scholarly journals LO092: The educational impact of a formalized RUSH (Rapid Ultrasound in Shock) protocol in emergency medicine residency ultrasound training

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S61-S62
Author(s):  
C. Hrymak ◽  
E. Weldon ◽  
C. Pham
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Image Acquisition ◽  
Image Interpretation ◽  
Comfort Level ◽  
Point Of Care Ultrasound ◽  
Educational Impact ◽  
Hands On ◽  
Before And After ◽  
Junior Residents

Introduction: Point of care ultrasound for assessment of undifferentiated hypotension and shock is part of the clinical scope of Emergency Physicians in Canada. The RUSH Exam outlines a systematic approach to these patients. A RUSH Exam educational model using didactic and hands on practice was developed and implemented for Emergency Medicine (EM) residents. This study evaluated the effectiveness of the module in a simulated setting on the following endpoints: improvement in image acquisition, interpretation, speed, and subjective comfort level, among EM residents with basic ultrasound training. Methods: Approval was received from the institutional health research ethics board for this before and after simulation study. Residents in the -EM Program or CCFP-EM Program from July 2014 to July 2015 were eligible to consent. Participants were excluded if they were unable to complete all portions. All residents were educated to the same level of introductory ultrasound training based on the curriculum in place at our institution. The 8-hour intervention included RUSH didactic and hands on small group sessions. Testing before and after the intervention was performed with the SonoSim Livescan training platform. Two evaluators scored each resident on the accuracy of image acquisition, image interpretation, and time to scan completion. A before and after survey assessed resident comfort level with performing ultrasound on an emergency patient in shock, and basing decisions on ultrasound findings. Statistical analysis was performed using McNemar’s test for image acquisition and interpretation, a paired T test for time, and the Bahpkar test for the questionnaire. Results: 16 EM residents including 11 senior residents and 5 junior residents were enrolled. Improvement was achieved in the categories of IVC image acquisition and interpretation, as well as interpretation for B-lines, lung sliding, cardiac apical and parasternal long axis, and DVT (p<0.05). Subjective comfort level of performing ultrasound in shock and basing decisions on the findings was increased (p<0.0001). Among junior residents, there was an increased speed of image acquisition. Conclusion: With the introduction of the RUSH Exam educational module, EM residents showed improved image acquisition, image interpretation, speed, and comfort level when using ultrasound in critically ill patients.

Competency of Ultrasound Knowledge of Laos Emergency Medicine Residents during International Elective Rotation in Thailand

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S20-S24
Keyword(s):  
Emergency Medicine ◽  
Residency Program ◽  
Clinical Decision Making ◽  
Journal Club ◽  
Point Of Care ◽  
Image Interpretation ◽  
Clinical Decision ◽  
Point Of Care Ultrasound ◽  
International Elective ◽  
Before And After

Background: International rotations for EM residents are becoming increasingly popular. However, there is a dearth of evidence to demonstrate that these rotations can be performed utilizing the POCUS training and that residents have appropriate training, which could assist them in improving their point-of-care ultrasound (POCUS) knowledge. Objective: The researchers aimed at evaluating the POCUS knowledge of the international EM residents after the POCUS training during an international elective rotation. Materials and Methods: A curriculum was developed in the form of a 4-week rotation in the Laos EM residency program at the Department of Emergency Medicine at Khon Kaen University’s Srinagarind Hospital. It consisted of didactic lectures, bedside ultrasound trainings, the journal club, and the process of reviewing the images. Tools were developed, which included a knowledge exam, which was designed to test the residents’ image interpretation abilities and their clinical decision-making processes. The assessments were administered before and after each resident’s rotation. Results: Eight Laos EM residents completed their rotations and the tests. The average Pre-training scores and Post-training scores were 11.13+1.27 and 17.75+1.30, respectively. The average knowledge test score was found to have significantly improved from 55.63% to 88.75%. Conclusion: A POCUS training for the Laos EM residency program in the international elective rotation was able to be developed. Through participating in this training, the residents had been able to improve their basic POCUS knowledge, which will aid the emergency physicians to better care for their patients. Keywords: Ultrasound, POCUS, Emergency medicine, International cooperation

scholarly journals LO090: Introduction of a formalized RUSH (Rapid Ultrasound in Shock) protocol in emergency medicine residency ultrasound training

