Abstract
BackgroundThe Hospital Pediatrico Universitario (HOPU) is the principal institution in Puerto Rico offering medical services to the children of the island and the Caribbean. There is limited use of point-of-care ultrasound (PoCUS) in their emergency department (ED) and obtaining an ultrasound through radiology is prohibitively time consuming. The objective of this study is to increase PoCUS knowledge and comfort by the ED physicians in the HOPU pediatric emergency department.ResultsThirteen general pediatricians completed the entire PoCUS course, but only 10 completed both the pre- and post-tests and therefore included in the analysis (N = 10). Pretest scores ranged from 30 to 63.3% with a mean of 41.6% [standard deviation (SD) 9.95]. The posttest scores ranged from 55 to 96%, with a mean of 66.1% (SD 12.26). The mean difference in scores was 24.42% (95% confidence interval 17.9, 30.9) with a significance of p < 0.05 and range of 8.3–36.6%. Physician experience and confidence with each topic improved from baseline. After the course, the majority of the participants (> 70%) had at least some confidence in 5 of the 6 topics.ConclusionsIn EDs with limited resources, a longitudinal PoCUS educational curriculum is effective in improving the knowledge and comfort of physicians with limited PoCUS experience. The effectiveness of scheduled, repeated courses to refresh and refocus participants was highlighted following the unexpected challenges encountered during the course, including multiple natural disasters.
Highlights
The Hospital Pediatrico Universitario (HOPU) is the principal institution in Puerto Rico offering medical services to the children of the island and the Caribbean
The mean change in test score for the participants was 24.42% with a range of 8.3–36.6% and a standard deviation of 9.03 (p value < 0.01) (Fig. 1). This is meant to be a challenging test with a passing score of 75% for University of Louisville pediatric emergency medicine (PEM) physicians who are seeking bedside point-of-care ultrasound (PoCUS) credentialing
The investigators show that a longitudinal PoCUS curriculum is an effective design to teach PoCUS to local physicians working in acute emergency department (ED) settings
Summary
The Hospital Pediatrico Universitario (HOPU) is the principal institution in Puerto Rico offering medical services to the children of the island and the Caribbean. There is limited use of point-of-care ultrasound (PoCUS) in their emergency department (ED) and obtaining an ultrasound through radiology is prohibitively time consuming. The objective of this study is to increase PoCUS knowledge and comfort by the ED physicians in the HOPU pediatric emergency department. PoCUS is an affordable, safe, and efficient imaging modality with a wide variety of uses in the medical field, in the emergency setting. Medical providers in Europe have utilized ultrasound for decades and over the last 20 years; its use has exploded in the United States. Since 1985, the World Health Organization (WHO) has recommended ultrasonography for developing countries because it is portable, inexpensive, non-invasive, safe, and provides information immediately [6, 8]. Via et al noted that point-of-care ultrasound (PoCUS) has a significant impact in undifferentiated shock, narrowing
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