Current Use, Training, and Barriers of Point-of-Care Ultrasound in Anesthesiology: A National Survey of Veterans Affairs Hospitals

Remskar, Mojca H.; Theophanous, Rebecca G.; Bowman, Amber; Simonson, Lindsey E.; Koehler, Jessica; Basrai, Zahir; Manohar, Crystal M; Mader, Michael; Nathanson, Robert; Soni, Nilam J.

doi:10.1053/j.jvca.2023.03.042

Cited by 10 publications

(3 citation statements)

References 31 publications

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“…This likely speaks to the nuances required to develop a robust POCUS training program—baseline access to ultrasound may not equate with adequate access to the correct probe in the right place at the right time. All responding programs highlighted a lack of experience, lack of oversight/guidance, and lack of time as additional barriers, which highlight similar themes identified in previous surveys exploring POCUS use in anesthesia 14,15 …”

Section: Discussionsupporting

confidence: 61%

“…All responding programs highlighted a lack of experience, lack of oversight/guidance, and lack of time as additional barriers, which highlight similar themes identified in previous surveys exploring POCUS use in anesthesia. 14,15 This is in contrast, however, to specialties like emergency medicine (EM), CCM, pediatric EM and pediatric CCM, all of which have high rates of reported POCUS education in fellowship training programs in the United States. [16][17][18][19] These specialties have leaned on shared strategies to implement successful and widespread POCUS training, including publishing societal guidelines on the scope of POCUS practice, outlining clear paths to certification, and establishing systems for resident/fellow oversight and quality assurance.…”

Section: Discussionmentioning

confidence: 99%

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The state of point‐of‐care ultrasound training in pediatric anesthesia fellowship programs in the United States: A survey assessment

O'Brien,

Guris,

Quarshie

et al. 2024

Pediatric Anesthesia

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BackgroundPoint‐of‐care ultrasound is an invaluable bedside tool for anesthesiologists and has been integrated into anesthesiology residency training and board certification in the United States. Little is known about point‐of‐care ultrasound training practices in pediatric anesthesia fellowship programs.AimsTo describe the current state of point‐of‐care ultrasound education in pediatric anesthesia fellowship programs in the United States.MethodsWe conducted a cross‐sectional survey study distributed to 60 American Accreditation Council for Graduate Medical Education‐accredited pediatric anesthesia fellowship programs. Two programs were in their initial accreditation period and were excluded due to lack of historical data. Program directors or associate program directors were invited to complete this 23‐item survey.ResultsThirty‐three of fifty‐eight programs (57%) completed the survey. Of those, 15 programs (45%) reported having a point‐of‐care ultrasound curriculum. Programs with ≤3 fellows per year were less likely to have an ultrasound curriculum compared to programs with ≥4 fellows per year (30% programs 0–3 fellows/year vs. 69% programs ≥4 fellows/year, odds ratio 0.19 [95% confidence intervals 0.04–0.87]; p = .03). Program directors and associate program directors rated point‐of‐care ultrasound training as highly valuable to fellows' education. Barriers to use most commonly included lack of experience (64%), lack of oversight/interpretive guidance (58%), and lack of time (45%). Programs without point‐of‐care ultrasound training had significantly higher odds of listing lack of ultrasound access as a primary barrier (50% programs without vs. 13% programs with, odds ratio 6.5, [95% confidence intervals 1.3–50]; p = .04).ConclusionsThis observational survey‐based study suggests that fewer than half of pediatric anesthesia training programs in the United States offer point‐of‐care ultrasound education. Additional research is needed to optimize this education and training in pediatric anesthesia fellowship programs.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

The state of point‐of‐care ultrasound training in pediatric anesthesia fellowship programs in the United States: A survey assessment

O'Brien,

Guris,

Quarshie

et al. 2024

Pediatric Anesthesia

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“…Although more medical schools and internal medicine residency programs are incorporating POCUS into training curricula, few geriatric fellowships currently provide POCUS training [ 12 , 17 ]. Training-related barriers, including lack of POCUS experts to oversee training and time for practice, are well described barriers to POCUS use in multiple specialties in the United States [ 19 – 21 , 29 , 30 ] and other countries [ 31 , 32 ]. Therefore, development of national POCUS training programs for academic geriatricians are needed to train geriatricians in-practice and ensure adequate supervision of trainees.…”

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasound in geriatrics: a national survey of VA medical centers

Gogtay,

Choudhury,

Williams

et al. 2023

BMC Geriatr

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Background Point-of-care ultrasound (POCUS) can aid geriatricians in caring for complex, older patients. Currently, there is limited literature on POCUS use by geriatricians. We conducted a national survey to assess current POCUS use, training desired, and barriers among Geriatrics and Extended Care (“geriatric”) clinics at Veterans Affairs Medical Centers (VAMCs). Methods We conducted a prospective observational study of all VAMCs between August 2019 and March 2020 using a web-based survey sent to all VAMC Chiefs of Staff and Chiefs of geriatric clinics. Results All Chiefs of Staff (n=130) completed the survey (100% response rate). Chiefs of geriatric clinics (“chiefs”) at 76 VAMCs were surveyed and 52 completed the survey (68% response rate). Geriatric clinics were located throughout the United States, mostly at high-complexity, urban VAMCs. Only 15% of chiefs responded that there was some POCUS usage in their geriatric clinic, but more than 60% of chiefs would support the implementation of POCUS use. The most common POCUS applications used in geriatric clinics were the evaluation of the bladder and urinary obstruction. Barriers to POCUS use included a lack of trained providers (56%), ultrasound equipment (50%), and funding for training (35%). Additionally, chiefs reported time utilization, clinical indications, and low patient census as barriers. Conclusions POCUS has several potential applications for clinicians caring for geriatric patients. Though only 15% of geriatric clinics at VAMCs currently use POCUS, most geriatric chiefs would support implementing POCUS use as a diagnostic tool. The greatest barriers to POCUS implementation in geriatric clinics were a lack of training and ultrasound equipment. Addressing these barriers systematically can facilitate implementation of POCUS use into practice and permit assessment of the impact of POCUS on geriatric care in the future.

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Current perception and barriers to implementing lung ultrasound in Canadian neonatal intensive care units: a national survey

Mohsen,

Yeung,

Fadel

et al. 2024

Eur J Pediatr

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Current Use, Training, and Barriers of Point-of-Care Ultrasound in Anesthesiology: A National Survey of Veterans Affairs Hospitals

Cited by 10 publications

References 31 publications

The state of point‐of‐care ultrasound training in pediatric anesthesia fellowship programs in the United States: A survey assessment

The state of point‐of‐care ultrasound training in pediatric anesthesia fellowship programs in the United States: A survey assessment

Point-of-care ultrasound in geriatrics: a national survey of VA medical centers

Current perception and barriers to implementing lung ultrasound in Canadian neonatal intensive care units: a national survey

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