Ultrasound Competency Research Articles

Musculoskeletal Ultrasound Training and Competency Assessment Program for Rheumatology Fellows

The purpose of this study was to establish standards for musculoskeletal ultrasound competency through knowledge and skills testing using criterion-referenced methods. Two groups of rheumatology fellows trained in musculoskeletal ultrasound through a standardized curriculum, which required submission of ultrasound studies for review over 8 months. Both groups then completed written and practical examinations in musculoskeletal ultrasound. Instructors, advanced users, and intermediate users of musculoskeletal ultrasound served as comparison groups. A passing score (competency) was established for the written examination by the Angoff procedure and for the practical examination by the borderline method. Thirty-eight fellows (19 in each group) took the final examination. Five fellows failed the written examination, and 1 failed the practical examination, whereas none of the advanced users failed. Written examination scores did not differ between the two fellow groups (74% versus 70%; P > .05), were reliable, and were able to discriminate between the intermediate and advanced groups. Practical and written examination results correlated in both groups (first group, r = 0.70; P = .0008; second group, r = 0.59; P = .009). Criterion-referenced methods were used for the first time to determine fellow musculoskeletal ultrasound competency. The examination used to determine competency was reproducible, was reliable, and could differentiate musculoskeletal ultrasound users with different levels of experience. Most rheumatology fellows completing our program passed the written and practical examinations, suggesting achievement of basic musculoskeletal ultrasound competency.

CORD-AEUS: Consensus Document for the Emergency Ultrasound Milestone Project

In 2012, the Accreditation Council for Graduate Medical Education (ACGME) designated ultrasound (US) as one of 23 milestone competencies for emergency medicine (EM) residency graduates. With increasing scrutiny of medical educational programs and their effect on patient safety and health care delivery, it is imperative to ensure that US training and competency assessment is standardized. In 2011, a multiorganizational committee composed of representatives from the Council of Emergency Medicine Residency Directors (CORD), the Academy of Emergency Ultrasound of the Society for Academic Emergency Medicine (SAEM), the Ultrasound Section of the American College of Emergency Physicians (ACEM), and the Emergency Medicine Residents' Association was formed to suggest standards for resident emergency ultrasound (EUS) competency assessment and to write a document that addresses the ACGME milestones. This article contains a historical perspective on resident training in EUS and a table of core skills deemed to be a minimum standard for the graduating EM resident. A survey summary of focused EUS education in EM residencies is described, as well as a suggestion for structuring education in residency. Finally, adjuncts to a quantitative measurement of resident competency for EUS are offered.

International Multispecialty Consensus on How to Evaluate Ultrasound Competence: A Delphi Consensus Survey

ObjectivesTo achieve international consensus across multiple specialties on a generic ultrasound rating scale using a Delphi technique.MethodsUltrasound experts from Obstetrics-Gynaecology, Surgery, Urology, Radiology, Rheumatology, Emergency Medicine, and Gastro-Enterology representing North America, Australia, and Europe were identified. A multi-round survey was conducted to obtain consensus between these experts. Of 60 invited experts, 44 experts agreed to participate in the first Delphi round, 41 remained in the second round, and 37 completed the third Delphi round. Seven key elements of the ultrasound examination were identified from existing literature and recommendations from international ultrasound societies. All experts rated the importance of these seven elements on a five-point Likert scale in the first round and suggested potential new elements for the assessment of ultrasound skills. In the second round, the experts re-rated all elements and a third round was conducted to allow final comments. Agreement on which elements to include in the final rating scale was pre-defined as more than 80% of the experts rating an element four or five, on importance to the ultrasound examination.ResultsTwo additional elements were suggested by more than 10% of the experts in the first Delphi round. Consensus was obtained to include these two new elements along with five of the original elements in the final assessment instrument: 1) Indication for the examination 2) Applied knowledge of ultrasound equipment 3) Image optimization 4) Systematic examination 5) Interpretation of images 6) Documentation of examination and 7) Medical decision making.ConclusionInternational multispecialty consensus was achieved on the content of a generic ultrasound rating scale. This is the first step to ensure valid assessment of clinicians in different medical specialties using ultrasound.

SYSTEMS AND METHODS FOR ASSESSING A MEDICAL ULTRASOUND IMAGING OPERATOR'S COMPETENCY

Methods and systems are provided for assessing a medical ultrasound imaging operator's competency. The system includes a console containing a plurality of virtual controls, such as knobs, for simulating a real-life examination of a patient. The images created by the system change dynamically as the different virtual knobs on the console are adjusted. The console provides a certification examination for a medical ultrasound imaging operator. The console also includes a process to assess the medical ultrasound imaging operator's competency. The process determines a plurality of scores in order to assess the competency of the medical ultrasound imaging operator.

