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Soni NJ, Nathanson R, Andreae M, Khosla R, Vadamalai K, Kode K, Boyd JS, LoPresti CM, Resop D, Basrai Z, Williams J, Bales B, Sauthoff H, Wetherbee E, Haro EK, Smith N, Mader MJ, Pugh J, Finley EP, Schott CK. Development of a multisystem point of care ultrasound skills assessment checklist. Ultrasound J 2022; 14:17. [PMID: 35551527 PMCID: PMC9096739 DOI: 10.1186/s13089-022-00268-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Many institutions are training clinicians in point-of-care ultrasound (POCUS), but few POCUS skills checklists have been developed and validated. We developed a consensus-based multispecialty POCUS skills checklist with anchoring references for basic cardiac, lung, abdominal, and vascular ultrasound, and peripheral intravenous line (PIV) insertion. Methods A POCUS expert panel of 14 physicians specializing in emergency, critical care, and internal/hospital medicine participated in a modified-Delphi approach to develop a basic POCUS skills checklist by group consensus. Three rounds of voting were conducted, and consensus was defined by ≥ 80% agreement. Items achieving < 80% consensus were discussed and considered for up to two additional rounds of voting. Results Thirteen POCUS experts (93%) completed all three rounds of voting. Cardiac, lung, abdominal, and vascular ultrasound checklists included probe location and control, basic machine setup, image quality and optimization, and identification of anatomical structures. PIV insertion included additional items for needle tip tracking. During the first round of voting, 136 (82%) items achieved consensus, and after revision and revoting, an additional 21 items achieved consensus. A total of 153 (92%) items were included in the final checklist. Conclusions We have developed a consensus-based, multispecialty POCUS checklist to evaluate skills in image acquisition and anatomy identification for basic cardiac, lung, abdominal, and vascular ultrasound, and PIV insertion. Supplementary Information The online version contains supplementary material available at 10.1186/s13089-022-00268-4.
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Affiliation(s)
- Nilam J Soni
- Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA. .,Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7982, San Antonio, TX, 78229, USA.
| | - Robert Nathanson
- Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7982, San Antonio, TX, 78229, USA
| | - Mark Andreae
- Departments of Critical Care Medicine and Emergency Medicine, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Rahul Khosla
- Veterans Affairs Medical Center, Washington, DC, USA.,George Washington University, Washington, DC, USA
| | | | - Karthik Kode
- Department of Medicine, University of Hawai'i at Manoa John A. Burns School of Medicine, Honolulu, HI, USA
| | - Jeremy S Boyd
- Emergency Medicine, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA.,Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Charles M LoPresti
- Medicine Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA.,Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Dana Resop
- Department of Emergency Medicine, University of Wisconsin, Madison, WI, USA.,Emergency Department, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Zahir Basrai
- Emergency Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Jason Williams
- Section of Hospital Medicine, Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA.,Division of Hospital Medicine, Emory School of Medicine, Atlanta, GA, USA
| | - Brian Bales
- Emergency Medicine, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA.,Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Harald Sauthoff
- Medicine Service, Veterans Affairs New York Harbor Healthcare System, New York, NY, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Erin Wetherbee
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, MN, USA.,Pulmonary, Critical Care, and Sleep Apnea, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
| | - Elizabeth K Haro
- Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7982, San Antonio, TX, 78229, USA
| | - Natalie Smith
- Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7982, San Antonio, TX, 78229, USA
| | - Michael J Mader
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Jacqueline Pugh
- Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7982, San Antonio, TX, 78229, USA
| | - Erin P Finley
- Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7982, San Antonio, TX, 78229, USA.,Emergency Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Christopher K Schott
- Departments of Critical Care Medicine and Emergency Medicine, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, PA, USA.,Department of Critical Care Medicine, Veterans Affairs of Pittsburgh Health Care Systems, Pittsburgh, PA, USA
