Training Pathways Research Articles

Global survey on point-of-care ultrasound (pocus) use in child surgery

PurposeTo undertake a global assessment of existing ultrasound practices, barriers to access, point-of-care ultrasound (POCUS) training pathways, and the perceived clinical utility of POCUS in Child Surgery.MethodsAn electronic survey was disseminated via the GICS (Global Initiative of Children’s Surgery) network. 247 anonymized responses from 48 countries were collated. 71.3% (176/247) worked in child surgery.ResultsUltrasound was critical to practice with 84% (147/176) of requesting one daily or multiple times per week. Only 10% (17/176) could access emergency ultrasound < 1 h from request. The main barrier was a lack of trained personnel. HIC surgeons were more likely to have ultrasound training (24/29; 82.8%) compared with LMICs (74/147; 50.3%) (p = .001319; CI 95%). Self-perceived POCUS competence was associated with regularity of POCUS use (p < 0.001; CI 95%). Those who already practice POCUS most commonly use it for trauma, intussusception, and ultrasound-guided procedures. Majority (90%; 159/176) of child surgeons would attend formal POCUS training if available.ConclusionsUltrasound is critically important in children’s surgery globally, however, many surgeons experience barriers to timely access. There is a strong interest in learning POCUS for relevant pediatric surgical applications. Further research is needed to evaluate the best methods of training, accreditation, and governance.

Competencies required by sonographers teaching ultrasound interprofessionally: a Delphi consensus study

BackgroundClinicians from multiple professional backgrounds are increasingly using point-of-care ultrasound in clinical practice. Performing ultrasound is a complex skill, and training is required to ensure competency and patient safety. There is a lack of skilled trainers within health professions to meet this increasing educational demand. The role of sonographers in educating other health professionals in point-of-care ultrasound has not yet been well defined. Sonographers can provide ultrasound education interprofessionally, if equipped with appropriate clinical knowledge and educational skills.MethodsA Delphi consensus study was conducted to define the knowledge, skills and attributes required of sonographers teaching point-of-care ultrasound to other health professionals in Australia and New Zealand. Health professionals with subject matter expertise in the leadership, facilitation, and delivery of ultrasound education by sonographers were invited to participate.ResultsThere were 72 expert participants in survey round one, and 49 in round two. Participants included physicians, sonographers, and other health professionals. Consensus was reached on 31 competency items for sonographers teaching ultrasound interprofessionally, with agreement of greater than 94% reached by participants.ConclusionsThis consensus study has defined the knowledge, skills and attitudes required for sonographer competence in point-of-care ultrasound education. This is an important step to developing a training pathway for sonographers engaging in this emerging area.

Consensus guidelines on the bedside assistant skills required in robotic surgery

BackgroundWhile bedside assistants play a critical role in many robotic operations, substantial heterogeneity remains in bedside assistant training pathways. As such, this study aimed to develop consensus guidelines for bedside assistant skills required for team members in robotic operations.MethodsWe designed a study using the Delphi process to develop consensus guidelines around bedside assistant skills. We generated an initial list of bedside assistant skills from the literature, training materials, and expert input. We selected experts for the Delphi process based on prior scholarship in the area of robotic bedside assistant education and experience facilitating robotic bedside assistant training. For each item, respondents specified which robotic team members should have the skill from a list of “basic” bedside assistants, “advanced” bedside assistants, surgeons, surgical technologists, and circulating nurses. We conducted two rounds of the Delphi process and defined 80% agreement as sufficient for consensus.ResultsFourteen experts participated in two rounds of the Delphi process. By the end of the second round, the group had reached consensus on 253 of 305 items (83%). The group determined that “basic” bedside assistants should have 52 skills and that “advanced” bedside assistants should have 60 skills. The group also determined that surgeons should have 54 skills, surgical technologists should have 25 skills, and circulating nurses should have 17 skills. Experts agreed that all participants should have certain communication skills and basic knowledge of aspects of the robotic system.ConclusionsWe developed consensus guidelines on the skills required during robotic surgery by bedside assistants and other team members using the Delphi process. These findings can be used to design training around bedside assistant skills and assess team members to ensure that each team member has the appropriate skills. Hospitals can also use these guidelines to standardize expectations for robotic team members.

