Point-of-care ultrasound as a competency for general internists: a survey of internal medicine training programs in Canada

Ailon, Jonathan; Nadjafi, Maral; Mourad, Ophyr; Cavalcanti, Rodrigo B.

doi:10.36834/cmej.36779

Cited by 47 publications

(39 citation statements)

References 28 publications

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“…Following this acknowledgement from the ACP, the Society of Hospital Medicine issued a similar position statement highlighting their support for the use of POCUS by hospitalists [5]. Nationally and internationally, POCUS is increasingly incorporated in IM residency training programs over the last decade [7][8][9][10][11]. Recognizing the importance of POCUS in medical education, the Alliance of Academic Internal Medicine supports the integration of POCUS across the training continuum [12].…”

Section: Introductionmentioning

confidence: 99%

“…Despite the growing appetite for POCUS training, progress in expanding POCUS in IM has been slow. A major obstacle to the expansion of POCUS training is a lack of skilled faculty, and previous studies have cited limited time, money and resources as the key barriers to faculty adoption of POCUS [7,11,[13][14][15][16][17][18]. A more nuanced understanding of perceived faculty barriers is needed, however, to allow for more targeted interventions.…”

Section: Introductionmentioning

confidence: 99%

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Barriers to learning and using point-of-care ultrasound: a survey of practicing internists in six North American institutions

et al. 2020

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Background: Point-of-care ultrasound (POCUS) is increasingly used in internal medicine, but a lack of trained faculty continues to limit the spread of POCUS education. Using a framework based on organizational change theories, this study sought to identify barriers and enablers for hospital-based practicing internists to learn and use POCUS in clinical practice. Methods: We invited practicing internists at six North American institutions to participate in an electronic survey on their opinions regarding 39 barriers and enablers. Results: Of the 342 participants invited, 170 participated (response rate 49.3%). The top barriers were lack of training (79%), lack of handheld ultrasound devices (78%), lack of direct supervision (65%), lack of time to perform POCUS during rounds (65%), and lack of quality assurance processes (53%). The majority of participants (55%) disagreed or strongly disagreed with the statement "My institution provides funding for POCUS training." In general, participants' attitudes towards POCUS were favourable, and future career opportunities and the potential for billing were not considered significant factors by our participants in the decision to learn or use POCUS. Conclusions: This survey confirms the perceived importance of POCUS to practicing internists. To assist in closing faculty development gap, interventions should address training, supervision, quality assurance processes, availability of handheld devices, as well as dedicated time to perform POCUS during clinical care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Barriers to learning and using point-of-care ultrasound: a survey of practicing internists in six North American institutions

et al. 2020

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“…GPs were asked to identify the clinical indications for which they presently utilize or anticipate using ultrasound for adult patients. An extensive list of indications was created based on previous surveys, published literature, and the clinical conditions targeted by POCUS according to the SGUM model [7,8,14,[19][20][21]. POCUS indications were not highlighted but blended in the list.…”

Section: Cross-sectional Survey Datamentioning

confidence: 99%

The use of ultrasound in primary care: Longitudinal billing and cross-sectional survey study in Switzerland

Touhami

Merlo

Hohmann

et al. 2020

Preprint

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Abstract Background Ultrasound imaging is utilized in Swiss primary care; however, little is known regarding the extent to which it is performed. A course in Point-of-Care ultrasound (POCUS) has been recently introduced to promote and improve the utilization of ultrasound. POCUS will offer faster certification compared to previous courses thanks to a limited set of targeted examinations. With this study, we aim to (1) provide an overview of ultrasound use by general practitioners (GPs), and (2) determine how the clinical uses of ultrasound relate to the targeted objectives of POCUS. Methods This is a quantitative study, analyzing fifteen years of billing data from 213 GPs in Central Switzerland and cross-sectional survey data completed by 61 GPs attending 26 certification and refresher courses offered by the Swiss Society of Ultrasound in Medicine (SGUM). Results According to billing data, 49% of the GPs used ultrasound and provided 130,245 exams to 67,180 patients between 2004 and 2018. Over the years, ultrasound use became more frequent among GPs. Male GPs provide more ultrasound exams than female GPs. Patients that are female, ≥65 years, and multi-morbid had more ultrasound exams compared to males, patients <65 years, and those with only one morbidity, respectively. GPs provided a mean of 129 ultrasound exams per physician-year. Abdominal ultrasound comprised almost 69% of all exams. According to survey data, indications covered many organ systems and clinical conditions, with most POCUS indications being among them. Conclusions Utilization of ultrasound is high among general practitioners and covers a wide range of indications. A focus in certification on POCUS might reduce the variety of indications. Keywords: Ultrasound; general practice; primary care; general practitioners; clinical indications; POCUS; ultrasound certification; Switzerland

