Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-26T08:02:25.978Z Has data issue: false hasContentIssue false
  • English
  • Français

Emergency medicine point-of-care ultrasonography: a national needs assessment of competencies for general and expert practice

Published online by Cambridge University Press:  11 February 2015

Lisa M. Fischer ,
Michael Y. Woo ,
A. Curtis Lee ,
Ray Wiss ,
Steve Socransky  and
Jason R. Frank
Lisa M. Fischer*
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, ON
Michael Y. Woo
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, ON
A. Curtis Lee
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, ON
Ray Wiss
Affiliation:
The Department of Emergency Medicine, Health Sciences North, Northern Ontario School of Medicine, Sudbury, ON
Steve Socransky
Affiliation:
The Department of Emergency Medicine, Health Sciences North, Northern Ontario School of Medicine, Sudbury, ON
Jason R. Frank
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, ON
*
Correspondence to: Dr. Lisa M. Fischer, 1053 Carling Avenue, Room EM-206, Box 227, Ottawa, ON K1Y 4E9; [email protected].

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Introduction

Emergency medicine point-of-care ultrasonography (EM-PoCUS) is a core competency for residents in the Royal College of Physicians and Surgeons of Canada and College of Family Physicians of Canada emergency medicine (EM) training programs. Although EM-PoCUS fellowships are currently offered in Canada, there is little consensus regarding what training should be included in a Canadian EM-PoCUS fellowship curriculum or how this contrasts with the training received in an EM residency.

Objectives

To conduct a systematic needs assessment of major stakeholders to define the essential elements necessary for a Canadian EM-PoCUS fellowship training curriculum.

Methods

We carried out a national survey of experts in EM-PoCUS, EM residency program directors, and EM residents. Respondents were asked to identify competencies deemed either nonessential to EM practice, essential for general EM practice, essential for advanced EM practice, or essential for EM-PoCUS fellowship trained (‘‘expert’’) practice.

Results

The response rate was 81% (351 of 435). PoCUS was deemed essential to general EM practice for basic cardiac, aortic, trauma, and procedural imaging. PoCUS was deemed essential to advanced EM practice in undifferentiated symptomatology, advanced chest pathologies, and advanced procedural applications. Expert-level PoCUS competencies were identified for administrative, pediatric, and advanced gynecologic applications. Eighty-seven percent of respondents indicated that there was a need for EM-PoCUS fellowships, with an ideal length of 6 months.

Conclusion

This is the first needs assessment of major stakeholders in Canada to identify competencies for expert training in EM-PoCUS. The competencies should form the basis for EM-PoCUS fellowship programs in Canada.

Résumé

Introduction

L’échographie pratiquée au point de service en médecine d’urgence (EPS-MU) est une compétence de base pour les résidents inscrits aux programmes de formation en médecine d’urgence (MU) du Collége royal des médecins et chirurgiens du Canada et du Collége des médecins de famille du Canada. Bien que des bourses de recherche soient offertes en EPS-MU au Canada, il existe un faible consensus quant á la formation á inclure dans un programme d’études postdoctorales en la matiére ou quant á la différence de contenu entre cette derniére formation et celle donnée dans les programmes de résidence en MU.

Objectif

L’étude visait á procéder á une évaluation méthodique des besoins des principaux intervenants afin de définir les éléments essentiels d’un programme canadien de formation postdoctorale en EPS-MU.

Méthode

Une enqueˆ te nationale a été menée parmi les spécialistes en EPS-MU, les directeurs de programme de résidence en MU et les résidents en MU. Les répondants devaient indiquer les compétences jugées non essentielles en MU, essentielles en MU générale, essentielles en MU avancée et essentielles en EPS-MU (degré d’«expert»).

Résultats

Le taux de réponse a atteint 81% (351 répondants sur 435). L’EPS a été jugée essentielle en MU générale dans les cas d’imagerie de base pour des troubles cardiaques, des lésions de l’aorte, des traumas et des interventions; l’EPS a été jugée essentielle en MU avancée dans les cas de symptoˆ mes indifférenciés, d’affections thoraciques rendues á un stade avancé ainsi que dans des applications interventionnelles avancées. Les compétences spécialisées en EPS ont été réservées á des fins administratives et á des applications pédiatriques et gynécologiques avancées. Enfin, 87% des répondants ont indiqué qu’il y avait des besoins en matiére de formation postdoctorale en EPS-MU, d’une durée idéale de 6 mois.

