scholarly journals The development of a provincial multidisciplinary framework of consensus-based standards for Point of Care Ultrasound at the University of Saskatchewan

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Paul Olszynski ◽  
Daniel J. Kim ◽  
Irene W. Y. Ma ◽  
Michelle Clunie ◽  
Peggy Lambos ◽  
...  
Keyword(s):  
Working Group ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Audience Response ◽  
Roundtable Discussion ◽  
Response System ◽  
Documentation Quality ◽  
Challenges And Opportunities ◽  
Survey Results ◽  
The University

Abstract Objectives The development and adoption of Point-of-Care Ultrasound (POCUS) across disciplines have created challenges and opportunities in implementing training and utilization standards. Within the context of a large, geographically disparate province, we sought to develop a multidisciplinary POCUS framework outlining consensus-based standards. Methods A core working group of local POCUS leaders from Anesthesia, Emergency Medicine, Family Medicine, Intensive Care, Internal Medicine, Pediatrics, and Trauma, in collaboration with western Canadian colleagues, developed a list of key domains for the framework along with a range of potential standards for each area. The members of the working group and the registrants for a multidisciplinary Roundtable discussion at the University of Saskatchewan’s annual POCUS conference (SASKSONO19, Saskatoon, Saskatchewan, March 2nd, 2019) were invited to complete a survey on POCUS standards for each domain. The survey results were presented to and discussed by participants at the Roundtable discussion at SASKSONO19 who reached consensus on modified standards for each domain. The modified standards were considered for endorsement by all conference attendees using an audience-response system. Results The working group proposed standards in eight domains: scope of use, credentialing and privileges, documentation, quality assurance, leadership and governance, teaching, research, and equipment maintenance. Consensus on modified standards was achieved in the 18 participant Roundtable. Each standard was then endorsed by > 90% of conference respondents. Conclusion The resulting framework will inform the utilization of POCUS within Saskatchewan. Both this process and its outcomes could inform the development of multidisciplinary POCUS standards within other jurisdictions.

Response to Letter to the editor: Acute Medicine Journal

2020 ◽  
Vol 19 (1) ◽  
pp. 57-57
Author(s):  
Ben Chadwick ◽  
◽  
Nick Murch ◽  
Anika Wijewardane ◽  
◽  
...  
Keyword(s):  
Internal Medicine ◽  
Acute Care ◽  
Working Group ◽  
Point Of Care ◽  
Early Years ◽  
Point Of Care Ultrasound ◽  
Acute Medicine ◽  
Front Door ◽  
Medicine Journal ◽  
Wide Range

Editor- Thank you for giving us the opportunity to respond to the letter received regarding the Joint Royal College of Physicians Training Board (JRCPTB) curriculum for Acute Internal Medicine (AIM) that has previously been circulated for comment and consideration of implementation in August 2022. Dr Williamson is correct in asserting that the proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions. It does aim to produce a workforce that reflects the current trends of increasing patient attendances to both primary care and emergency departments- one that has a high level of diagnostic reasoning, the ability to manage uncertainty, deal with co-morbidities and recognise when specialty input is required in a variety of settings, including ambulatory and critical care. Contrary to the situation described in the correspondence, the new curriculum does not move away from each trainee being required to develop a specialist skill, such as medical education, management, stroke medicine or focused echocardiography. Trainees will still need to acquire competency in a specialist skill for their final 36 months of their training programme, usually after they have completed their Point of Care Ultrasound (POCUS) certification. The thinking behind introducing mandatory POCUS in the curriculum is that: POCUS is in the proposed curricula for intensive care medicine, respiratory medicine and emergency medicine, therefore we feel that in order to recruit the best trainees it is imperative POCUS training is offered as standard As evidenced by the trainee surveys, they often do not get allocated time to develop their specialist skill, especially in the early years of Higher Specialty Training before they often have decided on a particular skill. The introduction of mandatory POCUS training should legtimise time off the ward to obtain this skill early in training. POCUS is becoming more and more standardised in 21st Century acute care alongside the reducing costs of Ultrasound probe e.g. Philips Lumify and Butterfly iQ which are compatible with smart phones POCUS has been heralded as the fifth pillar of examination (observation, palpation, percussion, auscultation, insonation)1 The proposed curriculum therefore facilitates trainees to have regular dedicated time to develop interests inside or outside acute medicine to supplement their professional experience and training. This will also enable trainees to have time away from the ‘front door’ high intensity acute care. Mandatory POCUS will continue to set AIM training apart from other physician training programmes and continue to attract high quality trainees to apply to the specialty. Formal feedback seen at the SAC meeting in October 2019 to the draft curriculum (personal correspondence from JRCPTB) showed a positive response from nine individuals, an ambivalent one from two people, and only two against the introduction of formal POCUS training in the curriculum. Point of Care Ultrasound will likely be a welcome addition to the curriculum and will benefit patients, trainees and front door services up and down the country. Concerns regarding supervision are being addressed by the POCUS working group, in anticipation of the lead in period of well over two years. It is anticipated that most trainees can achieve POCUS sign off (e.g. Focused Acute Medical Ultrasound) in 6 to 12 months (personal correspondence Nick Smallwood from POCUS working group). With ongoing concerns regarding recruitment and retention in Acute Internal Medicine we agree strongly that with POCUS inclusion, we have a further selling point for AIM training.

