Effect of ultrasound training of physicians working in the prehospital setting.

Charlotte Loumann Krogh,Lars S Rasmussen,Freddy K Lippert,Jacob Steinmetz,Peter A Berlac,Søren Steemann Rudolph,Rasmus Hesselfeldt

doi:10.1186/s13049-016-0289-1

Abstract

BackgroundAdvances in technology have made ultrasound (US) devices smaller and portable, hence accessible for prehospital care providers. This study aims to evaluate the effect of a four-hour, hands-on US training course for physicians working in the prehospital setting. The primary outcome measure was US performance assessed by the total score in a modified version of the Objective Structured Assessment of Ultrasound Skills scale (mOSAUS).MethodsPrehospital physicians participated in a four-hour US course consisting of both hands-on training and e-learning including a pre- and a post-learning test. Prior to the hands-on training a pre-training test was applied comprising of five videos in which the participants should identify pathology and a five-minute US examination of a healthy volunteer portraying to be a shocked patient after a blunt torso trauma. Following the pre-training test, the participants received a four-hour, hands-on US training course which was concluded with a post-training test. The US examinations and screen output from the US equipment were recorded for subsequent assessment. Two blinded raters assessed the videos using the mOSAUS.ResultsForty participants completed the study. A significant improvement was identified in e-learning performance and US performance, (37.5 (SD: 10.0)) vs. (51.3 (SD: 5.9) p = < 0.0001), total US performance score (15.3 (IQR: 12.0-17.5) vs. 17.5 (IQR: 14.5-21.0), p = < 0.0001) and in each of the five assessment elements of the mOSAUS.ConclusionIn the prehospital physicians assessed, we found significant improvements in the ability to perform US examinations after completing a four-hour, hands-on US training course.

Highlights

Advances in technology have made ultrasound (US) devices smaller and portable, accessible for prehospital care providers
3 did not complete the pre-training test 3 did not complete the post-training test 40 participants included in the study pre-training test and work related obligations immediately after the course (Fig. 1)
This study demonstrates that a four-hour, hands-on US training course, preceded by e-learning, had a substantial impact on prehospital physicians’ US skills

Summary

Introduction

Advances in technology have made ultrasound (US) devices smaller and portable, accessible for prehospital care providers. Advances in technology have reduced cost and size of US devices making them available for prehospital care providers. US examinations are highly operator dependent, yet prehospital US examinations are mostly performed by non-radiologists with variable US experience. To overcome this dilemma point-of-care US protocols are characterized by addressing specific (often dichotomous) questions [11]. This approach makes point-of-care US suitable for the prehospital setting enabling clinical decision making without delay in patient treatment.

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Conclusion