Onconephrology Fellowship Training: Current Status and Future Outlook.

Onconephrology, an emerging discipline nestled at the intersection of nephrology and oncology, has experienced remarkable growth over the past 15 years. This evolution has been punctuated by pivotal events, including establishing the American Society of Onconephrology, dedicated forums, and journals, highlighting its increasing significance. The clinical landscape of onconephrology is diverse, encompassing AKI in patients with cancer, toxicity from anticancer treatments, and a spectrum of electrolyte disorders, necessitating close collaboration between nephrologists and oncologists. However, trainees and mentors encounter various challenges surrounding its status as a distinct subspecialty. To overcome these barriers, there is a pressing need for streamlined training pathways, enhanced interdisciplinary collaboration, and targeted research efforts to elucidate the effect of onconephrology on patient outcomes. By addressing these challenges head-on, the field of onconephrology can continue its trajectory of growth and better serve patients with cancer with complex kidney needs.

The Fletcher-Cox Pathway: A Unique View on Clinical Trial Education

PurposeThere currently are no established formal mentorship and training program for radiation oncology (RO) trainees to learn trial design, creation, writing, or implementation. There only exists informal training on analyzing clinical trials in RO residency programs. The integration of a longitudinal formal training and mentorship program for clinical trialists - consisting of clinical trial education, design, mentorship, and implementation during the RO residency education will give residents not only formal teaching in the subject, but strong tools and requisite mentorship in hopes to help them succeed as future academic physicians and leaders in the field of radiation oncology. Methods and MaterialsWe developed a clinical trial training pathway in 2018 at XXX, proposing it as a pilot program. The “Fletcher-Cox Pathway” was accepted with a highly positive response by trainees. and is is now offered as a standard option to RO trainees at our institution. ResultsWith the guidance of their principal investigator (PI), residents participating in this pathway design and submit a clinical trial for institutional review board (IRB) review. In 2019, after implementation of the pilot program, 4 of the incoming 7 residents joined the pathway. The program continues, and the current cohort of trainees have received training in clinical trials design andworked with dedicated mentor(s) regarding clinical trial ideas; their studies are currently accruing patients. ConclusionsThis pilot program has been viewed by trainees and mentors as successful; it highlights how a structured approach meets a clear need within RO training. We envision the creation of a national platform to increase access, whereby programs adopt this clinical trialist educational pathway, which ultimately leads to the development of a robust clinical trial community with communal resources. We hope that this not only improves and provides educational initiatives to all trainees but also initiates further collaboration.

Exploring global barriers to optimal ovarian cancer care: thematic analysis

ObjectiveTo explore the barriers to ovarian cancer care, as reported in the open ended responses of a global expert opinion survey, highlighting areas for improvement in global ovarian cancer care....

Integrating academic medical education into vocational general practitioner training: how do these combined training posts impact on subsequent career paths?

ABSTRACT Background In the UK, to encourage academic careers, extended education posts (EEPs) exist, where standard three-year, general practice vocational training is extended, offering trainees dedicated time to spend in another specialty such as medical education (Med Ed). Little is known about whether this impacts positively on their subsequent careers. Aims To explore general practitioners’ (GPs’) experiences and career trajectories after undertaking Med Ed EEPs. Method Twenty-eight GPs who completed a Med Ed EEP between 2013 and 2021 were invited to participate. Semi-structured interviews were held virtually. Transcripts were coded with NVivo software and underwent thematic analysis using Braun and Clarke’s six-phase framework to ensure a reiterative process of internal validation. Results Eight GPs took part. All were working as NHS GPs, alongside other roles. Four themes emerged: ‘growing as an academic educator’, ‘research can be interesting’, ‘the academic environment’ and ‘juggling multiple roles is stressful’. Most were still teaching, involved in research and had undertaken formal Med Ed training. Role models and immersion in academic teams were influential. Significant tensions and stresses were experienced when balancing multiple roles. The absence of ongoing academic training tracks contributed to this. Conclusion EEPs impact positively on academic career development and the acquisition of appropriate skills. However, managing multiple roles is challenging and stressful. Short-term university contracts, difficulties obtaining flexible working and resultant lack of partnership or salaried clinical work highlight an urgent need to explore fixed academic training pathways after vocational training, if sustainable recruitment into primary care academia is to be achieved.

