Emergency Medicine Resident Assessment of the Emergency Ultrasound Milestones and Current Training Recommendations

Stolz, Lori; Stolz, Uwe; Fields, J. Matthew; Saul, Turandot; Secko, Michael; Flannigan, Matthew; Sheele, Johnathan M.; Rifenburg, Robert P.; Weekes, Anthony J.; Josephson, Elaine B.; Bedolla, John; Resop, Dana; Cruz, Jonathan dela; Boysen‐Osborn, Megan; Caffery, Terrell; Derr, Charlotte; Bengiamin, Rimon; Chiricolo, Gerardo; Backlund, Brandon; Heer, Jagdipak; Hyde, Robert J.; Adhikari, Srikar

doi:10.1111/acem.13113

Cited by 35 publications

(46 citation statements)

References 9 publications

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“…Despite generalized acceptance of ultrasound for procedural guidance as an essential skill for all graduates of ACGME‐accredited EM residencies, EM residents have expressed concern regarding the current standard of training and may lack the confidence and procedural mastery to efficiently perform ultrasound‐guided invasive procedures …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, EM residents—especially at junior levels of training—often lack the confidence and procedural mastery to efficiently perform these invasive procedures . A recent survey of EM residents indicates a general consensus that greater ultrasound instruction, beyond current residency expectations, should be required to achieve competency . Accordingly, residents might benefit from an intervention that encourages proper technique, bolsters confidence, and improves procedural success when performing ultrasound‐guided procedures.…”

mentioning

confidence: 99%

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New Ultrasound Technology Is a Useful Training Adjunct for Invasive Procedures

Wilson

Keefe

Ehmann

2017

AEM Education and Training

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

New Ultrasound Technology Is a Useful Training Adjunct for Invasive Procedures

Wilson

Keefe

Ehmann

2017

AEM Education and Training

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“…13,[24][25][26] Content from the Accreditation Council for Graduate Medical Education (ACGME) and the American College of Emergency Physicians (ACEP) was also incorporated because these organizations had published relevant guidelines for teaching POCUS. 13,26 Further development of the lectures occurred through review of previously described POCUS-relevant curricula. [27][28][29][30][31][32]…”

Section: Curriculum Implementationmentioning

confidence: 99%

“…13,24,26 Additional content was obtained from major society POCUS tutorials and deidentified images collected by the study authors. 13,24,33 In keeping with previously described methodology, the images were shown for approximately 12 seconds, followed by five additional seconds to allow the learner to answer the question. 32 Final assessment contents were determined by the authors using the Delphi method.…”

Section: Assessment Design and Implementationmentioning

confidence: 99%

Portable Ultrasound Device Usage and Learning Outcomes Among Internal Medicine Trainees: A Parallel-Group Randomized Trial

Kumar

Wang

Wang³

et al. 2019

J Hosp Med

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BACKGROUND: Little is known about how to effectively train residents with point-of-care ultrasonography (POCUS) despite increasing usage. OBJECTIVE: This study aimed to assess whether handheld ultrasound devices (HUDs), alongside a year-long lecture series, improved trainee image interpretation skills with POCUS. METHODS: Internal medicine intern physicians (N = 149) at a single academic institution from 2016 to 2018 participated in the study. The 2017 interns (n = 47) were randomized 1:1 to receive personal HUDs (n = 24) for patient care vs no-HUDs (n = 23). All 2017 interns received a repeated lecture series regarding cardiac, thoracic, and abdominal POCUS. Interns were assessed on their ability to interpret POCUS images of normal/abnormal findings. The primary outcome was the difference in end-of-the-year assessment scores between interns randomized to receive HUDs vs not. Secondary outcomes included trainee scores after repeating lectures and confidence with POCUS. Intern scores were also compared with historical (2016, N = 50) and contemporaneous (2018, N = 52) controls who received no lectures. RESULTS: Interns randomized to HUDs did not have significantly higher image interpretation scores (median HUD score: 0.84 vs no-HUD score: 0.84; P = .86). However, HUD interns felt more confident in their abilities. The 2017 cohort had higher scores (median 0.84), compared with the 2016 historical control (median 0.71; P = .001) and 2018 contemporaneous control (median 0.48; P < .001). Assessment scores improved after first-time exposure to the lecture series, while repeated lectures did not improve scores. CONCLUSIONS: Despite feeling more confident, personalized HUDs did not improve interns’ POCUS-related knowledge or interpretive ability. Repeated lecture exposure without further opportunities for deliberate practice may not be beneficial for mastering POCUS.

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“…In the United States, the Accreditation Council for Graduate Medical Education and the American Board of Emergency Medicine recently designated emergency US as a required milestone competency during emergency medicine residency training . These guidelines designate the use of advanced echocardiography as a level 5 competency, establishing extremely high standards for bedside echocardiography training programs. However, echocardiography requires a solid understanding of the physical basis of US, as well as intricate pathophysiology and cardiac structure and function.…”

mentioning

confidence: 99%