scholarly journals Feasibility and Acceptability of a Structured Curriculum in Teaching Procedural and Basic Diagnostic Ultrasound Skills to Internal Medicine Residents

2013 ◽  
Vol 5 (3) ◽  
pp. 493-497 ◽  
Author(s):  
Daniel J. Schnobrich ◽  
Andrew P. J. Olson ◽  
Alain Broccard ◽  
Alisa Duran-Nelson
Keyword(s):  
Internal Medicine ◽  
Medical Decision Making ◽  
Point Of Care ◽  
Image Acquisition ◽  
Abdominal Ultrasound ◽  
Medical Decision ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Residents ◽  
Teaching Interventions ◽  
Future Work

Abstract Background Point-of-care ultrasound has emerged as a powerful diagnostic tool and is also being increasingly used by clinicians to guide procedures. Many current and future internists desire training, yet no formal, multiple-application, program-wide teaching interventions have been described. Intervention We describe a structured 30-hour ultrasound training course in diagnostic and procedural ultrasound implemented during intern orientation. Internal medicine interns learned basic ultrasound physics and machine skills; focused cardiac, great vessel, pulmonary, and abdominal ultrasound diagnostic examinations; and procedural applications. Results In postcourse testing, learners demonstrated the ability to acquire images, had significantly increased knowledge scores (P < .001), and demonstrated good performance on practical scenarios designed to test abilities in image acquisition, interpretation, and incorporation into medical decision making. In the postcourse survey, learners strongly agreed (4.6 of 5.0) that ultrasound skills would be valuable during residency and in their careers. Conclusions A structured ultrasound course can increase knowledge and can result in learners who have skills in image acquisition, interpretation, and integration in management. Future work will focus on refining and improving these skills to allow these learners to be entrusted with the use of ultrasound independently for patient care decisions.

Entrusting internal medicine residents to use point of care ultrasound: Towards improved assessment and supervision

2018 ◽  
Vol 40 (11) ◽  
pp. 1130-1135 ◽  
Author(s):  
Daniel J. Schnobrich ◽  
Benji K. Mathews ◽  
Bernard E. Trappey ◽  
Brian K. Muthyala ◽  
Andrew P. J. Olson
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Residents

scholarly journals 1080: DESIGNING A POINT-OF-CARE ULTRASOUND CURRICULUM FOR OUR TRAINING AS INTERNAL MEDICINE RESIDENTS

2021 ◽  
Vol 50 (1) ◽  
pp. 538-538
Author(s):  
Ubaldo Madera Sanchez ◽  
Keila Díaz Rodriguez ◽  
Janice Cuevas Rivera ◽  
Javier Ortega Belasquide ◽  
Maria Cochran Perez ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Residents

scholarly journals Point-of-Care Ultrasound in Internal Medicine

2017 ◽  
Vol 12 (2) ◽  
Author(s):  
Mitch Levine
Keyword(s):  
Internal Medicine ◽  
Needs Assessment ◽  
Point Of Care ◽  
Digital Health ◽  
Pericardial Tamponade ◽  
Point Of Care Ultrasound ◽  
Residency Programs ◽  
Technological Advances ◽  
Internal Medicine Residents ◽  
Similar Survey

Over the past few decades a variety of technological advances have dramatically change the manner in which physicians practice medicine. Both clinically and administratively the practice of medicine is in evolution – for example; stents instead of surgery and digital health records instead of paper charts. For internal medicine physicians one of the biggest transformations with respect to how we will practice medicine is just on the horizon. The routine use of point-of-care ultrasound (PoCUS) will become an essential skill for the practicing internist. The application for PoCUS in the field of internal medicine is immense – accurately assessing the JVP in critically ill patients, performing arterial and venipunctures, diagnosing pericardial tamponade or determining the likelihood of a pulmonary embolus, or the diagnostic and therapeutic removal of body fluids, to name a few.While some of our colleagues have adopted this technology as an adjunct to the clinical examination or as an aid to conducting bedside procedures most have not adopted this as a routine skill set. Some of the barriers include insufficient training and a lack of readily accessible equipment in all clinical settings. But this will change, and the use of PoCUS will eventually become a required skill of all practicing internists.In the current issue of CJGIM Lewis et al have conducted a needs assessment of PoCUS in answering either a clinical question or in guiding a procedure. As the Royal College of Physicians and Surgeons does not yet require all internal medicine residency programs to provide a formal PoCUS curriculum, the objective of their study was to conduct a systematic needs assessment for the introduction of a PoCUS curriculum to an internal medicine program. The results showed that some internal medicine residents were already using PoCUS yet they had never been formal trained in the skill. One is left to wonder what a similar survey would find if conducted amongst practicing internists.While each residency programs will inevitably develop a PoCUS curriculum for their trainees, it will remain a continuing education challenge for internists already in practice. The importance of this skill cannot be under estimated and it will require the leadership in the internal medicine community to ensure that they create the opportunity for all internists to master the use of PoCUS.

scholarly journals First year internal medicine residents’ self-report point-of-care ultrasound knowledge and skills: what (Little) difference three years make

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tanner Chahley ◽  
Ada W Lam ◽  
Samantha Halman ◽  
Kathryn Watson ◽  
Irene WY Ma
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Internal Medicine Residency ◽  
Self Report ◽  
First Year ◽  
Learning Needs ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Residents ◽  
Study Support ◽  
B Lines