The Impact of a Pilot Oncology Summer Internship on Oncology Awareness Among Early Medical Students from Underrepresented Backgrounds: A Mixed-Methods Study.

Oncology is a field of medicine projected to face provider shortages as cancer prevalence rises. Moreover, the diversity of oncologists remains subpar compared to that of the general population despite initiatives to increase the number of students from underrepresented backgrounds (UIM). Thus, first-year UIM medical students interested in oncology were invited to participate in a 4-week oncology summer internship (OSI) to gain clinical exposure and mentorship experiences. The OSI connected students with oncologists for mentorship, provided tours of oncologic facilities, and coordinated shadowing opportunities. The impact of the OSI was assessed via a mixed-methods approach. Pre- and post-survey data were collected from eight of the nine OSI students. Quantitative data demonstrated improvement of students' understanding of oncology as a discipline, for example its training pathways (p = .02), and awareness of patient experiences in oncology, for example socioeconomic challenges (p = .008). Students reported an increased ability to identify with those in oncology and identify mentors in the field (p = .03 and p = .05, respectively). Qualitative data demonstrated continued interest in oncology with increased commentary on the patient experience and social determinants of health. Post-survey, students provided more commentary on the need for diversity in the field and possible increased professional connections in medicine. The OSI improved students' understanding of oncology and oncology patient experiences with potentially increased identification of and connection with others in the field. Further work will focus on assessing the impact of future OSIs on professional identity formation.

An integrated vascular surgery residency program would increase interest among Saudi medical students in a career in vascular surgery

Background and objectivesConsidering the absence of integrated vascular surgery residency programs in Saudi Arabia, and the need for planning training pathways, we aim to identify how many medical students are interested in vascular surgery, and the factors affecting students’ opinions on pursuing vascular surgery. Materials and Methods: A cross-sectional study was conducted using an online questionnaire that was distributed to medical students nationwide via social media and email. Data were collected from 13 February 2022 to 1 March 2022. Results: A total of 408 students participated. Among them, 152 students were interested in general surgery, of which 103 were considering vascular surgery as a possible future fellowship. However, only 29 out of 408 (7.1%) students picked vascular surgery as their 1st choice. The main motivating factors for students to pursue vascular surgery as a career were: an interest in vascular cases (cardiovascular science), the use of emerging technologies, and the endovascular capabilities of vascular surgeons. The negative factors were simply a preference for another specialty, followed by a lack of experience in vascular surgery. Conclusion: This study reveals that only 7.1% of students consider vascular surgery their first choice. Both the lack of vascular surgeons and students’ experience in vascular surgery affected awareness levels. Interaction with vascular surgeons through virtual rotations for under-served medical schools and the introduction of vascular sciences within the cardiology blocks during basic science years are recommended strategies.

Identifying and addressing mentorship gaps in European trauma and emergency surgical training. Results from the Young European Society of Trauma and Emergency Surgery (yESTES) mentorship survey.

