Monitoring Personalized Learning Curves for Emergency Ultrasound With Risk‐adjusted Learning‐curve Cumulative Summation Method

Peyrony, Olivier; Legay, Léa; Morra, Ivonne; Verrat, Anne; Milacic, Hélène; Franchitti, Jessica; Amami, Jihed; Gillet, Ariane; Azarnoush, Kouchiar; Elezi, Arben; Bragança, Ana Carolina Costa; Taboulet, P.; Bourrier, Pierre; Fontaine, Jean-Paul; Resche‐Rigon, Matthieu

doi:10.1002/aet2.10073

Cited by 15 publications

(28 citation statements)

References 14 publications

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“…Despite the PGY2-4 s having similar experience with POCUS scans (Table 1), the results of this study suggest that the PGY4 cohort outperformed the other trainees on the cardiac POCUS exam with a median entrustment score of ≥ 4 out of 5 on the UCAT. These results align with previous literature suggesting the number of previous scans and PGY year are not sufficiently reliable indicators of competency in isolation [12,[23][24][25], reinforcing the need for an assessment tool like the UCAT.…”

Section: Correlations With Other Variablessupporting

confidence: 88%

The ultrasound competency assessment tool for four-view cardiac POCUS

et al. 2021

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Background Point-of-care ultrasound (POCUS) has been recognized as an essential skill across medicine. However, a lack of reliable and streamlined POCUS assessment tools with demonstrated validity remains a significant barrier to widespread clinical integration. The ultrasound competency assessment tool (UCAT) was derived to be a simple, entrustment-based competency assessment tool applicable to multiple POCUS applications. When used to assess a FAST, the UCAT demonstrated high internal consistency and moderate-to-excellent inter-rater reliability. The objective of this study was to validate the UCAT for assessment of a four-view transthoracic cardiac POCUS. Results Twenty-two trainees performed a four-view transthoracic cardiac POCUS in a simulated environment while being assessed by two observers. When used to assess a four-view cardiac POCUS the UCAT retained its high internal consistency ($$\alpha =0.90)$$ α = 0.90 ) and moderate-to-excellent inter-rater reliability (ICCs = 0.61–0.91; p’s ≤ 0.01) across all domains. The regression analysis suggestion that level of training, previous number of focused cardiac ultrasound, previous number of total scans, self-rated entrustment, and intent to pursue certification statistically significantly predicted UCAT entrustment scores [F (5,16) = 4.06, p = 0.01; R2 = 0.56]. Conclusion This study confirms the UCAT is a valid assessment tool for four-view transthoracic cardiac POCUS. The findings from this work and previous studies on the UCAT demonstrate the utility and flexibility of the UCAT tool across multiple POCUS applications and present a promising way forward for POCUS competency assessment.

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Section: Correlations With Other Variablessupporting

confidence: 88%

The ultrasound competency assessment tool for four-view cardiac POCUS

et al. 2021

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“…While the ACGME EM ultrasound milestone suggests that performing a minimum number of ultrasound examinations can be used as a surrogate for overall clinical ultrasound competency, studies have found that different clinical ultrasound applications demonstrated different learning curves . Using a standard number of ultrasound examinations to determine competency may not be the most accurate means of measuring clinical ultrasound competency, as learners may not uniformly meet a level of mastery at a predefined number of performed ultrasound examinations.…”

Section: Defining Competency In Clinical Ultrasoundmentioning

confidence: 99%

Tools for Measuring Clinical Ultrasound Competency: Recommendations From the Ultrasound Competency Work Group

Damewood

Leo

Bailitz

et al. 2019

AEM Education and Training

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Competency in clinical ultrasound is essential to ensuring safe patient care. Competency in clinical ultrasound includes identifying when to perform a clinical ultrasound, performing the technical skills required for ultrasound image acquisition, accurately interpreting ultrasound images, and incorporating sonographic findings into clinical practice. In this concept paper, we discuss the advantages and limitations of existing tools to measure ultrasound competency. We propose strategies and future directions for assessing competency in clinical ultrasound.

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“…In one of the largest longitudinal studies to date, we present our findings on resident POCUS performance in an academic emergency department (ED) with a well‐established residency and ultrasound program as a function of PGY. Previous reports of longitudinal POCUS education in EM residencies have reported image acquisition and image interpretation accuracy as a function of number of examinations performed, not as a function of training year or time 10–13 . A study by Blehar et al 10 showed that 50 to 75 scans per application are needed to achieve “excellent interpretation and good image quality.” Our QA project was undertaken to identify trends in performance over the course of a 4‐year EM residency training in an effort to glean actionable data to inform additional educational initiatives.…”

Section: Discussionmentioning

confidence: 99%

“…It is not known is how resident ultrasound performance and interpretation changes over time or on how best to structured continued education throughout residency. Some studies have demonstrated how EM resident learning curves change with experience, although they report image acquisition and image interpretation accuracy as a function of number of examinations performed, not as a function of training year or time 10–14 …”

Section: Introductionmentioning

confidence: 99%

“…Some studies have demonstrated how EM resident learning curves change with experience, although they report image acquisition and image interpretation accuracy as a function of number of examinations performed, not as a function of training year or time. [10][11][12][13][14] The objective of this study was to analyze trends of ultrasound performance as a function of postgraduate year (PGY). We postulated that proximity in time to the ultrasound rotation may portend a higher level of accuracy and adherence to standards of scanning.…”

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confidence: 99%

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Longitudinal accuracy analysis of ultrasound performed during a four‐year emergency medicine residency

Schleifer

Haney

Shokoohi

et al. 2021

AEM Education and Training

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Point-of-care ultrasound (POCUS) training is well-established in emergency medicine (EM) residency programs in the United States. Demonstration of competency in POCUS has been required for graduates of United States EM residencies since 2001, yet EM resident POCUS education strategies vary widely. 1-4 In 2013, the American College of Emergency Physicians (ACEP), the Society for Academic Emergency Medicine (SAEM), and the Council of Emergency Medicine Residency Directors (CORD) published general guidelines for EM resident POCUS education and assessment. 1 Current EM POCUS education literature suggest that POCUS education and assessment should occur longitudinally and through

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Monitoring Personalized Learning Curves for Emergency Ultrasound With Risk‐adjusted Learning‐curve Cumulative Summation Method

Abstract: Background: Ultrasound (US) has been a regular practice in emergency departments for several decades. Thus,

Cited by 15 publications

References 14 publications

The ultrasound competency assessment tool for four-view cardiac POCUS

The ultrasound competency assessment tool for four-view cardiac POCUS

Tools for Measuring Clinical Ultrasound Competency: Recommendations From the Ultrasound Competency Work Group

Longitudinal accuracy analysis of ultrasound performed during a four‐year emergency medicine residency

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