Point of care ultrasound (POCUS) use in the emergency department is associated with improved patient outcomes and increased patient satisfaction. When used for procedural guidance, it has been shown to increase first pass success and decrease complications. As of 2012, ultrasound has been identified as a core skill required for graduating emergency medicine (EM) residents. Despite this, only a minority of EM faculty who trained prior to 2008 are credentialed in POCUS. Half of all EM training programs in the United States have less than 50% of their faculty credentialed to perform and teach POCUS to learners. As the use of POCUS continues to grow in medicine, it is especially important to have a pathway for faculty to attain competence and become credentialed in POCUS. The goal of this paper was to outline an implementation process of a curriculum designed to credential EM faculty in POCUS.
IntroductionAlthough clinical ultrasound (CUS) is a core skill that is a requirement for emergency medicine (EM) residency graduation, only a fraction of EM practitioners who trained prior to this requirement are certified in CUS. The objective of the study was to implement a CUS workshop for practicing EM physicians, identify barriers to utilization, and assess comfort with the machine, obtaining and interpreting images, and incorporating CUS into clinical practice.
MethodsThis was a prospective descriptive cohort study of EM physician faculty who participated in an interactive 5hour CUS workshop intervention that introduced four core CUS modalities via didactics and hands-on scanning stations. Pre-and post-surveys were administered to identify barriers to utilization and assess perceived comfort with CUS using a 5-point Likert scale. Results were analyzed using Fisher's exact and paired t-tests.
ResultsThirty-five EM physicians participated with a 100% survey response rate. Only five of the physicians were ultrasound certified at the time of the workshop. On average, physicians were 16 years post-residency. Prior to the workshop, 29% had minimal ultrasound experience and 43% had not performed more than 50 ultrasounds. In the pre-course survey, every physician expressed at least one barrier to CUS utilization. Postworkshop, physicians felt significantly more comfortable using the ultrasound machine (p=0.0008), obtaining and interpreting images (p=0.0009 and p=0.0004), and incorporating CUS into clinical practice (p=0.002).
ConclusionThis workshop is an effective tool to expose practicing physicians to core concepts of CUS, improve their comfort level, and reduce barriers to ultrasound utilization.
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