European training pathways for surgeons dedicated to treating severely injured and critically ill surgical patients lack a standardized approach and are significantly influenced by diverse organizational and cultural backgrounds. This variation extends into the realm of mentorship, a vital component for the holistic development of surgeons beyond mere technical proficiency. Currently, a comprehensive understanding of the mentorship landscape within the European trauma care (visceral or skeletal) and emergency general surgery (EGS) communities is lacking. This study aims to identify within the current mentorship environment prevalent practices, discern existing gaps, and propose structured interventions to enhance mentorship quality and accessibility led by the European Society for Trauma and Emergency Surgery (ESTES). Utilizing a structured survey conceived and promoted by the Young section of the European Society of Trauma and Emergency Surgery (yESTES), we collected and analyzed responses from 123 ESTES members (both surgeons in practice and in training) across 20 European countries. The survey focused on mentorship experiences, challenges faced by early-career and female surgeons, the integration of non-technical skills (NTS) in mentorship, and the perceived role of surgical societies in facilitating mentorship. Findings highlighted a substantial mentorship experience gap, with 74% of respondents engaging in mostly informal mentorship, predominantly centered on surgical training. Notably, mentorship among early-career surgeons and trainees was less reported, uncovering a significant early-career gap. Female surgeons, representing a minority within respondents, reported a disproportionately poorer access to mentorship. Moreover, while respondents recognized the importance of NTS, these were inadequately addressed in current mentorship practices. The current mentorship input of surgical societies, like ESTES, is viewed as insufficient, with a call for structured programs and initiatives such as traveling fellowships and remote mentoring. Our survey underscores critical gaps in the current mentorship landscape for trauma and EGS in Europe, particularly for early-career and female surgeons. A clear need exists for more formalized, inclusive mentorship programs that adequately cover both technical and non-technical skills. ESTES could play a pivotal role in addressing these gaps through structured interventions, fostering a more supportive, inclusive, and well-rounded surgical community.

The training pathway for residents: ‘Robotic Curriculum for young Surgeons’ (RoCS) does not impair patient outcome during implementation into clinical routine

The “Robotic Curriculum for young Surgeons” (RoCS) was launched 03/2020 to address the increasing importance of robotics in surgical training. It aims to provide residents with foundational robotic skills by involving them early in their training. This study evaluated the impact of RoCS’ integration into clinical routine on patient outcomes. Two cohorts were compared regarding the implementation of RoCS: Cohort 1 (before RoCS) included all robot-assisted procedures between 2017 and 03/2020 (n = 174 adults) retrospectively; Cohort 2 (after RoCS) included all adults (n = 177) who underwent robotic procedures between 03/2020 and 2021 prospectively. Statistical analysis covered demographics, perioperative parameters, and follow-up data, including mortality and morbidity. Subgroup analysis for both cohorts was organ-related (upper gastrointestinal tract (UGI), colorectal (CR), hepatopancreaticobiliary system (HPB)). Sixteen procedures were excluded due to heterogeneity. In-hospital, 30-, 90-day morbidity and mortality showed no significant differences between both cohorts, including organ-related subgroups. For UGI, no significant intraoperative parameter changes were observed. Surgery duration decreased significantly in CR and HPB procedures (p = 0.018 and p < 0.001). Estimated blood loss significantly decreased for CR operations (p = 0.001). The conversion rate decreased for HPB operations (p = 0.005). Length of hospitalization decreased for CR (p = 0.015) and HPB (p = 0.006) procedures. Oncologic quality, measured by histopathologic R0-resections, showed no significant changes. RoCS can be safely integrated into clinical practice without compromising patient safety or oncologic quality. It serves as an effective training pathway to guide robotic novices through their first steps in robotic surgery, offering promising potential for skill acquisition and career advancement.

Robotic colorectal surgery training: Portsmouth perspective.

This study aims to discuss the principles and pillars of robotic colorectal surgery training and share the training pathway at Portsmouth Hospitals University NHS Trust. A narrative review is presented to discuss all the relevant and critical steps in robotic surgical training. Robotic training requires a stepwise approach, including theoretical knowledge, case observation, simulation, dry lab, wet lab, tutored programs, proctoring (in person or telementoring), procedure-specific training, and follow-up. Portsmouth Colorectal has an established robotic training model with a safe stepwise approach that has been demonstrated through perioperative and oncological results. Robotic surgery training should enable a trainee to use the robotic platform safely and effectively, minimize errors, and enhance performance with improved outcomes. Portsmouth Colorectal has provided such a stepwise training program since 2015 and continues to promote and augment safe robotic training in its field. Safe and efficient training programs are essential to upholding the optimal standard of care.

