an EUS training program. The document focuses on US curriculum, US education, and competency assessment. The use of US in the management of critically ill patients will improve patient care and thus should be viewed as a required skill set for all future graduating EM residents. The authors consider EUS skills critical to the development of an emergency physician, and a minimum skill set should be mandatory for all graduating EM residents. The US education provided to EM residents should be structured to allow residents to incorporate US into daily clinical practice. Image acquisition and interpretation alone are insufficient. The ability to integrate findings with patient care and apply them in a busy clinical environment should be stressed.

Epert Consensus on a Canadian Internal Medicine Ultrasound Curriculum

“…Three Delphi rounds were conducted to reach a consensus. These 16 topics included measurement of the height of the internal jugular vein, 29,30 inferior vena cava measurement, 31,32 pleural effusion and thoracentesis, 8,33,34 central line insertion and pneumothorax, 3,6,7,35,36 liver and spleen examination, 2,37 ascites and paracentesis, 9,38 the bladder, 14,39,40 cellulitis/abscess/aspirates, 41,42 arterial line insertion, 43 peripheral intravenous access, 44,45 and joint aspiration. 10 Although the evidence for the role of ultrasound in establishing peripheral intravenous access in adults is not as consistent as that in pediatric patients, 46 the group felt that learning this skill is unlikely to be harmful and may improve the care of patients.…”

Point-of-Care Ultrasonography by Pediatric Emergency Medicine Physicians

“…They have established guidelines and policy statements regarding the use of point-of-care US in the ED. 9,10 Collaboration with neighboring or affiliated general EDs may also prove beneficial.…”

“…9 Subsequently, the Society for Academic Emergency Medicine, the Council of Emergency Medicine Residency Directors, and the American Institute of Ultrasound in Medicine officially recognized that document. 10,11 Currently, guidelines from the Council of Emergency Medicine Residency Directors consensus documents from 2009 and 2012 are a mainstay for residency education. 10,12 In addition, competency assessment tools for the evaluation of emergency medicine residents are being considered.…”

“…10,11 Currently, guidelines from the Council of Emergency Medicine Residency Directors consensus documents from 2009 and 2012 are a mainstay for residency education. 10,12 In addition, competency assessment tools for the evaluation of emergency medicine residents are being considered. 12 …”

Point-of-Care Echocardiography in the Accountable Care Organization Era

“…In practice, didactic and hands-on training in POC echocardiography has been imparted during residency, in the form of ultrasound fellowships or through dedicated curricula for practicing clinicians. 4,17,25,[44][45][46][47] For instance, during emergency medicine residency, training for POC ultrasound takes place in form of didactic training and dedicated ultrasound rotations. Many academic centers require their residents to complete a certain number of studies followed by written and practical examinations (objective standardized clinical examination) to assess both knowledge and skill acquisition.…”