Standardizing Point-of-Care Ultrasound Credentialing Across a Large Health Care System

Smalley, Courtney M.; Fertel, Baruch S.; Broderick, Erin

doi:10.1016/j.jcjq.2020.03.009

Cited by 15 publications

(19 citation statements)

References 17 publications

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“…Other studies in pediatric emergency medicine [ 23 , 48 , 49 ] have additionally noted to varying degrees institutional barriers to advancement of POCUS such as implementation of billing for POCUS, systems for archiving POCUS scans, consultant acceptance of non-radiology performed ultrasound, and funding for POCUS training. Credentialing and assessment of competency are also barriers which pediatric emergency medicine has recently started to address [ 32 ] and which emergency medicine physicians are still standardizing [ 50 ]. As more general pediatricians become trained in POCUS applications, additional research is required to address these important issues in POCUS.…”

Section: Discussionmentioning

confidence: 99%

The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

et al. 2022

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Background Point-of-care ultrasound (POCUS) is a noninvasive bedside tool with many pediatric applications but is not currently a formal part of pediatric training and practice. Formal surveys of general pediatricians regarding POCUS training are lacking. We aimed to quantify the baseline ultrasound experience and training needs of general pediatricians and pediatric residents across different practice settings. Methods In 2020, we sent an online survey to 485 current faculty, residents, and graduates from an urban pediatric academic medical center in Northern California. Pediatric subspecialists were excluded. Survey questions about baseline experience, comfort, and perceived usefulness of 20 common POCUS applications were developed by two POCUS experts using existing literature. Chi-squared analysis was used to compare residents versus attendings and to compare attendings practicing in inpatient versus outpatient versus mixed settings. Results Response rate was 20% (98/485). Compared to attendings (n = 73), residents (n = 25) endorsed more exposure to POCUS in medical school (32% vs 5%, p = 0.003) and residency (12% vs 5%, p = 0.003). Respondents endorsed low comfort with POCUS (mean 1.3 out of 5 on Likert scale). Of 20 procedural and diagnostic applications, respondents identified abscess drainage, bladder catheterization, soft tissue, neck, advanced abdominal, and constipation as most useful. Overall, 50% of pediatricians (and 70% of pediatric residents) responded that there were opportunities to use POCUS multiple times a week or more in their clinical practice. Conclusions There is an unmet demand for POCUS training among general pediatricians and trainees in our study. Although the majority of respondents were not POCUS users, our results could guide future efforts to study the role of POCUS in general pediatrics and develop pediatric curricula.

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Section: Discussionmentioning

confidence: 99%

The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

et al. 2022

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“…For these reasons, increasing EM physician faculty comfort and confidence with CUS is critical for managing patients and supervising learners. While a minority of EM physicians who trained prior to 2008 are certified in CUS, there is a need for studies on how to effectively train these physicians in CUS, whether as an educational program or refresher course [10,30]. Graglia et al provide evidence that physician comfort with using CUS is an important outcome measure to address in training physicians [17].…”

Section: Discussionmentioning

confidence: 99%

Teaching Seasoned Doctors New Technology: An Intervention to Reduce Barriers and Improve Comfort With Clinical Ultrasound

Kennedy¹,

Duncan²,

Herbert³

et al. 2021

Cureus

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IntroductionAlthough clinical ultrasound (CUS) is a core skill that is a requirement for emergency medicine (EM) residency graduation, only a fraction of EM practitioners who trained prior to this requirement are certified in CUS. The objective of the study was to implement a CUS workshop for practicing EM physicians, identify barriers to utilization, and assess comfort with the machine, obtaining and interpreting images, and incorporating CUS into clinical practice. MethodsThis was a prospective descriptive cohort study of EM physician faculty who participated in an interactive 5hour CUS workshop intervention that introduced four core CUS modalities via didactics and hands-on scanning stations. Pre-and post-surveys were administered to identify barriers to utilization and assess perceived comfort with CUS using a 5-point Likert scale. Results were analyzed using Fisher's exact and paired t-tests. ResultsThirty-five EM physicians participated with a 100% survey response rate. Only five of the physicians were ultrasound certified at the time of the workshop. On average, physicians were 16 years post-residency. Prior to the workshop, 29% had minimal ultrasound experience and 43% had not performed more than 50 ultrasounds. In the pre-course survey, every physician expressed at least one barrier to CUS utilization. Postworkshop, physicians felt significantly more comfortable using the ultrasound machine (p=0.0008), obtaining and interpreting images (p=0.0009 and p=0.0004), and incorporating CUS into clinical practice (p=0.002). ConclusionThis workshop is an effective tool to expose practicing physicians to core concepts of CUS, improve their comfort level, and reduce barriers to ultrasound utilization.

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“…However, in a recent survey of nonacademic EDs, it was found that most providers lack US training, credentialing, and quality assurance (QA) assessments of their POCUS studies [4]. In 2017, our healthcare system embarked on a systemwide credentialing process for POCUS to credential community physicians with little to no POCUS training [5]. After successful implementation and completion of the program in 2018, we sought to examine the group of mid to late career emergency physicians to assess how these physicians utilized POCUS longitudinally in their practice after credentialing and to assess QA issues with image acquisition and image interpretation in this cohort.…”

Section: Lettermentioning

confidence: 99%

“…We performed a retrospective qualitative review of POCUS studies performed after a POCUS credentialing initiative for EM physicians was completed across 11 non -academic hospitals from January 1, 2017 to July 1, 2018, [5]. Credentialing in "Basic" POCUS required a completion of a dedicated POCUS course as well as a practice-based competency pathway which included Focused Assessment of Sonography in Trauma (FAST), aorta, and central line ultrasound training (Table 1).…”

Section: Lettermentioning

confidence: 99%

Point-of-Care Ultrasound Training and Credentialing for mid-late Career Emergency Physicians: Is it worth it?

Smalley

Simon

Muir

et al. 2021

pocus

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Point-of-care ultrasound (POCUS) is becoming more prevalent in community emergency medicine (EM) practice with the current American College of Emergency Physician guidelines recommending POCUS training for all graduates from United States based residency programs as well as support for POCUS privileging by the American Medical Association. However, in a recent survey of nonacademic EDs, it was found that most providers lack US training, credentialing, and quality assurance (QA) assessments of their POCUS studies. In 2017, our healthcare system embarked on a system-wide credentialing process for POCUS to credential community physicians with little to no POCUS training.

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Standardizing Point-of-Care Ultrasound Credentialing Across a Large Health Care System

Cited by 15 publications

References 17 publications

The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

Teaching Seasoned Doctors New Technology: An Intervention to Reduce Barriers and Improve Comfort With Clinical Ultrasound

Point-of-Care Ultrasound Training and Credentialing for mid-late Career Emergency Physicians: Is it worth it?

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