Conclusions

Il s’agit lá de la premiére évaluation des besoins des principaux intervenants au Canada visant á cerner les compétences á acquérir dans la formation spécialisée en EPS-MU. Ces compétences devraient former les assises des programmes d’études postdoctorales en EPSMU, au Canada.

Keywords

educationemergency medicinepoint-of-care ultrasonography
Type
Education
Information
Canadian Journal of Emergency Medicine , Volume 17 , Issue 1 , January 2015 , pp. 74 - 88
Copyright
Copyright © Canadian Association of Emergency Physicians 2014 

References

REFERENCES

1.American College of Emergency Physicians. Emergency ultrasound guidelines. Available at: http://www.acep.org/WorkArea/linHt.aspx?LinHdentifier-id&ItemID=32878 (accessed December 6, 2012).Google Scholar
2.Moore, CL, Copel, JA. Point-of-care ultrasonography. N Engl J Med 2011;364:749–757, doi:10.1056/NEJMra0909487.CrossRefGoogle ScholarPubMed
3.Canadian Association of Emergency Physicians. Use of point of care ultrasound by emergency physicians. 2012 position statement. Available at: http://www.cjem-online.ca/v14/n2/p106 (accessed December 10, 2012).Google Scholar
4.Mateer, JR, Aiman, EJ, Brown, MH, Olson, DW. Ultrasonographic examination by emergency physicians of patients at risk for ectopic pregnancy. Acad Emerg Med 1995;2:867–873, doi:10.1111/j.1553-2712.1995.tb03099.x.Google Scholar
5.Blaivas, M, Harwood, RA, Lambert, MJ. Decreasing length of stay with emergency ultrasound examination of the gallbladder. Acad Emerg Med 1999;6:1020–1023, doi:10.1111/j.1553-2712.1999.tb01186.x.CrossRefGoogle ScholarPubMed
6.McKenney, MG. 1,000 consecutive ultrasounds for blunt abdominal trauma. J Trauma 1996;40:607–610; discussion 611-2 doi:10.1097/00005373-199604000-00015.Google Scholar
7.Randolph, AG, Cook, DJ, Gonzales, CA, Pribble, CG. Ultrasound guidance for placement of central venous catheters: a meta-analysis of the literature. Crit Care Med 1996;24:2053–2058, doi:10.1097/00003246-199612000-00020.Google Scholar
8.Hoppman, R, Blaivas, M, Elbarbary, M. Better medical education and health care through point-of-care ultrasound. Acad Med 2012;87:134doi:10.1097/ACM.0b013e31823f0e8f.CrossRefGoogle Scholar
9.Rippey, JC, Royse, AG. Ultrasound in trauma [review]. Best Pract Res Clin Anaesthesiol 2009;23:343–362, doi:10.1016/ j.bpa.2009.02.011.Google Scholar
10.Modayil, V, Ash, A, Raio, C. Cervical ectopic pregnancy diagnosed by point-of-care emergency department ultra- sound. J Emerg Med 2011;41:655–657, doi:10.1016/ j.jemermed.2011.05.048.Google Scholar
11.Abu-Zidan, FM. Point-of-care ultrasound in critically illpatients: where do we stand? J Emerg Trauma Shock 2012;5:70–71, doi:10.4103/0974-2700.93120.CrossRefGoogle Scholar
12.Royal College of Physicians and Surgeons of Canada. Objectives of training in emergency medicine. Available at:http://rcpsc.medical.org/residency/certification/objectives/emergmed_e.pdf (accessed December 10, 2012).Google Scholar
13.Mackey, DS, Steiner, IP. editors National guidelines: family medicine - emergency medicine residency programs. Available at: http://www.cfpc.ca/uploadedFiles/Education/FamilyMedEMResidencyPrograms(1).pdf (accessed December 10, 2012).Google Scholar
14.Canadian Emergency Ultrasound Society. Recommended standards. Available at: http://ceus.ca/002-standards/002-00.standards.htm (accessed December 10, 2012).Google Scholar
