Abstract
BackgroundPoint-of-care ultrasound (PoCUS) is currently not a universal component of curricula for medical undergraduate and postgraduate training. We designed and assessed a simulation-based PoCUS training program for medical learners, incorporating image acquisition and image interpretation for simulated emergency medical pathologies. We wished to see if learners could achieve competency in simulated ultrasound following focused training in a PoCUS protocol.MethodsTwelve learners (clerks and residents) received standardized training consisting of online preparation materials, didactic teaching, and an interactive hands-on workshop using a high-fidelity ultrasound simulator (CAE Vimedix). We used the Abdominal and Cardiothoracic Evaluation by Sonography (ACES) protocol as the curriculum for PoCUS training. Participants were assessed during 72 simulated emergency cardiorespiratory scenarios. Their ability to complete an ACES scan independently was assessed. Data was analyzed using R software.ResultsParticipants independently generated 574 (99.7%) of the 576 expected ultrasound windows during the 72 simulated scenarios and correctly interpreted 67 (93%) of the 72 goal-directed PoCUS scans.ConclusionsFollowing a focused training process using medical simulation, medical learners demonstrated an ability to achieve a degree of competency to both acquire and correctly interpret cardiorespiratory PoCUS findings using a high-fidelity ultrasound simulator.
Highlights
Point-of-care ultrasound (PoCUS) is currently not a universal component of curricula for medical undergraduate and postgraduate training
Given the increased usage and significance of PoCUS in clinical medicine [5] and the importance of ensuring that residents and students are familiar and competent with ultrasound, the purpose of this study is to evaluate the use of high-fidelity simulation to train medical learners in PoCUS
Participants had a minimum of 3 years of medical training, including classroom and clinical emergency medicine rotations focused around diagnosing emergency cardiorespiratory pathologies
Summary
Point-of-care ultrasound (PoCUS) is currently not a universal component of curricula for medical undergraduate and postgraduate training. Incorporation of goal-directed PoCUS in early patient management improves diagnostic accuracy, shortens the list of viable diagnostic etiologies, and changes treatment plans for certain emergency pathologies [1-3]. Goal-directed PoCUS protocols have been developed to provide a structured approach to improving the diagnostic accuracy of the initial clinical assessment of the critically ill patient and to monitor fluid resuscitation. Two common examples of these protocols are the ‘abdominal and cardiac evaluation with sonography in shock’ (ACES) protocol, proposed by one of the authors (Atkinson et al.) in 2009 [1], and the ‘rapid ultrasound for shock and hypotension’ (RUSH) protocol [4] These goal-directed scans aim to provide a structured approach to PoCUS in hypotension and require only an introductory level of training
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