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

Beal, Eliza W.; Sigmond, Benjamin R.; Sage-Silski, Latifa; Lahey, Samantha; Nguyen, Victor; Bahner, David P.

doi:10.1002/jum.14298

Cited by 28 publications

(24 citation statements)

References 38 publications

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“…Missed or incorrect diagnoses can have substantial adverse consequences for the patient. Numerous training guides are available, for example, in surgery residency, anesthesiology, pediatrics, emergency medicine, resource‐limited emergency physicians, critical care, and clinical practice . Hands‐on training is critical and represents an important medical application of diagnostic US (with attention to potential incidental findings of medical importance) .…”

Section: Discussion Of Us Safety In the Pocus Perspectivementioning

confidence: 99%

Diagnostic Ultrasound Safety Review for Point‐of‐Care Ultrasound Practitioners

Miller

Abo

Abramowicz

et al. 2019

J of Ultrasound Medicine

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Potential ultrasound exposure safety issues are reviewed, with guidance for prudent use of point-of-care ultrasound (POCUS). Safety assurance begins with the training of POCUS practitioners in the generation and interpretation of diagnostically valid and clinically relevant images. Sonographers themselves should minimize patient exposure in accordance with the as-low-as-reasonably-achievable principle, particularly for the safety of the eye, lung, and fetus. This practice entails the reduction of output indices or the exposure duration, consistent with the acquisition of diagnostically definitive images. Informed adoption of POCUS worldwide promises a reduction of ionizing radiation risks, enhanced cost-effectiveness, and prompt diagnoses for optimal patient care.

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Section: Discussion Of Us Safety In the Pocus Perspectivementioning

confidence: 99%

Diagnostic Ultrasound Safety Review for Point‐of‐Care Ultrasound Practitioners

Miller

Abo

Abramowicz

et al. 2019

J of Ultrasound Medicine

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“…Given the cost of HUDs, further studies are needed to assess the degree to which HUD access will improve trainee interpretive ability, especially as more training programs consider the creation of ultrasound curricula. 10,11,24,39,40 This study was unique because it followed interns over a year-long course that repeated the same material to assess rates of learning with repeated exposure. Learners improved their scores after the first, but not second, block.…”

Section: Discussionmentioning

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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“…A follow‐up study in 2010 showed that 64% of emergency medicine residency programs required more than 150 ultrasound examinations for competency, which was a considerable improvement from previous reports before the American College of Emergency Physicians statement . Recent literature regarding general surgery training calls for an urgent need for a standardized ultrasound curriculum such as inclusion in the Accreditation Council for Graduate Medical Education Milestones Project . Currently, most residents who are exposed to diagnostic or interventional ultrasound in otolaryngology do not log or track these procedures in a formal way.…”

Section: Discussionmentioning

confidence: 99%

“…6 Recent literature regarding general surgery training calls for an urgent need for a standardized ultrasound curriculum such as inclusion in the Accreditation Council for Graduate Medical Education Milestones Project. 7,8 Currently, most residents who are exposed to diagnostic or interventional ultrasound in otolaryngology do not log or track these procedures in a formal way. Encouragement of such a mechanism may be vital to legitimize and potentially credential our trainees as competent in performing ultrasound procedures.…”

Section: Discussionmentioning

confidence: 99%