Women’s Mental Health: Current and Future Training Pathways

Women’s Mental Health: Current and Future Training Pathways

Mind the Gap: Understanding Palliative Care Clinician Attitudes Toward Mental Health Training.

Background: Palliative care (PC) clinicians provide mental healthcare to individuals with serious illnesses. Despite this, there is limited knowledge regarding their mental health training opportunities. Methods: To identify predictors of satisfaction with mental health training opportunities and assess the relationship between training opportunities and clinician comfort in managing mental health comorbidities, we conducted a secondary analysis of a nationwide survey involving 708 PC clinicians. Results: Satisfaction with mental health training was moderate (M = 2.75/5, SD = .915). Access to lectures/webinars was the most common training opportunity (54%). Significant predictors of satisfaction with training included access to lectures/webinars (β = .328, P <.001) and case discussions (β = .231, P = .007). Academic practice settings and satisfactory mental health referrals were associated with a greater number of different training opportunities. Clinicians in academic settings had higher odds of accessing various training opportunities, such as lectures/webinars (OR = 2.58, P <.001) and longitudinal training pathways (OR = 4.51, P <.001). A moderate, positive correlation was found between training satisfaction and comfort in managing mental health comorbidities (r = .30, P <.001). Discussion: This study is among the first to elucidate factors influencing PC clinicians' satisfaction with mental health training. Low-resource training opportunities, such as webinars and lectures, significantly predict satisfaction, suggesting the potential of these scalable solutions to enhance training. The findings underscore the importance of expanding evidence-based mental health training for PC clinicians to improve patient care.

Are There Differences in Short-Term Postoperative Outcomes Among Surgical Subspecialists Performing Lower Extremity Flap Procedures? A National Surgical Quality Improvement Project (NSQIP) Analysis of 1324 Patients

Introduction: Soft tissue flaps are an integral and versatile tool to help manage soft tissue defects of varying severities. These complex procedures can be done by a variety of specialties and can lead to a variety of postoperative complications. Locoregional flaps are the middle rung of the reconstructive ladder and can be performed by surgeons of various training pathways. The profile of patients and their complications when stratified by surgical specialty is unknown. The purpose of this study was to compare short-term postoperative outcomes between surgical subspecialists performing a locoregional flap of the lower extremity to determine factors influencing complication rates. Methods: The National Surgical Quality Improvement Project (NSQIP) database was queried using Current Procedural Terminology code 15,738 to identify adult patients undergoing a muscle, myocutaneous, or fasciocutaneous lower extremity flap procedure from 2016 to 2019. We examined the primary outcome of a pooled wound complication rate with secondary outcomes including the individual NSQIP wound- and nonwound complications. Results: A total of 1324 patients were identified. Plastic surgeons performed 926 (70%) procedures, general surgeons performed 243 (18%) procedures, orthopedic surgeons performed 89 (7%) procedures, and vascular surgeons performed 66 (5%) procedures. On multivariate analysis, surgical subspecialty was not associated with the primary outcome, but malignancy-related operations and nonelective status were considered significant. Conclusions: Patient characteristics, but not surgeon subspecialty, account for the variation in patient outcomes in lower extremity flap reconstruction. Larger, prospective studies examining these outcomes are needed to further characterize complication risk factors in this patient population.

Opportunities in Pulmonary and Critical Care Medicine for Dual-trained Medicine and Pediatric Physicians.