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Soni NJ, Boyd JS, Mints G, Proud KC, Jensen TP, Liu G, Mathews BK, Schott CK, Kurian L, LoPresti CM, Andrus P, Nathanson R, Smith N, Haro EK, Mader MJ, Pugh J, Restrepo MI, Lucas BP. Comparison of in-person versus tele-ultrasound point-of-care ultrasound training during the COVID-19 pandemic. Ultrasound J 2021; 13:39. [PMID: 34487262 PMCID: PMC8419826 DOI: 10.1186/s13089-021-00242-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background Lack of training is currently the most common barrier to implementation of point-of-care ultrasound (POCUS) use in clinical practice, and in-person POCUS continuing medical education (CME) courses have been paramount in improving this training gap. Due to travel restrictions and physical distancing requirements during the COVID-19 pandemic, most in-person POCUS training courses were cancelled. Though tele-ultrasound technology has existed for several years, use of tele-ultrasound technology to deliver hands-on training during a POCUS CME course has not been previously described. Methods We conducted a retrospective observational study comparing educational outcomes, course evaluations, and learner and faculty feedback from in-person versus tele-ultrasound POCUS courses. The same POCUS educational curriculum was delivered to learners by the two course formats. Data from the most recent pre-pandemic in-person course were compared to tele-ultrasound courses during the COVID-19 pandemic. Results Pre- and post-course knowledge test scores of learners from the in-person (n = 88) and tele-ultrasound course (n = 52) were compared. Though mean pre-course knowledge test scores were higher among learners of the tele-ultrasound versus in-person course (78% vs. 71%; p = 0.001), there was no significant difference in the post-course test scores between learners of the two course formats (89% vs. 87%; p = 0.069). Both learners and faculty rated the tele-ultrasound course highly (4.6–5.0 on a 5-point scale) for effectiveness of virtual lectures, tele-ultrasound hands-on scanning sessions, and course administration. Faculty generally expressed less satisfaction with their ability to engage with learners, troubleshoot image acquisition, and provide feedback during the tele-ultrasound course but felt learners completed the tele-ultrasound course with a better basic POCUS skillset. Conclusions Compared to a traditional in-person course, tele-ultrasound POCUS CME courses appeared to be as effective for improving POCUS knowledge post-course and fulfilling learning objectives. Our findings can serve as a roadmap for educators seeking guidance on development of a tele-ultrasound POCUS training course whose demand will likely persist beyond the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s13089-021-00242-6.
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Affiliation(s)
- Nilam J Soni
- South Texas Veterans Health Care System, San Antonio, TX, USA. .,Department of Medicine, UT Health San Antonio, San Antonio, TX, USA. .,University of Texas Health San Antonio, South Texas Veterans Health Care System, 7703 Floyd Curl Drive, MC 7982, San Antonio, TX, 78229, USA.
| | - Jeremy S Boyd
- Department of Emergency Medicine, Veterans Affairs - Tennessee Valley Healthcare System, Nashville, TN, USA.,Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Gregory Mints
- Division of Hospital Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Kevin C Proud
- South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Trevor P Jensen
- Division of Hospital Medicine, University of California San Francisco Medical Center at Parnassus, San Francisco, CA, USA
| | - Gigi Liu
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Benji K Mathews
- Department of Hospital Medicine, Regions Hospital, HealthPartners, St. Paul, MN, USA
| | - Christopher K Schott
- Department of Critical Care Medicine, Veterans Affairs of Pittsburgh Health Care System, Pittsburgh, PA, USA.,Departments of Critical Care Medicine and Emergency Medicine, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Linda Kurian
- Division of Hospital Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Charles M LoPresti
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA.,Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Phil Andrus
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Robert Nathanson
- South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Natalie Smith
- South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Elizabeth K Haro
- South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Michael J Mader
- South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Jacqueline Pugh
- Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Marcos I Restrepo
- South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Brian P Lucas
- White River Junction VA Medical Center, White River Junction, VT, USA.,Department of Medicine, Dartmouth Geisel School of Medicine, Hanover, NH, USA
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