Multi-Site Validation of an Emergency Ultrasound Image Rating Scale–A Pilot Study

Currently, bedside ultrasound (BUS) competency in the United States is largely defined by number of examinations completed. We hypothesize that quantifying BUS image attributes is a better mechanism for quality assurance feedback and a more accurate indicator of trainee progress. To date there has been no widely accepted BUS image rating scale. Our aim was to introduce and report preliminary testing of a three-component, eight-point BUS rating scale (URS).

Focused ultrasound training for speciality registrars: a simple solution to curriculum difficulties

It has been recognised that trainees often have difficulty in developing skills in ultrasound scanning additionally there is no established RCOG regime for hands-on training in ultrasonography. Ultrasound skills are...

Is Basic Emergency Ultrasound Training Feasible as Part of Standard Undergraduate Medical Education?

Bedside ultrasonography is regularly used by surgeons and emergency physicians to perform focused assessment with sonography in trauma (FAST) in acutely-injured patients. Despite this, there is no formal ultrasound training in UK undergraduate curricula and postgraduate accreditation remains difficult to achieve. This study aims to assess the feasibility of teaching basic ultrasound skills to undergraduates using FAST scanning as a model module. Students were enrolled in a 5-hour theoretical and practical FAST scanning course. Ultrasound scanning competencies were ascertained using a 1-hour formal objective structured clinical examination (OSCE) assessment consisting of case-based discussions, problem-solving exercises, a complete FAST scan on a human volunteer, and free fluid detection exercises in organic simulators. A questionnaire was used to ascertain students' opinion on ultrasonography in undergraduate training. Twenty-five volunteer medical students (years 3 and 5) from a London medical school. Students did not have prior experience of formal ultrasound training. The mean score achieved in the summative assessment was 86%. Eighty-five percent of students completed a full FAST scan at an adequate level of performance in under 6 minutes. The feedback survey indicated that all students felt confident in operating the ultrasound apparatus and were able to obtain good quality images at the end of the 5-hour course. Eighty-eight percent of students thought ultrasonography was relevant to their training; all students intended to seek formal ultrasound accreditation; 92% believed ultrasound training should be a regular component of the curriculum; and 96% of students preferred using cart-based ultrasound machines rather than hand-held devices. Undergraduate ultrasound tuition is an achievable educational goal which is well received by medical students. Medical schools need to consider the formal introduction of ultrasound teaching in their curricula to equip future doctors with relevant skill sets. The role of handheld ultrasound machines requires further investigation.

Ultrasound Educational Competency Hierarchical Outcomes: A Report on the Novice Ultrasound User, the First Year Medical Student

Ultrasound Educational Competency Hierarchical Outcomes: A Report on the Novice Ultrasound User, the First Year Medical Student

Obstetrical ultrasound training of and practise by general practitioners in the private sector, Free State

Background: The aim of the study was to determine the level of obstetrical ultrasound training and practice of general practitioners in the Free State private sector. Methods: In this descriptive study, questionnaires were mailed to all general practitioners in the Free State private sector. The questionnaire included demographic information about the practitioner, the ultrasound profile of the practice, and the type of machine used. Results: Four hundred and eighty-one questionnaires were sent to general practitioners and 229 (47.6%) were returned. Of the 176 practising respondents, 47 (26.8%) used ultrasound. The majority of ultrasound examinations done per month were obstetrical. Eight practitioners had relevant qualifications for using ultrasound and more than a third (18, 38.3%) had no training in ultrasound use. Less than half (19, 40.4%) of the practitioners that use ultrasound were aware of the South African Association of Ultrasound in Obstetrics and Gynaecology (SASUOG). Conclusions: The response to the questionnaire was low and may have influenced the results. The study indicates that there are general practitioners who perform ultrasound examinations without training. As general practitioners mainly do obstetrical ultrasound, it is recommended that the SASUOG play a bigger role in their training. A diploma course in ultrasound and support from medical aid organisations to only pay full fees to doctors who can prove that they have sufficient ultrasound training and competence will be ideal. (SA Fam Pract 2004;46(6): 25-27)

Endoscopic Ultrasound and Clinical Competence

The last few years have seen substantial growth in technology, research, and performance of endoscopic ultrasound. Unfortunately, opportunities for training in EUS have not kept pace with this growth. To improve the breadth and quality of training in EUS, resources will need to be channeled in two directions. One is the development of endoscopic ultrasound training programs in academic centers. These would provide the expertise and the number of patients necessary to train selected GI fellows in EUS. The second direction is toward development of systems for retraining of physicians already in practice. We believe that this would require the development of EUS simulation systems combined with a short, intense, hands-on training in centers of excellence. How fast these training systems will develop is dependent upon market forces. If the information provided by EUS can be proven to reduce costs and if the results improved patient's quality of life, the development of training programs for EUS would accelerate markedly.