Combined internal medicine-pediatrics (med-peds) training has been recognized as a unique, Accreditation Council for Graduate Medical Education-accredited residency pathway since 1967, resulting in more than 10,000 graduates. Med-peds graduates have the option of pursuing combined med-peds fellowships with a 1-year reduction in training time compared with pursuing such fellowships separately. The typical med-peds resident spends 8-9 months in the intensive care unit during residency, with additional rotations in pulmonary medicine; not surprisingly, residents are increasingly inquiring about combined med-peds fellowship training within the fields of pulmonary and critical care medicine. In this review, we outline both the advantages and challenges of such training and present various pathways and considerations to achieve board certification.

Responding to the workforce crisis: consensus recommendations from the Second Workforce Summit of the American Society of Pediatric Nephrology

ImportancePediatric patients with complex medical problems benefit from pediatric sub-specialty care; however, a significant proportion of children live greater than 80 mi. away from pediatric sub-specialty care.ObjectiveTo identify current knowledge gaps and outline concrete next steps to make progress on issues that have persistently challenged the pediatric nephrology workforce.Evidence reviewWorkforce Summit 2.0 employed the round table format and methodology for consensus building using adapted Delphi principles. Content domains were identified via input from the ASPN Workforce Committee, the ASPN’s 2023 Strategic Plan survey, the ASPN’s Pediatric Nephrology Division Directors survey, and ongoing feedback from ASPN members. Working groups met prior to the Summit to conduct an organized literature review and establish key questions to be addressed. The Summit was held in-person in November 2023. During the Summit, work groups presented their preliminary findings, and the at-large group developed the key action statements and future directions.FindingsA holistic appraisal of the effort required to cover inpatient and outpatient sub-specialty care will help define faculty effort and time distribution. Most pediatric nephrologists practice in academic settings, so work beyond clinical care including education, research, advocacy, and administrative/service tasks may form a substantial amount of a faculty member’s time and effort. An academic relative value unit (RVU) may assist in creating a more inclusive assessment of their contributions to their academic practice. Pediatric sub-specialties, such as nephrology, contribute to the clinical mission and care of their institutions beyond their direct billable RVUs. Advocacy throughout the field of pediatrics is necessary in order for reimbursement of pediatric sub-specialist care to accurately reflect the time and effort required to address complex care needs. Flexible, individualized training pathways may improve recruitment into sub-specialty fields such as nephrology.Conclusions and relevanceThe workforce crisis facing the pediatric nephrology field is echoed throughout many pediatric sub-specialties. Efforts to improve recruitment, retention, and reimbursement are necessary to improve the care delivered to pediatric patients.Graphical A higher resolution version of the Graphical abstract is available as Supplementary information.

807 Reliability of Simulation-Based Assessment of Surgical Technical Skills

Abstract Aim To examine the reliability of surgical trainees’ assessment data from a structured simulation training and assessment programme. Method The General Surgical Skills Programme is a simulation-based surgical training programme integrated within the clinical training pathway for surgical trainees across London. It is tailored to each trainee’s level of training and subspecialty. The ‘Junior’ pathway involves nine training sessions and one assessment session performing three procedures (Inguinal hernia [IH], laparoscopic cholecystectomy [LC] and small bowel anastomoses [SBA]). Within the scope of the Programme, skills assessment data collection was initiated in 2012. Data collected includes demographics and training data (grade/subspecialty/case numbers). Each procedure is assessed by two consultant surgeons using two procedure specific assessment tools, a visual analogue scale (VAS) and competency assessment tool (CAT). Reliability analyses were performed using SPSS for ‘Junior’ data over a four-year period. Results In total, 355 surgical trainees (Male = 199, Female = 154, Missing = 2) were assessed from 2014 to 2017 (2014 n=105; 2015 n=92; 2016 n=89; 2017 n=69). Both assessment tools showed satisfactory inter-item reliability (IH-CAT α=.794-.903, LC-CAT α=.837–910, IH-VAS α=.851-.991, LC-VAS α=.831-.986, SBA-VAS α=.778-.984). Inter-rater reliability, ICC (1,2), was good to poor across all tools. (IH-CAT .345-.510, IH-VAS .243-.600, LC-CAT .271-.766, LC-VAS .157-.678, SBA-VAS .225-.278). Conclusions The assessment tools used within the Programme both demonstrate satisfactory inter-item reliability. Inter-rater reliability is variable, highlighting a potential utility for assessor training within the Programme.

