In 2012, the Accreditation Council for Graduate Medical Education (ACGME) designated ultrasound (US) as one of 23 milestone competencies for emergency medicine (EM) residency graduates. With increasing scrutiny of medical educational programs and their effect on patient safety and health care delivery, it is imperative to ensure that US training and competency assessment is standardized. In 2011, a multiorganizational committee composed of representatives from the Council of Emergency Medicine Residency Directors (CORD), the Academy of Emergency Ultrasound of the Society for Academic Emergency Medicine (SAEM), the Ultrasound Section of the American College of Emergency Physicians (ACEM), and the Emergency Medicine Residents' Association was formed to suggest standards for resident emergency ultrasound (EUS) competency assessment and to write a document that addresses the ACGME milestones. This article contains a historical perspective on resident training in EUS and a table of core skills deemed to be a minimum standard for the graduating EM resident. A survey summary of focused EUS education in EM residencies is described, as well as a suggestion for structuring education in residency. Finally, adjuncts to a quantitative measurement of resident competency for EUS are offered. 1 Soon thereafter, the Society for Academic Emergency Medicine (SAEM) endorsed this position and recommended the development of a training curriculum.2 In 1994, Mateer and colleagues 3 published the model curriculum for physician training in EUS and by 1996 the EM core content curriculum required EUS competency for residency graduates. A landmark resolution by the American Medical Association in 1999 (Resolution 802 and policy H-230.960) stated that ultrasound (US) is "within the scope of practice of appropriately trained physicians" and that each specialty should decide the necessary training requirements for sonography competency.4 ACEP further developed the standard recognition of EUS as "a skill integral to the practice of EM" in the 2001 Model of the Clinical Practice of Emergency Medicine (EM Model), which resulted in the Accreditation Council for Graduate Medical Education (ACGME) mandating that all EM residents attain competency in the use of EUS by the completion of residency training. 5 In 2008, as an update and revision, ACEP published more comprehensive specialty-specific guidelines as a standard for EUS.6 Subsequently, SAEM, the Council of Emergency Medicine
Over the past 25 years, research performed by emergency physicians (EPs) demonstrates that bedside ultrasound (US) can improve the care of emergency department (ED) patients. At the request of the Council of Emergency Medicine Residency Directors (CORD), leaders in the field of emergency medicine (EM) US met to delineate in consensus fashion the model ''US curriculum'' for EM residency training programs. The goal of this article is to provide a framework for providing US education to EM residents. These guidelines should serve as a foundation for the growth of resident education in EM US. The intent of these guidelines is to provide minimum education standards for all EM residency programs to refer to when establishing an EUS training program. The document focuses on US curriculum, US education, and competency assessment. The use of US in the management of critically ill patients will improve patient care and thus should be viewed as a required skill set for all future graduating EM residents. The authors consider EUS skills critical to the development of an emergency physician, and a minimum skill set should be mandatory for all graduating EM residents. The US education provided to EM residents should be structured to allow residents to incorporate US into daily clinical practice. Image acquisition and interpretation alone are insufficient. The ability to integrate findings with patient care and apply them in a busy clinical environment should be stressed.
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