Abstract Background With increasing availability of point-of-care ultrasound (POCUS) education in medical schools, it is unclear whether or not learning needs of junior medical residents have evolved over time. Methods We invited all postgraduate year (PGY)-1 residents at three Canadian internal medicine residency training programs in 2019 to complete a survey previously completed by 47 Canadian Internal Medicine PGY-1 s in 2016. Using a five-point Likert scale, participants rated perceived applicability of POCUS to the practice of internal medicine and self-reported skills in 15 diagnostic POCUS applications and 9 procedures. Results Of the 97 invited residents, 58 (60 %) completed the survey in 2019. Participants reported high applicability but low skills across all POCUS applications and procedures. The 2019 cohort reported higher skills in assessing pulmonary B lines than the 2016 cohort (2.3 ± SD 1.0 vs. 1.5 ± SD 0.7, adjusted p-value = 0.01). No other differences were noted. Conclusions POCUS educational needs continue to be high in Canadian internal medicine learners. The results of this needs assessment study support ongoing inclusion of basic POCUS elements in the current internal medicine residency curriculum.

I-AIM (Indication, Acquisition, Interpretation, Medical Decision-making) Framework for Point of Care Lung Ultrasound

2017 ◽  
Vol 127 (3) ◽  
pp. 568-582 ◽  
Author(s):  
Richelle Kruisselbrink ◽  
Vincent Chan ◽  
Gian Alfonso Cibinel ◽  
Simon Abrahamson ◽  
Alberto Goffi
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Comprehensive Approach ◽  
Medical Decision ◽  
Digital Content ◽  
Point Of Care Ultrasound ◽  
Ultrasound Application ◽  
Decision Making Model

The I-AIM (Indication, Acquisition, Interpretation, Medical decision-making) model is a conceptive framework uniquely applicable to every point of care ultrasound application. We present a systematic comprehensive approach to lung ultrasound based on the I-AIM framework. Supplemental Digital Content is available in the text.

scholarly journals Development and Evaluation of Resident-Championed Point-of-Care Ultrasound Curriculum for Internal Medicine Residents

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 103-108
Author(s):  
Leila Haghighat ◽  
Heyley Israel ◽  
Eric Jordan ◽  
Ethan L. Bernstein ◽  
Merilyn Varghese ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Resident Education ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Testing Methods ◽  
Clinical Tool ◽  
Didactic Teaching ◽  
Internal Medicine Residents ◽  
Before And After

Introduction: Point-of-care ultrasound (POCUS) is a powerful clinical tool that has seen widespread adoption, including in Internal Medicine (IM), yet standardized curricula designed by trained faculty are scant. To address the demand for POCUS education at our institution, we created a resident-championed curriculum with support from skilled faculty across multiple specialties. Our objective was to teach postgraduate year (PGY)-3 IM residents the basics of POCUS for evaluation of the pulmonary, cardiac, and abdominal systems through resident-developed workshops. The goal of acquisition of these skills was for resident education and to inform decisions to pursue further patient testing. Methods: Three half-day workshops were created to teach residents how to obtain and interpret ultrasound images of the pulmonary, cardiac, and abdominal systems. Workshops were comprised of didactic teaching and practical ultrasound instruction with expert supervision of clinicians within and outside of IM. Residents were asked to complete a written survey before and after each workshop to assess confidence, knowledge, and likelihood of future POCUS use. Results: Across the three workshops (pulmonary, cardiac, and abdominal), 66 sets of pre- and post-workshop surveys (32 pulmonary, 25 cardiac, and 9 abdominal) were obtained and analyzed. Confidence in and knowledge regarding POCUS use increased significantly across all three workshops. Likelihood of future use increased in the cardiac workshop. Conclusions: We implemented a resident-championed POCUS curriculum that led to improved attitudes and increased knowledge of POCUS for PGY-3 IM residents.

798 Introduction of Bedside Echocardiography by Mid-level Providers into Burn Intensive Care

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S235-S236
Author(s):  
Michael G Chambers ◽  
Garrett W Britton ◽  
Leopoldo C Cancio
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Medical Decision Making ◽  
Point Of Care ◽  
Physical Exam ◽  
Medical Decision ◽  
Point Of Care Ultrasound ◽  
Laboratory Findings ◽  
Radiographic Findings ◽  
Us Findings

Abstract Introduction Point-of-care ultrasound (US) has been shown to be a useful adjunct in assessment of various shock states and has been utilized to guide both resuscitation and post-resuscitation de-escalation. We aimed to characterize the use of bedside ultrasound examinations performed by advance practice providers (APPs) and attending physicians in a burn intensive care unit (BICU). Methods We introduced routine US by an APP into our BICU and evaluated our experience under an approved PI project. Daily beside US exams were performed utilizing a portable US machine with a cardiac probe and tissue filter. US exams included focused transthoracic echocardiography, assessment of inferior vena cava diameter with distensibility/collapsibility indices, and pulmonary evaluation. The images were archived to a centralized repository and reviewed daily during multi-disciplinary rounds. US data were utilized in conjunction with physical exam, radiographic, and laboratory findings for medical management decision making. Results Thirty-four exams of 34 patients have been conducted to date. 91% of US findings corresponded to physical, laboratory, and radiographic findings, and contributed positively to medical decision making. 9% of US findings either did not contribute to medical decision making or conflicted with physical exam, radiographic, or laboratory findings. Conclusions Our results demonstrate the feasibility of routine US by an APP in the BICU, and indicate that bedside US helps guide both resuscitative and post-resuscitative care. Applicability of Research to Practice It is well known that positive fluid balance is associated with worse clinical outcomes. We believe point-of-care US is a viable tool in preventing over-resuscitation as well as to guide post-resuscitative diuresis.

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