scholarly journals Point-of-Care Ultrasound and the Rapid Response System

Global Heart ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. 335 ◽  
Author(s):  
Daniel J. Lakoff ◽  
Maya H. Barghash ◽  
Scott Lorin ◽  
Ryan Ungaro ◽  
Vinh-Tung Nguyen ◽  
...  
Keyword(s):  
Point Of Care ◽  
Rapid Response ◽  
Point Of Care Ultrasound ◽  
Rapid Response System ◽  
Response System

scholarly journals P068: Patient satisfaction following educational ultrasounds in the emergency department

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S101
Author(s):  
P. Kapur ◽  
M. Betz ◽  
J. Chenkin ◽  
C. Brick
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Negative Experiences ◽  
Patient Demographics ◽  
Included Patient ◽  
Survey Results ◽  
Age Range ◽  
Do So

Introduction: Development of point-of-care ultrasound (POCUS) image-generating skills requires residents to practice on patients awaiting care in the emergency department (ED) for unrelated reasons. While patients are almost universally agreeable to the scans, there is the possibility that they feel pressured to do so and may have negative experiences that go unreported. The objective of this study was to determine the self-reported patient satisfaction and identify any concerns after educational ultrasounds performed in the ED. Methods: We conducted a survey of patients at a single academic ED. Patients were eligible for enrollment if they had volunteered for an ultrasound when study personnel were available. The survey was administered by a representative from the Patient Affairs Department who advised the patients that the results would remain anonymous and would have no impact on their care. The survey included patient demographics, questions about the consent process, communication by the trainee, adverse reactions and patient satisfaction. The primary outcome was the overall satisfaction level reported by the volunteer patients on a 5-point Likert scale. Secondary outcomes included identification of any discomfort or concerns about the process as expressed by patients. Simple descriptive statistics were used to report survey results. Results: Ninety-nine patients fully completed the questionnaire. Fifty (50%) were women. The age range was 18 to 99 years. Satisfaction among volunteers was high, with 94% of respondents giving a rating of 4 or 5 (five being an excellent experience). No patients gave a negative rating (1 or 2). Three (3%) patients felt “somewhat” pressured to volunteer. A majority of patients (72%) experienced no discomfort during the scan however 16% experienced some physical discomfort. Comments indicated that too much pressure applied with the ultrasound probe or cold ultrasound gel were the main sources of discomfort. Despite some discomfort 95 (95%) patients stated they would likely volunteer again if asked in the future. Conclusion: ED patients volunteering as models for residents learning POCUS expressed generally positive perceptions of their experience. While only a small minority of patients experienced some discomfort or felt pressured into participating, it is important to ensure that patients have a process to communicate any concerns about educational ultrasounds in the ED.

scholarly journals From Bricks and Mortar to Bits and Bytes: Examining the Changing State of Reference Services at the University of Toronto Libraries During COVID-19

2021 ◽  
Vol 16 (1) ◽  
pp. 1-10
Author(s):  
Madeline Gerbig ◽  
Kathryn Holmes ◽  
Mai Lu ◽  
Helen Tang
Keyword(s):  
Service Providers ◽  
Reference Services ◽  
University Of Toronto ◽  
Online Tools ◽  
Challenges And Opportunities ◽  
Reference Service ◽  
Survey Results ◽  
Rapid Transition ◽  
Teaching Learning ◽  
The University

