scholarly journals Operating bedside cardiac ultrasound program in emergency medicine residency: a retrospective observation study from the perspective of performance improvement

2020 ◽  
Author(s):  
Kihong Kim ◽  
Jae Yun Jung ◽  
JoongWan Park ◽  
Minsung Lee ◽  
Yonghee Lee
Keyword(s):  
Emergency Medicine ◽  
Regression Analysis ◽  
Point Of Care ◽  
Linear Regression Analysis ◽  
P Value ◽  
Point Of Care Ultrasound ◽  
Cardiac Ultrasound ◽  
Performance Score ◽  
Performance Improvements ◽  
Multivariable Linear Regression Analysis

Abstract Background Point-of-care Ultrasound is one of useful diagnostic tools in emergency medicine practice and considerably depends on physician’s performance. This study was performed to evaluate performance improvements and favorable attitudes through structured cardiac ultrasound program for emergency medicine residents. Methods Retrospective observational study using the Point-of-care ultrasound (PoCUS) database in one tertiary academic-teaching hospital emergency department has been conducted. Cardiac ultrasound education and rotation program has been implemented in emergency medicine residency program. Structured evaluation sheet for cardiac ultrasound and questionnaire toward PoCUS have been developed. An early-phase and a late-phase case were selected randomly for each participant. Two emergency medicine specialists with expertise in PoCUS evaluated saved images independently. We used a paired t-test to compare the performance score of each phase and the results of the questionnaire. Multivariable linear regression analysis was conducted to evaluate the association between the characteristics of participants and performance improvements. Results During the study period, a total of 1,652 bedside cardiac ultrasounds were administered. Forty-six examinations conducted by 23 emergency medicine residents were randomly selected for analysis. The performance score increased from 39.5 to 56.1 according to expert A and 45.3 to 62.9 according to expert B (p-value < 0.01 for both). The average questionnaire score, which was analyzed for 17 participants, showed improvement from 18.9 to 20.7 (p-value < 0.01). In multivariable linear regression analysis, younger age, higher early-phase score and higher confidence had a negative association with a greater improvement of performance, while the number of examinations had a positive association. Conclusions Bedside cardiac ultrasound performance and attitudes toward PoCUS have been improved through structured residency program.

scholarly journals Operating bedside cardiac ultrasound program in emergency medicine residency: A retrospective observation study from the perspective of performance improvement

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248710
Author(s):  
Ki Hong Kim ◽  
Jae Yun Jung ◽  
Joong Wan Park ◽  
Min Sung Lee ◽  
Yong Hee Lee
Keyword(s):  
Emergency Medicine ◽  
Regression Analysis ◽  
Point Of Care ◽  
Linear Regression Analysis ◽  
P Value ◽  
Point Of Care Ultrasound ◽  
Cardiac Ultrasound ◽  
Performance Score ◽  
Performance Improvements ◽  
Multivariable Linear Regression Analysis

Background Point-of-care ultrasound is one of useful diagnostic tools in emergency medicine practice and considerably depends on physician’s performance. This study was performed to evaluate performance improvements and favorable attitudes through structured cardiac ultrasound program for emergency medicine residents. Methods Retrospective observational study using the point-of-care ultrasound (PoCUS) database in one tertiary academic-teaching hospital emergency department has been conducted. Cardiac ultrasound education and rotation program has been implemented in emergency medicine residency program. Structured evaluation sheet for cardiac ultrasound and questionnaire toward PoCUS have been developed. An early-phase and a late-phase case were selected randomly for each participant. Two emergency medicine specialists with expertise in PoCUS evaluated saved images independently. We used a paired t-test to compare the performance score of each phase and the results of the questionnaire. Multivariable linear regression analysis was conducted to evaluate the association between the characteristics of participants and performance improvements. Results During the study period, a total of 1,652 bedside cardiac ultrasounds were administered. Forty-six examinations conducted by 23 emergency medicine residents were randomly selected for analysis. The performance score increased from 39.5 to 56.1 according to expert A and 45.3 to 62.9 according to expert B (p-value <0.01 for both). The average questionnaire score, which was analyzed for 17 participants, showed improvement from 18.9 to 20.7 (p-value <0.01). In multivariable linear regression analysis, younger age, higher early-phase score and higher confidence had a negative association with a greater improvement of performance, while the number of examinations had a positive association. Conclusions Bedside cardiac ultrasound performance and attitudes toward PoCUS have been improved through structured residency program.