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S61-S61
Author(s):  
C. Hrymak ◽  
C. Pham
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Educational Module ◽  
Ultrasound Education ◽  
Didactic Teaching ◽  
Video Clips ◽  
Simulation Based ◽  
Hands On ◽  
Future Direction

Introduction / Innovation Concept: Expanding point of care ultrasound education in emergency medicine (EM) programs is a necessary part of curriculum development. Our objective was to integrate core and advanced applications for point of care ultrasound in caring for critically ill patients with undifferentiated shock. We chose to develop and implement an educational module using the systematic approach of the RUSH Exam for EM residents in our institution. Methods: After review of the literature in point-of-care ultrasound, a module was designed. An educational proposal outlining the RUSH Exam training within the -EM and CCFP-EM curricula was submitted to and accepted by the residency training committee. The objectives and goals were outlined in accordance with CanMEDS roles, and the ultrasound director provided supervision for the project. Curriculum, Tool, or Material: An 8-hour educational module was implemented between October 7 and November 18, 2014. All residents received formal training on the core applications in FAST and aortic scans prior to implementation. The following components of the RUSH Exam were included: two hours of didactic teaching with video clips on advanced cardiac, IVC, DVT, and pulmonary assessment; three hours of hands-on practice on standardized patients performed in the simulation lab to practice image acquisition and interpretation; one hour of didactic teaching on the overall approach to a patient with undifferentiated shock using the RUSH Exam; and two hours of hands-on RUSH Exam practice. A corresponding research project integrating a SonoSim Livescan training platform, a simulation-based testing device, demonstrated improvement in resident performance, subjective comfort with imaging patients in shock and making clinical decisions based on the findings. Conclusion: This 8-hour RUSH Exam educational module combined theoretical learning and hands-on practice for trainees. This module significantly broadened the scope of ultrasound training in our curriculum by providing the necessary skills in approaching patients in shock in a systematic fashion. Future direction will include ongoing education in this area and expansion as appropriate.

Ultrasound

2019 ◽  
pp. 1001-1028
Author(s):  
Matthew Lyon ◽  
W. Ted Kuhn
Keyword(s):  
Clinical Management ◽  
Point Of Care ◽  
Image Acquisition ◽  
Image Interpretation ◽  
Ultrasound Image ◽  
Point Of Care Ultrasound ◽  
Clinical Integration ◽  
Humanitarian Emergency ◽  
Emergency Situations ◽  
Essential Components

This chapter outlines how clinical management decisions in humanitarian emergency situations can be greatly enhanced by the utilization of point-of-care ultrasound. The chapter recognizes the advancing technology of point-of care ultrasound and its use in humanitarian missions, and provides guidance on the essential components of clinical ultrasound (image acquisition, image interpretation, and clinical integration).

scholarly journals Design and evaluation of the I-SCAN faculty POCUS program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Janjigian ◽  
Anne Dembitzer ◽  
Caroline Srisarajivakul-Klein ◽  
Khemraj Hardower ◽  
Deborah Cooke ◽  
...  
Keyword(s):  
Training Programs ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Median Score ◽  
Introductory Course ◽  
Hands On ◽  
Before And After ◽  
Online Feedback ◽  
Passing Score ◽  
Longitudinal Phase

Abstract Background Point-of-care ultrasound (POCUS) is becoming widely adopted with increasing accessibility of courses. Little is known about the optimal design of the introductory course or longitudinal training programs targeting hospitalists that are critical to success. Methods Hospitalists at four academic sites participated in a two-day introductory course and a longitudinal phase comprising clinical POCUS practice, clip uploading with online feedback, hands-on teaching, and monthly ultrasound conferences. Assessments were performed immediately before and after the two-day course and after 1 year. Results Knowledge increased from baseline to post two-day course (median score 58 and 85%, respectively, p < 0.001) and decreased slightly at 1 year (median score 81%, p = 0.012). After the two-day introductory course, the median score for hands-on image acquisition skills, the principal metric of participant success, was 75%. After 1 year, scores were similar (median score 74%). Confidence increased from baseline to post two-day course (1.5 to 3.1 on a 4 point Likert scale from Not at all confident (1) to Very confident (4), p < 0.001), and remained unchanged after 1 year (2.73). Course elements correlating with a passing score on the final hands-on test included number of clip uploads (r = 0.85, p,0.001), attendance at hands-on sessions (r = 0.7, p = 0.001), and attendance at monthly conferences (r = 0.50, p = 0.03). Conclusions The I-ScaN POCUS training program increased hospitalist knowledge, skill and confidence with maintained skill and confidence after 1 year. Uploading clips and attending hands-on teaching sessions were most correlative with participant success.

