Impact of Point-of-Care Ultrasound Training on Surgical Residents’ Confidence

Abstract

Objective Point-of-care ultrasound (POCUS) is a vital tool for diagnosis and management of critically ill patients, particularly in resource-limited settings where access to diagnostic imaging may be constrained. We aimed to develop a novel POCUS training curriculum for surgical practice in the United States and in resource-limited settings in low- and middle-income countries and to determine its effect on surgical resident self-assessments of efficacy and confidence. Design We conducted an observational cohort study evaluating a POCUS training course that comprised 7 sessions of 2 hours each with didactics and proctored skills stations covering ultrasound applications for trauma (Focused Assessement with Sonography for Trauma (FAST) examination), obstetrics, vascular, soft tissue, regional anesthesia, focused echocardiography, and ultrasound guidance for procedures. Surveys on attitudes, prior experience, and confidence in point-of-care ultrasound applications were conducted before and after the course. Setting General Surgery Training Program in Seattle, Washington. Participants A total of 16 residents participated in the course; 15 and 10 residents completed the precourse and postcourse surveys, respectively. Results The mean composite confidence score from pretest compared with posttest improved from 23.3 (±10.2) to 37.8 (±6.7). Median confidence scores (1-6 scale) improved from 1.5 to 5.0 in performance of FAST (p < 0.001). Residents reported greater confidence in their ability to identify pericardial (2 to 4, p = 0.009) and peritoneal fluid (2 to 4.5, p < 0.001), to use ultrasound to guide procedures (3.5 to 4.0, p = 0.008), and to estimate ejection fraction (1 to 4, p = 0.004). Both before and after training, surgical residents overwhelmingly agreed with statements that ultrasound would improve their US-based practice, make them a better surgical resident, and improve their practice in resource-limited settings. Conclusions After a POCUS course designed specifically for surgeons, surgical residents had improved self-efficacy and confidence levels across a broad range of skills.

Point‐of‐Care Ultrasound in General Surgery Residency Training: A Proposal for Milestones in Graduate Medical Education Ultrasound

“…Additionally, surgical residents believe that US training would make them better physicians and improve their practice in resource‐limited settings. In fact, most report improved self‐efficacy and self‐confidence after participation in a point‐of‐care US course specifically designed for surgeons . Along with the increased introduction of point‐of‐care US education into general surgery residency training, there is a need for increased standardization of training and competency assessment.…”

Utilisation of radiology rotations in ACGME-accredited general surgery programmes

“…With limited patient exposure due to constraints in working hours, an efficient method of delivering resident education is needed. A dedicated point-of-care US course has been shown to improve residents’ confidence in accurately identifying pericardial and peritoneal fluid, US-guided procedures and estimation of ejection fraction 17. Other reports have shown improved resident performance in US-guided breast biopsies after a dedicated course 18–20.…”

Evaluation of a point‐of‐care ultrasound curriculum taught by medical students for physicians, nurses, and midwives in rural Indonesia

“…Ultrasound (US) continues to be an accessible diagnostic tool due to its mobility, noninvasive nature, and low cost. Point‐of‐care ultrasound (POCUS) refers to the use of portable ultrasonography at bedside for diagnostic and therapeutic purposes, and can be used to quickly assess pathology in settings where other equipment may not be readily available, such as computed tomography or magnetic resonance imaging machines . This may help ease the burden of diagnosis in settings where access to physicians and medical imaging equipment is limited .…”

“…Point-of-care ultrasound (POCUS) refers to the use of portable ultrasonography at bedside for diagnostic and therapeutic purposes, and can be used to quickly assess pathology in settings where other equipment may not be readily available, such as computed tomography or magnetic resonance imaging machines. [4][5][6] This may help ease the burden of diagnosis in settings where access to physicians and medical imaging equipment is limited. 1 In developing countries, lack of training serves as the main barrier to US use.…”