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“…9 Internal medicine (IM) is similarly gaining PoCUS interest, with approximately 30-50% of IM residents using PoCUS. 10,11 A nationwide survey found that only 25% of IM programs have formal PoCUS education, with many curricula limited to USguided central venous cannulation. 10 We recently published that while 27% of IM residents are using PoCUS to guide clinical decision-making, only 9.7% of residents have formal PoCUS training.…”

Section: Résultatsmentioning

confidence: 99%

“…10,11 A nationwide survey found that only 25% of IM programs have formal PoCUS education, with many curricula limited to USguided central venous cannulation. 10 We recently published that while 27% of IM residents are using PoCUS to guide clinical decision-making, only 9.7% of residents have formal PoCUS training. 11 As with any tool, there is a risk of causing more harm than benefit with inadequate training.…”

Section: Résultatsmentioning

confidence: 99%

Implementation of a Progressive Three-Year Point of Care Ultrasound Curriculum for Internal Medicine Residents

Lewis¹,

Martin²,

Mazzetti³

et al. 2018

Can Journ Gen Int Med

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Background Point-of-Care Ultrasound (PoCUS) is an ultrasound examination performed by the clinician to answer a focused question or guide an invasive procedure. Despite gaining popularity and evidence supporting the use of PoCUS, core Internal Medicine (IM) residency programs in Canada have yet to implement a comprehensive PoCUS curriculum. The objective of this study was to create a formal PoCUS curriculum. Methods We conducted a systematic needs assessment with a survey that assessed IM attending and resident comfort, training, and application of PoCUS. We also performed a literature review of selected PoCUS-guided procedures and diagnostics to assess the evidence. A working group analyzed the collected data and designed a graduated 3-year curriculum. Results The needs assessment demonstrated that PoCUS education was both necessary and in high demand. The PoCUS-guided procedures and diagnostics that were identified by the survey to be necessary for IM training were then evaluated by a literature review. Based on the evidence, a progressive 3-year curriculum was created. The working group decided on the method and timing of curriculum delivery. Conclusion McMaster University is the first IM residency program to introduce a graduated 3-year curriculum complete with competency assessment and quality assurance. Résumé Contexte L'échographie ponctuelle est un examen d'échographie effectué par le clinicien pour répondre à une question ciblée ou guider une procédure invasive. Malgré l'obtention de la popularité et des preuves appuyant l'utilisation de la messagerie instantanée, les programmes de résidence au Canada pour la médecine interne de base (GI) n'ont pas encore mis en œuvre un programme exhaustif. L'objectif de cette étude était de créer un programme d'études officiel. Méthodes Nous avons effectué une évaluation systématique des besoins avec un sondage qui évaluait la présence de GI et le confort des résidents, la formation et l'application de ces programmes. Nous avons également effectué un examen de la documentation de certaines procédures et diagnostics guidés pour évaluer la preuve. Un groupe de travail a analysé les données collectées et conçu un programme gradué de trois ans. Résultats L'évaluation des besoins a démontré que l'éducation était à la fois nécessaire et trèsdemandée. Les procédures et les diagnostics qui ont été identifiés par le sondage comme étant nécessaires à la formation en GI ont ensuite été évalués par un examen de la documentation. Sur la base des données probantes, un programme d'études progressive de trois ans a été créé. Le groupe de travail a décidé de la méthode et ducalendrier de l'exécution des programmes. Conclusion L'Université McMaster est le premier programme de résidence en GI à présenter un programme gradué de trois ans complété par l'évaluation des compétences et l'assurance de la qualité.

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Point-of-care ultrasound as a competency for general internists: a survey of internal medicine training programs in Canada

Cited by 47 publications

References 28 publications

Barriers to learning and using point-of-care ultrasound: a survey of practicing internists in six North American institutions

Barriers to learning and using point-of-care ultrasound: a survey of practicing internists in six North American institutions

The use of ultrasound in primary care: Longitudinal billing and cross-sectional survey study in Switzerland

Implementation of a Progressive Three-Year Point of Care Ultrasound Curriculum for Internal Medicine Residents

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