CRITICAL CARE ULTRASONOGRAPHY USE AT ACADEMIC TRAINING PROGRAMS: A SURVEY OF CRITICAL CARE FELLOWS

Abstract

SESSION TITLE: PCCM - The Next Generation or Building the Skills of Tomorrow SESSION TYPE: Original Investigations PRESENTED ON: 10/21/2019 1:30 PM - 2:30 PM PURPOSE: Although in widespread use, data regarding the training and practice of critical care fellows in critical care ultrasonography (CCUS) are limited. We hypothesized that significant variation exists in critical care training programs in relation to accessibility to expert faculty, number of dedicated ultrasonography machines for teaching and patient care, methods of instruction, and modes of application. METHODS: An anonymous online survey was sent to program directors (PD) of all ACGME accredited critical care training programs (n = 453). PD were asked to forward the survey to their critical care fellows. The 22-question survey consisted of questions related to training by expert faculty, modalities of ultrasonography used, and methods of instruction. Data was collected over a three-month period. RESULTS: There were 73 respondents, from the critical care fields of pulmonary (n = 31), pediatrics (n = 21), surgery (n = 9), internal medicine (n = 8) and anesthesia (n = 4). The response rate was not calculated as the total number of critical care fellows is not known. The majority of respondents reported having faculty with expertise in CCUS (73%). Methods of learning included mandatory rotation (14%), national course attendance (25%), elective rotation (29%), local course attendance (40%), simulation (53%), lectures (53%), hands-on lectures (67%), and informal bedside teaching (85%). More expert faculty was associated with participation in institutional-based CCUS training and through local, national, or international courses (78%). Although >80% of respondents utilize CCUS for vascular access, lung ultrasonography, and volume responsiveness, While the majority of critical care fellows reported having an ultrasound machine for learning (95%), agree that CCUS is clinically useful (99%) and can result in a change in patient management (80%), < 50% use CCUS daily. Only 13% of respondents were actively engaged in CCUS research, and fewer than 30% are required to submit CCUS studies and interpretations to expert faculty for review. Low response rates in this study make generalization of this data problematic. CONCLUSIONS: Critical care fellows report widespread use of CCUS; however, there exists a disconnect between its use and the allotment of necessary resources and attention to ensure the modality is correctly taught and used. Further research is needed to confirm the generalizability of this study. CLINICAL IMPLICATIONS: The widespread use of CCUS amongst critical care fellows without formal standardization of training has resulted in widespread variation in fellow training and overall practice patterns with varied emphasis on allotment of resources to ensure safe and successful CCUS programs. DISCLOSURES: No relevant relationships by Andrew Berman, source=Web Response No relevant relationships by Sunil Chulani, source=Web Response No relevant relationships by Yonatan Greenstein, source=Web Response No relevant relationships by Keith Guevarra, source=Web Response No relevant relationships by Amee Patrawalla, source=Web Response