Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Abstract

BACKGROUND: Despite the future potential of using ultrasound stethoscopes to augment the bedside cardiac physical, few data exist on a general cardiovascular imaging protocol that can be taught to physicians on a perpetual basis as a curriculum in graduate medical education. METHODS: During the past decade, we developed and integrated a cardiovascular limited ultrasound training program within the confines of an internal medicine residency. The evidence‐based rationale for the exam, the teaching methods, and curriculum are delineated, and subsequent observations regarding program requirements, proficiency, and academic outcomes are explored. Analysis of variance and linear regression assessed for relationships between academic scores, chief resident selection, and gender to proficiency in ultrasound. RESULTS: A brief, 5‐minute cardiovascular limited ultrasound exam (CLUE) was taught using both didactic and bedside methods, and practiced primarily within the cardiology consult, outpatient clinic, and intensive care rotations. Program costs were minimized by employing readily available institutional resources. After a 2‐year lead‐in training phase, the subsequent 4 years of senior resident performance (n = 41 residents) showed an 81% pass rate in CLUE competency. Resident ultrasound performance did not relate to academic scores (r = 0.05, P = 0.75), chief resident selection, nor gender. Observations regarding resident pitfalls in CLUE practice and increased participation in extracurricular research are described. CONCLUSIONS: We report our initial experience in developing and implementing a training program for bedside cardiovascular ultrasound examination that employed evidence‐based techniques, set proficiency goals, and assessed resident performance. It may be feasible to teach future internist–hospitalists the technique of bedside ultrasound during residency. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine

Learning to apply the pocket ultrasound device on the critically ill: comparing six 'quick-look' signs for quality and prognostic values during initial use by novices

“…We have similarly noted that an evidence-based 'quick-look', cardiac limited ultrasound examination has diagnostic and prognostic value [2], can affect medical decision-making [3], and can be successfully taught to internal medicine residents [4]. As few data describe the learning curve of ultrasound imaging with PUDs, we observed the initial quality and prognostic value of six 'quick-look' signs obtained by residents learning to use the PUD.…”

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H2 Receptor Antagonists versus Proton Pump Inhibitors in Patients on Dual Antiplatelet Therapy for Coronary Artery Disease: A Systematic Review

“…Except for 4 [9,14,17,24], most studies were at moderate to high risk of bias and had unclear reporting of funding sources. Individual study definitions for GI complications, MACE, and HTPR are described in online supplementary Tables S1-S3 respectively.…”

Actual use of pocket-sized ultrasound devices for cardiovascular examination by trained physicians during a hospitalist rotation

“…As a mandatory part of the residency curriculum, all residents had received formal training in CLUE as detailed elsewhere (16, 22, 23). The CLUE involves acquisition of six quick-look views and recognition of six evidence-based signs and can typically be performed within 2 min.…”