scholarly journals Point-of-care ultrasonography for the diagnosis of testicular torsion: a practical resident curriculum

2021 ◽  
Vol 64 (2) ◽  
Author(s):  
Leandra Stringer ◽  
Sarah Cocco ◽  
Alex Jiang ◽  
Ernest Pang Chan ◽  
Frank Myslik ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Testicular Torsion ◽  
Point Of Care ◽  
Modified Delphi ◽  
Likert Score ◽  
Hands On ◽  
Before And After ◽  
Point Of Care Ultrasonography ◽  
Teaching Modules ◽  
Didactic Curriculum

Background: Prompt Doppler ultrasonography to aid in diagnosis is often key to managing testicular torsion, but there may be delays in access; a faster, more widely available alternative is point-of-care ultrasonography (POCUS). The purpose of this study was to develop and evaluate a scrotal POCUS curriculum for urology and emergency medicine residents. Methods: Content experts in urology, emergency medicine and diagnostic imaging collaborated in a modified Delphi method to design a practical didactic curriculum for scrotal POCUS for the identification of testicular torsion. Training included 3 online video teaching modules and a 1-hour hands-on teaching session with standardized adult patients. We evaluated participants’ competency in scrotal POCUS using a validated scale. We assessed participants’ knowledge, comfort and confidence in performing scrotal POCUS before and after the intervention and at 3 months. Results: Twenty-four urology (n = 12) and emergency medicine (n = 12) residents participated in the curriculum. After hands-on practice, 23 participants (96%) were deemed competent at scrotal POCUS. Pre–post testing showed significant improvement in knowledge (mean score 63% v. 80%, p < 0.001), comfort (mean Likert score 0.6 v. 3.6, p < 0.001) and confidence (mean Likert score 1.0 v. 2.1, p < 0.001) after the intervention. These effects were maintained at the 3-month assessment. Conclusion: The scrotal POCUS curriculum was effective and acceptable to both urology and emergency medicine residents. The findings suggest that scrotal POCUS can be learned effectively through a short hands-on session and didactic instruction.

scholarly journals Point-of-Care Ultrasound for Family Medicine Residents: Attitudes and Confidence

2021 ◽  
Vol 53 (6) ◽  
pp. 457-460
Author(s):  
Jerica Johnson ◽  
David Stromberg ◽  
Byrch Willims ◽  
Nina Greenberg ◽  
Orrin Myers
Keyword(s):  
Family Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Family Medicine Residency ◽  
University Of New Mexico ◽  
Confidence Levels ◽  
Significant Difference ◽  
Hands On ◽  
Before And After ◽  
Family Medicine Residents

Background and Objectives: Point-of-care ultrasound (POCUS) is increasingly being incorporated into family medicine residency training. Attitudes towards POCUS among family medicine residents (FMRs) are largely unknown, and confidence levels with performing and interpreting POCUS exams are also unknown among this group of learners. Our aim was to evaluate FMRs’ attitudes and confidence levels before and after the implementation of a new POCUS curriculum. Methods: Study participants included FMRs in all postgraduate years (ie, PGY1-PGY3) at the University of New Mexico (UNM) Family Medicine Residency Program. Our intervention was a yearlong implementation of a new POCUS curriculum based on the American Academy of Family Physicians POCUS curriculum guidelines. Our interventions included hands-on training sessions for both FMRs and faculty along with a resource website. We assessed attitudes and confidence levels with various POCUS exams using a pre- and postintervention survey. Results: Overall, FMRs felt significantly more confident in their ability to perform and interpret a point-of-care ultrasound after the implementation of POCUS curriculum. There was no significant difference in participants’ expectations of their use of POCUS during or after residency. Conclusions: Overall, this study provides evidence that the implementation of a POCUS curriculum that includes hands-on and didactic training is associated with increased confidence in utilizing POCUS among FMRs.

