Impact of Point-of-care Ultrasound Training on Surgical Residents' Confidence

Overview

Journal J Surg Educ

Publisher Elsevier

Specialty General Surgery

Date 2015 Apr 26

PMID 25911457

Citations 18

Authors

Meera Kotagal

Elina Quiroga

Benjamin J Ruffatto

Adeyinka A Adedipe

Brandon H Backlund

Robert Nathan

Anthony Roche

Dana Sajed

Sachita Shah

Affiliations

Soon will be listed here.

Abstract

Objective: Point-of-care ultrasound (POCUS) is a vital tool for diagnosis and management of critically ill patients, particularly in resource-limited settings where access to diagnostic imaging may be constrained. We aimed to develop a novel POCUS training curriculum for surgical practice in the United States and in resource-limited settings in low- and middle-income countries and to determine its effect on surgical resident self-assessments of efficacy and confidence.

Design: We conducted an observational cohort study evaluating a POCUS training course that comprised 7 sessions of 2 hours each with didactics and proctored skills stations covering ultrasound applications for trauma (Focused Assessement with Sonography for Trauma (FAST) examination), obstetrics, vascular, soft tissue, regional anesthesia, focused echocardiography, and ultrasound guidance for procedures. Surveys on attitudes, prior experience, and confidence in point-of-care ultrasound applications were conducted before and after the course.

Setting: General Surgery Training Program in Seattle, Washington.

Participants: A total of 16 residents participated in the course; 15 and 10 residents completed the precourse and postcourse surveys, respectively.

Results: The mean composite confidence score from pretest compared with posttest improved from 23.3 (±10.2) to 37.8 (±6.7). Median confidence scores (1-6 scale) improved from 1.5 to 5.0 in performance of FAST (p < 0.001). Residents reported greater confidence in their ability to identify pericardial (2 to 4, p = 0.009) and peritoneal fluid (2 to 4.5, p < 0.001), to use ultrasound to guide procedures (3.5 to 4.0, p = 0.008), and to estimate ejection fraction (1 to 4, p = 0.004). Both before and after training, surgical residents overwhelmingly agreed with statements that ultrasound would improve their US-based practice, make them a better surgical resident, and improve their practice in resource-limited settings.

Conclusions: After a POCUS course designed specifically for surgeons, surgical residents had improved self-efficacy and confidence levels across a broad range of skills.

Citing Articles

Point-of-care ultrasound in palliative medicine residency programs: report of a national survey and local workshop.

McCarthy E, Takami K, Lamichhane S, Herx L, Goldie C, Kain D Support Care Cancer. 2024; 32(12):847.

PMID: 39623051 DOI: 10.1007/s00520-024-09046-5.

Barriers to Point-of-Care Ultrasound Utilization Among Emergency Medicine Residents in Riyadh, Saudi Arabia.

Abuguyan F, Almasry N, Alzahrani A Cureus. 2024; 16(7):e65765.

PMID: 39211663 PMC: 11361400. DOI: 10.7759/cureus.65765.

Point-of-care-ultrasound for the assessment of post-renal transplant recipients.

Uy M, Lam C, Guo Y, Bansal R, Hae R, Gangji A Can Urol Assoc J. 2024; 18(4):110-114.

PMID: 38381939 PMC: 11034972. DOI: 10.5489/cuaj.8531.

Implementing a 3 year, longitudinal point of care ultrasound curriculum in an internal medicine residency program.

Rappaport C, Schwartz A, McConomy B, Choice S, Ten Eyck P, Smock J J Ultrasound. 2023; 27(1):123-127.

PMID: 37973677 PMC: 10908930. DOI: 10.1007/s40477-023-00838-9.

Point-of-care ultrasound Usage and accuracy within a Canadian urology division.

van der Leek A, Metcalfe P Can Urol Assoc J. 2023; 18(2):48-54.

PMID: 37931281 PMC: 10841567. DOI: 10.5489/cuaj.8513.

References

Neri L, Storti E, Lichtenstein D . Toward an ultrasound curriculum for critical care medicine. Crit Care Med. 2007; 35(5 Suppl):S290-304. DOI: 10.1097/01.CCM.0000260680.16213.26. View

Jayaraman S, Ayzengart A, Goetz L, Ozgediz D, Farmer D . Global health in general surgery residency: a national survey. J Am Coll Surg. 2009; 208(3):426-33. DOI: 10.1016/j.jamcollsurg.2008.11.014. View

Forster R, Pillasch J, Zielke A, Malewski U, Rothmund M . Ultrasonography in blunt abdominal trauma: influence of the investigators' experience. J Trauma. 1993; 34(2):264-9. View