Before the pandemic, the University of Toronto was predominantly an in-person experience. The closure of physical libraries and shift to remote learning required library staff and users to adapt to new modes of supporting teaching, learning, and research. A survey was conducted about reference service delivery, staffing models, resources and tools, which asked the respondents to describe reference services at their libraries before and during the pandemic. The objectives of this survey were to capture the state of reference services at the University of Toronto Libraries (UTL), and to compare data about reference practices during the pre-pandemic and pandemic periods with the goal of identifying challenges and opportunities for the future of reference services at UTL. 70% of libraries surveyed used reference desks for reference services pre-pandemic, and during the pandemic, 75% of libraries used virtual reference appointments by video conferencing. The survey results show that reference service staffing and service hours in most surveyed libraries were reduced during the pandemic. Many respondents reported that while they offered fewer reference service hours during the pandemic, they continued to provide assistance outside of scheduled hours. Online tools and platforms that were already familiar to librarians remained popular during the pandemic, allowing service providers to quickly adapt to the virtual environment and ensure seamless service continuity. While the rapid transition in services at the University of Toronto was not without its challenges, it has also offered many new opportunities for re-envisioning reference services at the University of Toronto Libraries.

scholarly journals Point-of-Care Ultrasound in Family Medicine Residencies 5-Year Update: A CERA Study

2020 ◽  
Vol 52 (7) ◽  
pp. 505-511
Author(s):  
Jeffrey W. W. Hall ◽  
Harland Holman ◽  
Tyler W. Barreto ◽  
Paul Bornemann ◽  
Andrew Vaughan ◽  
...  
Keyword(s):  
Family Medicine ◽  
Core Curriculum ◽  
Point Of Care ◽  
Program Directors ◽  
Point Of Care Ultrasound ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Survey Results ◽  
Research Alliance ◽  
Residency Program Directors

Background and Objectives: In 2014, family medicine residency programs began to integrate point-of-care ultrasound (POCUS) into training, although very few had an established POCUS curriculum. This study aimed to evaluate the resources, barriers, and scope of POCUS training in family medicine residencies 5 years after its inception. Methods: Questions regarding current training and use of POCUS were included in the 2019 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency program directors, and results compared to similar questions on the 2014 CERA survey. Results: POCUS is becoming a core component of family medicine training programs, with 53% of program directors reporting establishing or an established core curriculum. Only 11% of program directors have no current plans to add POCUS training to their program, compared to 41% in 2014. Despite this increase in training, the reported clinical use of POCUS remains uncommon. Only 27% of programs use six of the eight surveyed POCUS modalities more than once per year. The top three barriers to including POCUS in residency training in 2019 have not changed since 2014, and are (1) a lack of trained faculty, (2) limited access to equipment, and (3) discomfort with interpreting images without radiologist review. Conclusions: Training in POCUS has increased in family medicine residencies over the last 5 years, although practical use of this technology in the clinical setting may be lagging behind. Further research should explore how POCUS can improve outcomes and reduce costs in the primary care setting to better inform training for this technology.

scholarly journals Improving the documentation quality of point-of-care ultrasound scans in the emergency department

2020 ◽  
Vol 9 (1) ◽  
pp. e000636
Author(s):  
Shadman Aziz ◽  
James Bottomley ◽  
Vasant Mohandas ◽  
Arif Ahmad ◽  
Gemma Morelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Royal College ◽  
Point Of Care ◽  
University Hospital ◽  
Point Of Care Ultrasound ◽  
Core Element ◽  
Improvement Project ◽  
Documentation Quality ◽  
Minimum Requirements

