Point of Care Ultrasound Training during the Coronavirus Disease 2019 Pandemic

Concepts for point-of-care ultrasound training in low resource settings: a scoping review

BACKGROUND

Point-of-care ultrasound (POCUS) is a potent diagnostic tool especially in resource-limited settings. The implementation of POCUS diagnostics requires adequate training of POCUS operators. This scoping review aimed to identify and describe POCUS training concepts that have been applied in low-and middle-income countries (LMICs).

METHODS AND FINDINGS

All studies on diagnostic POCUS training in LMICs that could be found in the Cochrane, Embase, Google Scholar, and Medline databases up to July 6, 2023, were included and data was extracted for descriptive analysis. The review protocol was registered at OSF https://doi.org/10.17605/OSF.IO/8FQJW . A total of 53 publications were included with 59% of studies (n = 31) conducted in Africa and 23% (n = 12) in Asia. The majority of studies (n = 41, 81%) described short courses amongst which 40% were one-off sessions and 60% described longitudinal trainings. Curricula were mostly related to emergency medicine and obstetrics and organ-focused protocols (lung n = 29 (54%), cardiac n = 28 (53%), obstetric n = 23 (43%)). Trainees were largely medical doctors and clinical officers with minimal or absent ultrasound skills. Training challenges included resource constraints and lack of context adaptation. Best practice recommendations included focus on hands-on training, low trainer to trainee ratio, protected training time, online training options, use of local trainers, short and concise training manuals in print, continuous supervision and early and on-going evaluation, as well as tele-mentoring.

CONCLUSIONS

Context integration and focus on local needs, trainer availability and suitability, durable equipment and maintenance, as well as emphasis on hands on training including patients with relevant pathology, were key aspects for targeted and sustainable POCUS training in LMICs identified in this review.

Can you teach a hands-on skill online? A scoping review of e-learning for point-of-care ultrasound in medical education

Background

There is an increasing need and interest in teaching point-of-care ultrasound (POCUS) online. The objective of this study was to systematically review the literature regarding e-learning as a method for teaching POCUS in medical education, to assess the benefits and limitations of various styles of e-learning for POCUS, and to identify gaps in the literature that could help guide future research in this field.

Methods

A literature search was conducted on three databases including MEDLINE (Ovid), EMBASE and Cochrane Central Register of Controlled Clinical Trials on October 12, 2021, retrieving a total of 1630 studies. 31 studies met the inclusion and exclusion criteria. These studies were separated into different styles of e-learning and learner outcomes were analyzed based on Kirkpatrick's hierarchy.

Results

The studies were categorized into three styles of e-learning: a) blended learning b) online-only (asynchronous or synchronous) and c) use of handheld machines or telesonography. POCUS knowledge and image interpretation were successfully taught online, however online-only learning for image acquisition was not as consistently effective. Blended learning and telesonography were beneficial for learning image acquisition skills. Generally, novice learners benefited most from e-learning.

Conclusion

E-learning for POCUS is gaining in popularity in recent years. POCUS is a complex technical skill, and depending on the individual task being taught, different styles of e-learning may be more successful. These findings can inform future POCUS educational programs.