61 Investigating Barriers to Surgical Careers and Addressing the Growing Need for Diverse Role Models in Surgery Through a Mentoring Event

Abstract Aim Attrition of females during surgical training remains a significant problem; only 14.7% become consultants. This project aimed to assess barriers to surgical careers and provide diverse role models to support uptake. Method A mentoring event was held, first-of-its-kind locally, including surgeons from diverse backgrounds and career stages discussing career journeys, work-life balance, parenthood, and less-than-full-time training. Surveys were disseminated before (“pre-event”), immediately after (“post-event”), and five months later (“follow-up”), to assess longevity of impact. Surveys involved open-ended and Likert-scale questions (‘10=very-much’; ‘0=not at all’) across a series of statements assessing opinion regarding surgical careers. Descriptive statistics and thematic qualitative analysis were undertaken. Results Students identifying as female across all year-groups from London completed pre-event (n=25), post-event (n=25), and follow-up (n=11) surveys. More students were considering surgical careers following the event (score ≥7/10: pre-event 76%; post-event 92%; follow-up 91%). The most common uncertainties and worries reduced after the event: work-life balance (pre-event 48%; post-event 24%); and parenthood (32%;24%). However, remaining concerns included the training pathway (32%;36%) and competitiveness (20%;36%), with 18% citing sexual harassment as a deterrent at follow-up. 84% scored ≥8/10 stating the event strengthened their decision to become a surgeon. The event met all expectations, exceeding in 28%. The format was well received (60% scoring 10/10), and 96% signed for additional mentoring. Conclusions The value of mentoring through a single evening and early support in decision making is potentially beneficial to career progression for aspiring surgeons. Continuous support in the form of further evenings and long-term mentoring should be explored.

Improving lung point-of-care ultrasound (POCUS) training and accreditation - a multidisciplinary, multi-centre and multi-pronged approach to development and delivery using the action learning process

BackgroundPoint-of-Care Ultrasound (POCUS) consists of a range of increasingly important imaging modalities across a variety of specialties. Despite a variety of accreditation pathways available in the UK, lung POCUS training remains difficult to deliver and accreditation rates remain suboptimal. We describe a multidisciplinary, multi-centre, and multi-pronged approach to lung POCUS education within a region.MethodsA survey was conducted in a region. From these results, bottlenecks were identified for improvement. We utilised key stages in an established accreditation pathway, and the Action Learning process. Analysing participant feedback, consensus amongst the team, regional educational needs, and leveraging the expertise within the faculty, we implemented several solutions which were multidisciplinary, multi-centre, and multi-pronged. We also set up a database across several accreditation pathways to facilitate supervision and assessment of rotational trainees.ResultsUtilising the Action Learning process, we implemented several improvements at elements of the lung ultrasound accreditation pathways. An initial regional survey identified key barriers to accreditation: lack of courses (52%), lack of mentors (93%), and difficulty arranging directly supervised scans (73%). A multidisciplinary team of trainers was assembled. Regular courses were organised and altered based on feedback and anecdotal educational needs within the region. Courses were set up to also facilitate continuing professional development and exchange of knowledge and ideas amongst trainers. The barrier of supervision was removed through the organisation of regular supervision sessions, facilitating up to fifty scans per half day per trainer. We collected feedback from courses and optimised them. Remote mentoring platforms were utilised to encourage asynchronous supervision. A database of trainers was collated to facilitate triggered assessments. These approaches promoted a conducive environment and a commitment to learning. Repeat survey results support this.ConclusionLung ultrasound accreditation remains a complex educational training pathway. Utilising an education framework, recruiting a multidisciplinary team, ensuring a multi-pronged approach, and fostering a commitment to learning can improve accreditation success.