Protocol for a Delphi Consensus Study to Determine the Essential and Optional Ultrasound Skills for Medical Practitioners Working in District Hospitals in South Africa

Mans, P.; Yogeswaran, Parimalaranie; Adeniyi, Oladele Vincent

doi:10.3390/ijerph19159640

Cited by 2 publications

(2 citation statements)

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“…In addition, we decided to remove all skillsets that did not prompt a significant change in opinion (<5%) over two or more rounds, designating them as skillsets for which consensus could not be achieved. Although this last aspect is not typically part of a Delphi design, we opted to include it to streamline the process, and we included it in the published protocol [24]. The reporting for this study adheres to the CREDES (Guidance on Conducting and Reporting Delphi Studies) guidelines [25].…”

Section: Methodsmentioning

confidence: 99%

“…Looking at the existing generalist POCUS publications from sub-Saharan Africa, the varying scope and extent were seen as major limitations. We opted to start with the POCUS skillsets identified in the American Academy of Family Physicians (AAFP) curriculum, since this is the most extensive generalist POCUS publication [24,26]. These 93 skillsets and their descriptions, along with a literature reference for each skillset, formed our starting questionnaire.…”

Section: Survey Developmentmentioning

confidence: 99%

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Building Consensus on the Point-of-Care Ultrasound Skills Required for Effective Healthcare Service Delivery at District Hospitals in South Africa: A Delphi Study

Mans,

Yogeswaran,

Adeniyi

2023

IJERPH

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Background: Despite the widespread availability of ultrasound machines in South African district hospitals, there are no guidelines on the competency in point-of-care ultrasound (POCUS) use required by generalist doctors in this setting. This study aimed to define the required POCUS competencies by means of consensus via the Delphi method. Methods: An online Delphi process was initiated in June 2022, using the existing American Academy of Family Physicians’ ultrasound curriculum (84 skillsets) as the starting questionnaire. Panelists were selected across the country, including two from district hospitals in each province and two from each academic family medicine department in South Africa (N = 36). In each iterative round, the participants were asked to identify which POCUS skillsets were essential, optional (region-specific), or non-essential for South African district hospitals. This process continued until consensus (>70% agreement) was achieved on all of the skillsets. Results: Consensus was achieved on 81 of the 84 skillsets after 5 iterative rounds (96.4%), with 3 skillsets that could not achieve consensus (defined as <5% change over more than 2 consecutive rounds). The final consensus identified 38 essential, 28 optional, and 15 non-essential POCUS skillsets for the South African district hospital context. Conclusions: The list of essential POCUS skillsets provided by this study highlights the predominance of obstetric- and trauma-based skillsets required for generalist healthcare workers in South African district hospitals. The findings will require priority setting and revalidation prior to their implementation across the country.

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Section: Methodsmentioning

confidence: 99%

Section: Survey Developmentmentioning

confidence: 99%

Building Consensus on the Point-of-Care Ultrasound Skills Required for Effective Healthcare Service Delivery at District Hospitals in South Africa: A Delphi Study

Mans,

Yogeswaran,

Adeniyi

2023

IJERPH

Self Cite

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Physicians’ clinical experience and perspectives following a pilot, blended learning, point of care ultrasound course in Ghana- a mixed methods analysis

Pathak,

Limbani,

Awuku

et al. 2024

BMC Med Educ

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Background Point of Care ultrasound (POCUS) is rapidly gaining popularity in resource constrained settings. Optimising training is important to ensure safe and effective implementation. To expand POCUS expertise in Ghana, we co-developed and piloted a context specific, multi-disciplinary, blended learning programme, targeted at physicians of any grade or speciality providing acute care in the public health sector. In this retrospective mixed method study, we capture the "real world" experience of participants, using POCUS in their daily practice, as well as the barriers and enablers they perceived to implementation. ResultsEight emergency and internal medicine specialists and residents participated, working across three teaching hospitals, treating both general and specialist patients. They implemented each POCUS application taught, with cardiac indications, inferior vena cava (IVC) assessment, deep venous thrombosis (DVT) diagnosis, lung/pleural assessment and peripheral vascular access being most frequent at 3-6 times/week. An estimated 40% of patients could not have afforded any other diagnostic tests. They considered the pilot curriculum adequate for general practice and the majority of applications of low difficulty (71%). For cases sent for second opinion, they are selfreported that their findings were confirmed in 60-78% of cases. Perceptions about the relative advantage of POCUS over the usual approaches to diagnosing patients enabled implementation. Generally, they believed that POCUS improved their clinical decision making and that more certified training courses need to be run at lower cost to make them more accessible. All participants valued ongoing connections after training to ask for help and consolidate their skills. Continued evaluation and reflection on their POCUS practice to improve quality was unanimously reported as important, yet none had a formal system for this. The strongest barrier was access to equipment and maintenance. A lack of training opportunities and local mentors, and negative beliefs from other departments and hospital administration were further barriers. ConclusionOur new blended learning curriculum met the needs of physicians caring for patients with general and specialist presentations, with strong reported positive experience of improved bedside diagnostic capabilities, especially for the large proportion of patients unable to afford or access alternative diagnostic tests. Their experience

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Protocol for a Delphi Consensus Study to Determine the Essential and Optional Ultrasound Skills for Medical Practitioners Working in District Hospitals in South Africa

Cited by 2 publications

References 35 publications

Building Consensus on the Point-of-Care Ultrasound Skills Required for Effective Healthcare Service Delivery at District Hospitals in South Africa: A Delphi Study

Building Consensus on the Point-of-Care Ultrasound Skills Required for Effective Healthcare Service Delivery at District Hospitals in South Africa: A Delphi Study

Physicians’ clinical experience and perspectives following a pilot, blended learning, point of care ultrasound course in Ghana- a mixed methods analysis

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