Point of Care Ultrasound for Emergency Medicine and Resuscitation

2019 ◽  
Keyword(s):  
Emergency Medicine ◽  
Soft Tissues ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Cardiac Ultrasound ◽  
Clinical Imaging ◽  
User Friendly ◽  
Basic Level ◽  
Short Section ◽  
Advanced Applications

Point-of-Care Ultrasound for Emergency Medicine and Resuscitation (Oxford Clinical Imaging Guides) focuses on the day-to-day utility of point-of-care ultrasound in emergency medicine. The book explains how clinicians can safely and accurately use ultrasound for the diagnosis and management of shock, acute presentations, and phases of key conditions. The book begins with a summary of cardiac ultrasound before continuing through the chest, moving down to the abdomen, and finally considers the major vessels and soft tissues. Paediatric and pre-hospital ultrasound, as well as practical procedures, are also addressed. Each chapter begins at a basic level and moves on to higher-level skills. The book is highly illustrated with annotated diagrams showing structures and explaining how to interpret findings. The text is written in a user-friendly fashion with short paragraphs and headings. Technical terminology is explained throughout. A short section in each chapter outlines ‘core’ and ‘advanced’ applications. Each chapter has a clear ‘how to scan’ summary. The book reflects the content and skills included in current curricula for ultrasound use in national and international emergency medicine.

scholarly journals Use of a Refresher Course Increases Confidence in Point-of-Care Ultrasound Skills in Emergency Medicine Faculty

Cureus ◽  
2019 ◽  
Author(s):  
Madeline Schwid ◽  
Owen Harris ◽  
Adaira Landry ◽  
Andrew Eyre ◽  
Patricia Henwood ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound

Perception of point-of-care ultrasound performed by emergency medicine physicians

2017 ◽  
Vol 45 (7) ◽  
pp. 408-415 ◽  
Author(s):  
Whitney Hansen ◽  
Carl E. Mitchell ◽  
Bikash Bhattarai ◽  
Napatkamon Ayutyanont ◽  
Jeffrey R. Stowell
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound

Barriers to reporting guideline adherence in point-of-care ultrasound research: a cross-sectional survey of authors and journal editors

2021 ◽  
pp. bmjebm-2020-111604
Author(s):  
Ross Prager ◽  
Luke Gagnon ◽  
Joshua Bowdridge ◽  
Rudy R Unni ◽  
Trevor A McGrath ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Peer Review ◽  
Review Process ◽  
Response Rate ◽  
Peer Review Process ◽  
Point Of Care ◽  
Reporting Quality ◽  
Point Of Care Ultrasound ◽  
Research Reporting ◽  
Journal Editors

ObjectiveAlthough the literature supporting the use of point-of-care ultrasound (POCUS) continues to grow, incomplete reporting of primary diagnostic accuracy studies has previously been identified as a barrier to translating research into practice and to performing unbiased systematic reviews. This study assesses POCUS investigator and journal editor attitudes towards barriers to adhering to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 guidelines.Design, setting, participantsTwo separate surveys using a 5-point Likert scale were sent to POCUS study investigators and journal editors to assess for knowledge, attitude and behavioural barriers to the complete reporting of POCUS research. Respondents were identified based on a previous study assessing STARD 2015 adherence for POCUS studies published in emergency medicine, anaesthesia and critical care journals. Responses were anonymously linked to STARD 2015 adherence data from the previous study. Written responses were thematically grouped into the following categories: knowledge, attitude and behavioural barriers to quality reporting, or other. Likert response items are reported as median with IQRs.Main outcome measuresThe primary outcome was the median Likert score for the investigator and editor surveys assessing knowledge, attitude and behavioural beliefs about barriers to adhering to the STARD 2015 guidelines.ResultsThe investigator survey response rate was 18/69 (26%) and the editor response rate was 5/21 (24%). Most investigator respondents were emergency medicine practitioners (13/21, 62%). Two-thirds of investigators were aware of the STARD 2015 guidelines (12/18, 67%) and overall agreed that incomplete reporting limits generalisability and the ability to detect risk of bias (median 4 (4, 5)). Investigators felt that the STARD 2015 guidelines were useful, easy to find and easy to use (median 4 (4, 4.25); median 4 (4, 4.25) and median 4 (3, 4), respectively). There was a shared opinion held by investigators and editors that the peer review process be primarily responsible for ensuring complete research reporting (median 4 (3, 4) and median 4 (3.75, 4), respectively). Three of 18 authors (17%) felt that the English publication language of STARD 2015 was a barrier to adherence.ConclusionsAlthough investigators and editors recognise the importance of completely reported research, reporting quality is still a core issue for POCUS research. The shared opinion held by investigators and editors that the peer review process be primarily responsible for reporting quality is potentially problematic; we view completely reported research as an integral part of the research process that investigators are responsible for, with the peer review process serving as another additional layer of quality control. Endorsement of reporting guidelines by journals, auditing reporting guideline adherence during the peer review process and translation of STARD 2015 guidelines into additional languages may improve reporting completeness for the acute POCUS literature.Trial registration numberOpen Science Framework Registry (https://osf.io/5pzxs/).