A point-of-care ultrasound scan (POCUS) is a core element of the Royal College of Emergency Medicine (RCEM) specialty training curriculum. However, POCUS documentation quality can be poor, especially in the time-pressured environment of the emergency department (ED). A survey of 10 junior ED clinicians at the Princess Royal University Hospital (PRUH) found that total POCUS documentation was as low as 38% in some examinations.This quality improvement project aimed to increase the coverage and quality of POCUS documentation in the ED. This was done by using a plan-do-study-act (PDSA) regime to improve the quality of POCUS documentation from the original baseline to 80%. There were three discreet PDSA cycles and the interventions included improving education and training about POCUS documentation and the introduction of an original proforma, which incorporated six minimum requirements for POCUS documentation as per the joint RCEM and Royal College of Radiologists (RCR) guidelines for POCUS documentation (patient details, indications, findings, conclusions, signature and date).The project team audited the quality of all documented scans in the resuscitation department of the PRUH against the RCEM/RCR guidelines at baseline and following three discrete PDSA cycles. This was done over an 8-week period, spanning 696 attendances to the resuscitation area of the ED and 42 documented POCUS examinations.Quality recording of the six RCEM/RCR elements of POCUS documentation was poor at baseline but improved following three successful PDSA cycles. There was a demonstrated improvement in five of six documentation elements: patient details on POCUS documentation increased from 53.3% to the 66.7%, indication from 60.0% to 66.7%, conclusion from 13.0% to 83.0%, signature from 86.7% to 100.0% and date from 46.7% to 66.7%.These results suggest that the introduction of a proforma and a vigorous education strategy are effective ways to improve the quality of documentation of ED POCUS.

scholarly journals Introducing point-of-care ultrasound through structured multifaceted ultrasound module in the undergraduate medical curriculum at the University of Hong Kong

Ultrasound ◽  
2019 ◽  
Vol 28 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Benedicte Coiffier ◽  
Pascale Chung Hang Shen ◽  
Elaine Yuen Phin Lee ◽  
Teresa Sui Ping Kwong ◽  
Alta Yee Tak Lai ◽  
...  
Keyword(s):  
Hong Kong ◽  
Medical Curriculum ◽  
Point Of Care ◽  
Round Table ◽  
Round Table Discussion ◽  
Point Of Care Ultrasound ◽  
Undergraduate Medical Curriculum ◽  
Learning Platform ◽  
E Learning ◽  
The University

Incorporation of point-of-care ultrasound in the undergraduate medical curriculum is of great importance to ensure early exposure and safe use of the modality. We aimed to assess the students' learning experiences following implementing an ultrasound module in the medical curriculum at the University of Hong Kong. Medical students in semester 6 (n = 221) were enrolled in the module in 2018. It consisted of 1 hour of didactic lecture, followed by 3 hours of hands-on session. The students had the opportunity to enroll into a four-week Special Study Module to further practice their skills. The students had access to an e-learning platform to assist in their learning. Outcome measures include task-based performance, quizzes, feedback, and round-table discussion to assess the learning experiences. The module was highly rated by over 90% of students (response rate of 96%). Students practiced on peer subject on upper abdominal scanning. Post-training assessment showed an increment of 16% in their understanding of the modality. Students were motivated to enroll into the Special Study Module, where they were trained and became proficient with Focused Assessment with Sonography with Trauma. More than 86% of the students found the e-learning platform easy to use and assisted the training session. Round-table discussion suggested more simulated clinical cases to be added and expansion of future modules. Ultrasound module was successfully implemented into the undergraduate medical curriculum at the University of Hong Kong through new pedagogical approaches. This integration was highly rated by the medical students with improved awareness and better understanding of point-of-care ultrasound.

Feedback From Medical and Biology Students on Distance Learning: Focus on a Useful Interactive Software, Wooclap®

2021 ◽  
pp. 004723952110233
Author(s):  
Julie Marin ◽  
Ségolène Brichler ◽  
Hervé Lecuyer ◽  
Etienne Carbonnelle ◽  
Mathilde Lescat
Keyword(s):  
Distance Learning ◽  
Audience Response ◽  
Mixed Solution ◽  
Interactive Software ◽  
Face To Face ◽  
Biology Students ◽  
Response System ◽  
University Courses ◽  
Internet Connections ◽  
The University

The coronavirus disease 2019 epidemic has prompted all universities to completely change their teaching in a very rapid way around the world. In France, most of the university courses for the year 2020 had to be delivered at distance. This can be an opportunity for some to rethink the place and the form of distance learning (DL). We present here the feedback of students about DL, who answered a questionnaire about classes they followed between October and December 2020. In addition, we evaluated the use and utility of an audience response system promoting interaction. Our results showed that overall the organization and internet connections allowed DL to run smoothly. Interestingly, all students were in favor of the development of a mixed solution, with distant lectures and face-to-face practical lessons. Finally, the use of interactive software such as Wooclap® has proven to be easy to use and to develop for all lessons.

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