Abstract
PurposeDeveloping countries need effective and efficient training curriculum for the point-of-care ultrasound (POCUS) in the emergency department (ED). We have developed a new goal-directed training curriculum focusing on critical POCUS procedures used in ED.MethodsTo evaluate the impact of the new POCUS curriculum on ED physicians’ performance/self-confidence, we carried out a quasi-experimental trial at ED training center of Peking Union Medical College Hospital, in which we trained two groups of physicians using either traditional curriculum or the new goal-directed curriculum. We measured the confidence in performing Focused Assessment with Sonography in Trauma, thoracic, vascular, ultrasound-guided puncture, echocardiography and undifferentiated shock diagnostic ultrasound at baseline, training completion and 1 month after training. We also measured the performance skills at the time of training completion. The relative value of the new curriculum was evaluated by differences in the confidence and performance measurements, with control for baseline measurements and confounding characteristics in univariate analyses and multivariate linear regression models.ResultsAfter training, both groups of trainees reported significantly increased self-confidence in performing POCUS as compared with baseline. Trainees with the new curriculum had statistically significant higher self-confidence increase and performance scores (p < 0.05), e.g., increase in confidence for diagnosis of undifferentiated shock at training completion = 3.14 vs. 1.85, 1 month after training = 2.22 vs. 1.56, for new and traditional curriculum, respectively. The new curriculum also resulted in a higher number of shock POCUS done within 1 month after training: 1.73 vs. 0, and higher overall performance scores: 165 vs. 113. The findings were robust when controlling for imbalanced baseline characteristics in multivariate regression models.ConclusionWe conclude that a goal-directed, intensive but brief ED POCUS curriculum significantly increases trainee self-confidence, performance, and promote trainees to perform more procedures.
Highlights
Many clinical settings have adopted the point-of-care ultrasound (POCUS) in practices [1,2,3,4,5]
Twenty-seven trainees enrolled before 2017 received traditional POCUS training, while 37 trainees received training using the new curriculum
The prior experiences with different ultrasound procedures were reflected in the corresponding baseline self-confidence, with diagnosing undifferentiated shock being the one with the lowest confidence
Summary
Many clinical settings have adopted the point-of-care ultrasound (POCUS) in practices [1,2,3,4,5]. Recognizing the value of the POCUS and the need for adequate training, various clinical settings have developed POCUS training curriculums [6,7,8,9,10,11]. Time-consuming sessions are expensive to institute, especially for developing countries with a considerable gap in physician POCUS expertise and limited resources. Curriculums that delivers both efficiency and quality are in great need to enable trainees in achieving a solid understanding of the anatomic structure, obtaining high-quality images in standard views, recognizing pathological findings and supporting clinical decisions
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