The abdomen

2019 ◽  
pp. 89-106
Author(s):  
Justin Bowra ◽  
Osama Loubani ◽  
Paul Atkinson
Keyword(s):  
Emergency Medicine ◽  
Bowel Obstruction ◽  
Peritoneal Fluid ◽  
Renal Colic ◽  
Point Of Care ◽  
Clinical Situation ◽  
Point Of Care Ultrasound ◽  
Quadrant Pain ◽  
Diagnosis And Management ◽  
Rule Out

Abdominal point-of-care ultrasound (PoCUS) for intra-peritoneal fluid in trauma is one of the earliest, and now most accepted, uses of PoCUS in emergency medicine and resuscitation. It is an essential part of the e-FAST (Extended Focused Assessment in Trauma) examination. Abdominal PoCUS can also guide diagnosis and management of right upper quadrant pain and renal colic. PoCUS can also ‘rule in’ (but not ‘rule out’) bowel obstruction and appendicitis. Regardless of the clinical situation, PoCUS is used to answer specific binary questions, rather than to perform an exhaustive survey of the abdomen.

scholarly journals Effect of Number of Clinics and Panel Size on Patient Continuity for Medical Residents

2009 ◽  
Vol 1 (2) ◽  
pp. 310-315 ◽  
Author(s):  
Maureen D. Francis ◽  
Whitney E. Zahnd ◽  
Andrew Varney ◽  
Steven L. Scaife ◽  
Mark L. Francis
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Linear Regression Analysis ◽  
Medical Residents ◽  
Panel Size ◽  
Medical Education Program ◽  
Internal Medicine Residency Training ◽  
Multivariable Linear Regression Analysis ◽  
Linear Regression Modeling ◽  
Attending Physician

Abstract Background Accreditation Council for Graduate Medical Education program requirements for internal medicine residency training include a longitudinal, continuity experience with a panel of patients. Objective To determine whether the number of resident clinics, the resident panel size, and the supervising attending physician affect patient continuity. To determine the number of clinics and the panel size necessary to maximize patient continuity. Design We used linear regression modeling to assess the effect of number of attended clinics, the panel size, and the attending physician on patient continuity. Participants Forty medicine residents in an academic medicine clinic. Measurements Percent patient continuity by the usual provider of care method. Results Unadjusted linear regression analysis showed that patient continuity increased 2.3% ± 0.7% for each additional clinic per 9 weeks or 0.4% ± 0.1% for each additional clinic per year (P  =  .003). Conversely, patient continuity decreased 0.7% ± 0.4% for every additional 10 patients in the panel (P  =  .04). When simultaneously controlling for number of clinics, panel size, and attending physician, multivariable linear regression analysis showed that patient continuity increased 3.3% ± 0.5% for each additional clinic per 9 weeks or 0.6% ± 0.1% for each additional clinic per year (P &lt; .001). Conversely, patient continuity decreased 2.2% ± 0.4% for every additional 10 patients in the panel (P &lt; .001). Thus, residents who actually attend at least 1 clinic per week with a panel size less than 106 patients can achieve 50% patient continuity. Interestingly, the attending physician accounted for most of the variability in patient continuity (51%). Conclusions Patient continuity for residents significantly increased with increasing numbers of clinics and decreasing panel size and was significantly influenced by the attending physician.

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