scholarly journals National Survey of Point-of-Care Ultrasound Scholarly Tracks in Emergency Medicine Residency Programs

2021 ◽  
Vol 22 (5) ◽  
pp. 1095-1101
Author(s):  
Stephen Alerhand ◽  
Elaine Situ-Lacasse ◽  
Christine Ramdin ◽  
Michael Gottlieb
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Survey Study ◽  
Point Of Care Ultrasound ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
The Past ◽  
Current Prevalence ◽  
Hands On

Introduction: Residency scholarly tracks are educational programs, designed to help trainees develop an area of expertise. Although the breadth of residency point-of-care ultrasound (POCUS) education has developed considerably in recent years, there is no literature to date describing scholarly tracks specifically in POCUS. In this study we sought to determine the prevalence, characteristics, and outcomes of POCUS scholarly tracks in emergency medicine (EM). Methods: This was a cross-sectional survey of EM residency programs accredited by the Accreditation Council for Graduate Medical Education. Surveys were distributed between March-August 2020 using a listserv followed by targeted emails to residency and ultrasound leadership. We summarized data using descriptive statistics, and performed logistic regression to identify factors associated with a POCUS scholarly track. Results: Of 267 residency programs 199 (74.5%) completed the survey. Fifty-seven (28.6%) had a POCUS scholarly track as of the 2019-2020 academic year. Scholarly tracks in POCUS were more common in university-based/academic sites and larger residency programs. Of the 57 programs with POCUS scholarly tracks, 48 (84.2%) required residents to present at least one POCUS lecture, 45 (78.9%) required residents to serve as instructor at a hands-on workshop, and 42 (73.7%) required residents to participate in quality assurance of departmental POCUS scans. Only 28 (49.1%) tracks had a structured curriculum, and 26 (45.6%) required POCUS research. In total, 300 EM residents completed a POCUS scholarly track over the past three academic years, with a median of 4 (2-9) per program. Seventy-five (25.0%) proceeded to a clinical ultrasound fellowship after residency graduation, with a median of 1 (interquartile range 0-2) per program. A total of 139 POCUS-specific abstracts (median 2 [0-3]) and 80 peer-reviewed manuscripts (median 1 [0-2]) were published by scholarly track residents over the past three years. Conclusion: This survey study describes the current prevalence, characteristics, and outcomes of POCUS scholarly tracks across EM residency programs. The results may inform the decisions of residency programs to create these tracks.

scholarly journals Can ultrasound novices develop image acquisition skills after reviewing online ultrasound modules?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Situ-LaCasse ◽  
Josie Acuña ◽  
Dang Huynh ◽  
Richard Amini ◽  
Steven Irving ◽  
...  
Keyword(s):  
Medical Students ◽  
Point Of Care ◽  
Image Acquisition ◽  
Positive Association ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Psychomotor Skills ◽  
Median Score ◽  
Hands On ◽  
A Prospective Study

Abstract Background Point-of-care ultrasound is becoming a ubiquitous diagnostic tool, and there has been increasing interest to teach novice practitioners. One of the challenges is the scarcity of qualified instructors, and with COVID-19, another challenge is the difficulty with social distancing between learners and educators. The purpose of our study was to determine if ultrasound-naïve operators can learn ultrasound techniques and develop the psychomotor skills to acquire ultrasound images after reviewing SonoSim® online modules. Methods This was a prospective study evaluating first-year medical students. Medical students were asked to complete four SonoSim® online modules (aorta/IVC, cardiac, renal, and superficial). They were subsequently asked to perform ultrasound examinations on standardized patients utilizing the learned techniques/skills in the online modules. Emergency Ultrasound-trained physicians evaluated medical students’ sonographic skills in image acquisition quality, image acquisition difficulty, and overall performance. Data are presented as means and percentages with standard deviation. All P values are based on 2-tailed tests of significance. Results Total of 44 medical students participated in the study. All (100%) students completed the hands-on skills evaluation with a median score of 83.7% (IQR 76.7–88.4%). Thirty-three medical students completed all the online modules and quizzes with median score of 87.5% (IQR 83.8–91.3%). There was a positive association between module quiz performance and the hands-on skills performance (R-squared = 0.45; p < 0.001). There was no statistically significant association between module performance and hands-on performance for any of the four categories individually. In all four categories, the evaluators’ observation of the medical students’ difficulty obtaining views correlated with hands-on performance scores. Conclusions Our study findings suggest that ultrasound-naïve medical students can develop basic hands-on skills in image acquisition after reviewing online modules.

