Point-Of-Care Ultrasound in Resource-Limited Settings

Glomb, Nicolaus W; D’Amico, Beth; Rus, Marideth; Chen, Carol

doi:10.1016/j.cpem.2015.10.001

Cited by 16 publications

(19 citation statements)

References 38 publications

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“…[2][3][4][5][6][7] It can be applied in resource-limited settings, where restricted access to traditional radiological equipment can be a barrier to care. 8 POCUS has experienced increased usage given its positive impact on patient care. 4,5 Greater than 60% of US medical schools report having an ultrasound curriculum, 9 and program directors across varying medical specialties have reported plans to start their own curricula in the future.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Trainee Competency with Point-of-Care Ultrasonography (POCUS): a Conceptual Framework and Review of Existing Assessments

2019

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Section: Introductionmentioning

confidence: 99%

Evaluation of Trainee Competency with Point-of-Care Ultrasonography (POCUS): a Conceptual Framework and Review of Existing Assessments

2019

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“…1,5 Therefore, ultrasonography (USG) has immense utility and potential for developing emergency health services in low-and middle-income countries (LMICs) due to its relatively low cost and accessibility Several educational initiatives in clinical ultrasound have been reported in these parts of the world. [6][7][8][9][10] Standard USG or echocardiography requires the treating physician in the ED to rely on the radiologist or cardiologist to perform it in a timely and clinically relevant manner. 11 Provided the physicians in the ED have skill at image acquisition, image interpretation, and the cognitive elements required for using POCUS, they are able to rapidly incorporate the results of the POCUS examination into the management plan without delay.…”

Section: Introductionmentioning

confidence: 99%

<p>Evaluation of Interdisciplinary Emergency Ultrasound Workshop for Primary Care Physicians in Nepal</p>

Shrestha¹,

Blank²,

Shrestha³

et al. 2020

OAEM

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Point-of-care ultrasound (POCUS) is a quick bedside tool that has the potential to improve emergency care in resource-limited settings due to its relatively low cost and accessibility. Effort to disseminate the knowledge and skills about POCUS is inadequate in low and middle income countries like Nepal. We conducted a two-day interdisciplinary advanced emergency ultrasound workshop that targeted physicians working in emergency department and primary care, especially in rural Nepal. We explored the effectiveness of this training based on validated Kirkpatrick's 4 steps of evaluating training outcomes. Materials and Methods: We conducted a prospective quasi-experimental study with mixed research design. Multidisciplinary physicians working in emergency departments participated in the two-day workshop. We assessed and compared the pre-and post-workshop knowledge. We collected on-site and a follow-up feedback to explore pre-and post-workshop confidence level, perceived usefulness and clinical use of ultrasound using a 5-point Likert scale. The barriers to use POCUS were explored. Results: A total of 50 physicians from different parts of Nepal participated in the workshop. The academic level of the participants, duration of their clinical experience and the previous use of POCUS did not have a significant difference in their pre-and posttest knowledge scores. The difference between the median (IQR) pre-and posttest scores [14 (12.75-17.75) and 24.5 (22.25-25.5), respectively] was statistically significant (p<0.001). Perceived confidence level and usefulness of the POCUS increased significantly in all of its domains (p<0.001). Self-reported increase in its clinical use was significant (p<0.001) for all fields. Conclusion: The participation in this emergency ultrasound workshop increased the knowledge of participants in POCUS. Their confidence, perceived usefulness and clinical use of POCUS improved significantly. Objective longitudinal follow-up of participants' skill and demonstration of increased clinical use of POCUS in emergency department influencing the clinical outcome would be the focus of future research.

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“…The use of POCUS has become increasingly popular within the field of Internal Medicine (IM) worldwide [1][2][3][4][5]. In settings where material and human resource constraints limit the availability of many diagnostic modalities, POCUS is a particularly valuable tool [4,[6][7][8]. The increased utilization of POCUS demands a proportional commitment to creating structured curricula.…”

Section: Introductionmentioning

confidence: 99%

Developing and Evaluating a Remote Quality Assurance System for Point-of-Care Ultrasound for an Internal Medicine Residency Global Health Track

Fox

Fleshner

Flanagan

et al. 2020

POCUS

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Background: A quality assurance system is vital when using point-of-care ultrasound (POCUS) to ensure safe and effective ultrasound use. There are many barriers to implementing a quality assurance system including need for costly software, faculty time, and extra work to log images. Methods: With minimal funding or protected faculty time, we successfully developed an effective remote quality assurance system between residents rotating internationally and faculty in the US. Results: 270 total exams were logged using this system (41 per resident over a 7 week period). Over the course of the implementation period, a significant increase was seen in average image quality (p = 0.030) and percent agreement with reviewer (p = 0.021). No significant increase was seen for percent images with quality rating 5/5 (p = 0.068) or for studies per resident per week (p = 0.30). Discussion/Conclusions: A quality assurance system for remote review and feedback of POCUS exams was successfully developed with limited available funding, using consumer-level software and an educational collaboration. Residents used the system regularly and demonstrated improvement in reviewer-rated image acquisition and interpretation skills. A similar system can be applied for physicians in any geographic area looking to learn POCUS, in partnership with local or international POCUS mentors. We detail a step-by-step approach, challenges encountered, and lessons learned, to help guide others seeking to implement similar programs.

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Point-Of-Care Ultrasound in Resource-Limited Settings

Cited by 16 publications

References 38 publications

Evaluation of Trainee Competency with Point-of-Care Ultrasonography (POCUS): a Conceptual Framework and Review of Existing Assessments

Evaluation of Trainee Competency with Point-of-Care Ultrasonography (POCUS): a Conceptual Framework and Review of Existing Assessments

<p>Evaluation of Interdisciplinary Emergency Ultrasound Workshop for Primary Care Physicians in Nepal</p>

Developing and Evaluating a Remote Quality Assurance System for Point-of-Care Ultrasound for an Internal Medicine Residency Global Health Track

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