Kotlyar S, Moore C . Assessing the utility of ultrasound in Liberia. J Emerg Trauma Shock. 2009; 1(1):10-4. PMC: 2700563. DOI: 10.4103/0974-2700.41785. View

Mateer J, Valley V, Aiman E, Phelan M, Thoma M, Kefer M . Outcome analysis of a protocol including bedside endovaginal sonography in patients at risk for ectopic pregnancy. Ann Emerg Med. 1996; 27(3):283-9. DOI: 10.1016/s0196-0644(96)70260-3. View

Levine A, Shah S, Umulisa I, Mark Munyaneza R, Dushimiyimana J, Stegmann K . Ultrasound assessment of severe dehydration in children with diarrhea and vomiting. Acad Emerg Med. 2010; 17(10):1035-41. DOI: 10.1111/j.1553-2712.2010.00830.x. View

Kimberly H, Murray A, Mennicke M, Liteplo A, Lew J, Bohan J . Focused maternal ultrasound by midwives in rural Zambia. Ultrasound Med Biol. 2010; 36(8):1267-72. DOI: 10.1016/j.ultrasmedbio.2010.05.017. View

Akhtar S, Theodoro D, Gaspari R, Tayal V, Sierzenski P, LaMantia J . Resident training in emergency ultrasound: consensus recommendations from the 2008 Council of Emergency Medicine Residency Directors Conference. Acad Emerg Med. 2010; 16 Suppl 2:S32-6. DOI: 10.1111/j.1553-2712.2009.00589.x. View

Blaivas M, Kuhn W, Reynolds B, Brannam L . Change in differential diagnosis and patient management with the use of portable ultrasound in a remote setting. Wilderness Environ Med. 2005; 16(1):38-41. DOI: 10.1580/1080-6032(2005)16[38:ciddap]2.0.co;2. View

10.

Han D, Rozycki G, Schmidt J, Feliciano D . Ultrasound training during ATLS: an early start for surgical interns. J Trauma. 1996; 41(2):208-13. DOI: 10.1097/00005373-199608000-00002. View

11.

Heller M, Mandavia D, Tayal V, Cardenas E, Lambert M, Mateer J . Residency training in emergency ultrasound: fulfilling the mandate. Acad Emerg Med. 2002; 9(8):835-9. DOI: 10.1111/j.1553-2712.2002.tb02174.x. View

12.

Rozycki G, Ochsner M, Jaffin J, Champion H . Prospective evaluation of surgeons' use of ultrasound in the evaluation of trauma patients. J Trauma. 1993; 34(4):516-26; discussion 526-7. DOI: 10.1097/00005373-199304000-00008. View

13.

Staren E, Knudson M, Rozycki G, Harness J, Wherry D, Shackford S . An evaluation of the American College of Surgeons' ultrasound education program. Am J Surg. 2006; 191(4):489-96. DOI: 10.1016/j.amjsurg.2005.10.023. View

14.

Leow J, Kingham T, Casey K, Kushner A . Global surgery: thoughts on an emerging surgical subspecialty for students and residents. J Surg Educ. 2010; 67(3):143-8. DOI: 10.1016/j.jsurg.2010.03.002. View

15.

Mahran M, Omran M . The impact of diagnostic ultrasound on the prediction of intrauterine growth retardation in developing countries. Int J Gynaecol Obstet. 1988; 26(3):375-8. DOI: 10.1016/0020-7292(88)90332-3. View

16.

Stein W, Katunda I, Butoto C . A two-level ultrasonographic service in a maternity care unit of a rural district hospital in Tanzania. Trop Doct. 2008; 38(2):125-6. DOI: 10.1258/td.2007.070045. View

17.

Chen L, Hsiao A, Langhan M, Riera A, Santucci K . Use of bedside ultrasound to assess degree of dehydration in children with gastroenteritis. Acad Emerg Med. 2010; 17(10):1042-7. PMC: 3058669. DOI: 10.1111/j.1553-2712.2010.00873.x. View

18.

Hoppmann R, Rao V, Poston M, Howe D, Hunt P, Fowler S . An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience. Crit Ultrasound J. 2011; 3(1):1-12. PMC: 3064888. DOI: 10.1007/s13089-011-0052-9. View

19.

Gogalniceanu P, Sheena Y, Kashef E, Purkayastha S, Darzi A, Paraskeva P . Is basic emergency ultrasound training feasible as part of standard undergraduate medical education?. J Surg Educ. 2010; 67(3):152-6. DOI: 10.1016/j.jsurg.2010.02.008. View

20.

Spencer J, Adler R . Utility of portable ultrasound in a community in Ghana. J Ultrasound Med. 2008; 27(12):1735-43. DOI: 10.7863/jum.2008.27.12.1735. View