scholarly journals Evaluating a longitudinal point-of-care-ultrasound (POCUS) curriculum for pediatric residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julia Aogaichi Brant ◽  
Jonathan Orsborn ◽  
Ryan Good ◽  
Emily Greenwald ◽  
Megan Mickley ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Imaging Modality ◽  
Point Of Care ◽  
Ease Of Use ◽  
Comfort Level ◽  
Point Of Care Ultrasound ◽  
Good Tolerability ◽  
Pediatric Residents ◽  
Pediatric Residency ◽  
Hands On

Abstract Background POCUS is a growing field in medical education, and an imaging modality ideal for children given the lack of ionizing radiation, ease of use, and good tolerability. A 2019 literature review revealed that no US pediatric residency programs integrated obligatory POCUS curricula. Our objective was to provide a formalized POCUS curriculum over multiple years, and to retrospectively assess improvement in resident skills and comfort. Methods During intern year, pediatric residents received didactics and hands-on scanning opportunities in basic POCUS applications. Their evaluation tools included pre- and post-surveys and tests, and a final performance exam. In the second and third years of residency, all participants were required to complete 8 hours per year of POCUS content review and additional hands-on training. An optional third-year curriculum was offered to interested residents as career-focused education elective time. Results Our curriculum introduced POCUS topics such as basic and advanced cardiac, lung, skin/soft tissues and procedural based ultrasound to all pediatric residents. Among first-year residents, application-specific results showed POCUS comfort level improved by 61–90%. Completed evaluations demonstrated improvement in their ability to recognize and interpret POCUS images. Second- and third-year residents reported educational effectiveness that was rated 3.9 on a 4-point Likert scale. Four third-year residents took part in the optional POCUS elective, and all reported a change in their practice with increased POCUS incorporation. Conclusions Our longitudinal pediatric residency POCUS curriculum is feasible to integrate into residency training and exhibits early success.

scholarly journals Randomized study of effectiveness of computerized ultrasound simulators for an introductory course for residents in Brazil

2016 ◽  
Vol 13 ◽  
pp. 16 ◽  
Author(s):  
Jack Philip Silva ◽  
Trevor Plescia ◽  
Nathan Molina ◽  
Ana Claudia de Oliveira Tonelli ◽  
Mark Langdorf ◽  
...  
Keyword(s):  
Point Of Care ◽  
Image Acquisition ◽  
Simulator Training ◽  
Point Of Care Ultrasound ◽  
Ultrasound Simulation ◽  
Live Model ◽  
Hands On ◽  
Model Training ◽  
The Impact ◽  
Experimental Group

Purpose: This study aimed to assess the impact of ultrasound simulation (SonoSim) on educational outcomes of an introductory point-of-care ultrasound course compared to hands-on training with live models alone. Methods: Fifty-three internal medicine residents without ultrasound experience were randomly assigned to control or experimental groups. They participated in an introductory point-of-care ultrasound course covering eight topics in eight sessions from June 23, 2014 until July 18, 2014. Both participated in lecture and hands-on training, but experimental group received an hour of computerized simulator training instead of a second hour of hands-on training. We assessed clinical knowledge and image acquisition with written multiple-choice and practical exams, respectively. Of the 53 enrolled, 40 participants (75.5%) completed the course and all testing. Results: For the 30-item written exam, mean score of the experimental group was 23.1±3.4 (n=21) vs. 21.8±4.8 (n=19), (P>0 .05). For the practical exam, mean score for both groups was 8.7 out of 16 (P>0 .05). Conclusion: The substitution of eight hours of ultrasound simulation training for live model scanning in a 24 hour training course did not enhance performance on written and image acquisition tests in an introductory ultrasound course for residents. This result suggests that ultrasound simulation technology used as a substitute for live model training on an hour-for-hour basis, did not improve learning outcomes. Further investigation into simulation as a total replacement for live model training will provide a clearer picture of the efficacy of ultrasound simulators in medical education.

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