15.Society for Academic Emergency Medicine. Ultrasound position statement. SAEM Newsletter 1991;3:3.Google Scholar
16. Emergency Ultrasound Fellowships. EUS fellowship programs. Available at: http://eusfellowships.com/programs. php (accessed December 10, 2012).Google Scholar
17.Blaivas, M, Theodoro, DL, Sierzenski, P. Proliferation in ultrasound fellowships in emergency medicine: how do we ensure future experts are expertly trained? Acad Emerg Med 2002;9:863–864, doi:10.1111/j.1553-2712.2002.tb02181.x.Google Scholar
18.Kim, DJ, Theoret, J, Liao, MM, et al. The current state of ultrasound training in Canadian emergency medicine programs: perspectives from program directors. Acad Emerg Med 2012;19:1073–1078, doi:10.1111/j.1553-2712.2012.01430.x.CrossRefGoogle ScholarPubMed
19.Counselman, FL, Sanders, A, Slovis, CM, et al. The status of bedside ultrasonography training in emergency medicine residency programs. Acad Emerg Med 2003;10:37–42, doi:10.1111/j.1553-2712.2003.tb01974.x.CrossRefGoogle ScholarPubMed
29.Dillman, D, Smyth, M. Design effects in the transition to web-based surveys. Am JPrev Med 2007;32(5 Suppl):S90–6, doi:10.1016/j.amepre.2007.03.008.Google Scholar
30.Ramirez-Schrempp, D, Dorfman, DH, Tien, I, Liteplo, AS. Bedside ultrasound in pediatric emergency medicine fellowship programs in the United States: little formal training. Pediatr Emerg Care 2008;24:664–667, doi:10.1097/PEC. 0b013e3181884955.Google Scholar
31.Lambert, RL, Boker, JR, Maffei, FA. National survey of bedside ultrasound use in pediatric critical care. Pediatr Crit Care Med 2011;12:655–659, doi:10.1097/PCC.0b013e 3182266a51.Google Scholar
32.Chamberlain, MC, Reid, SR, Madhok, M. Utilization ofemergency ultrasound in pediatric emergency departments. Pediatr Emerg Care 2011;27:628–632, doi:10.1097/PEC.0b013e3182259908.CrossRefGoogle Scholar
33.Lamperti, M, Bodenham, AR, Pittiruti, M, et al. International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Med 2012;38:1105–1117, doi:10.1007/s00134-012-2597-x.CrossRefGoogle ScholarPubMed
34.Malcom, GE, Raio, CC, Del Rios, M, et al. Feasibility of emergency physician diagnosis of hypertrophic pyloric stenosis using point-of-care ultrasound: a multi-center case series. J Emerg Med 2009;37:283–286, doi:10.1016/j.jemermed.2007.11.053.Google Scholar
35.Paziana, K, Fields, JM, Rotte, M, et al. Soft tissue foreign body removal technique using portable ultrasonography. Wilderness Environ Med 2012;23:343–348, doi:10.1016/ j.wem.2012.04.006.CrossRefGoogle ScholarPubMed
36.Taggart, I, Voskoboynik, N, Shah, S, Liebmann, O. ED point-of-care ultrasound in the diagnosis of ankle fractures in children. Am J Emerg Med 2012;30(1328):e1–3, doi:10.1016/ j.ajem.2011.06.037.Google Scholar
37.Halm, BM, Boychuk, RB, Franke, AA. Diagnosis of intussusception using point-of-care ultrasound in the pediatric ED: a case report. AmJ Emerg Med 2011;29(354):e1–3, doi:10.1016/j.ajem.2010.03.016.Google Scholar
38.Alrajhi, K, Woo, MY, Vaillancourt, C. Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis. Chest 2012;141:703–708, doi:10.1378/chest.11-0131.Google Scholar
39.Volpicelli, G, Ebarbary, M, Blaivas, M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 2012;38:577–591, doi:10.1007/s00134-012-2513-4.CrossRefGoogle ScholarPubMed
40.Agricola, E, Arbelot, C, Blaivas, M, et al. Ultrasound performs better than radiographs. Thorax 2011;66:828–829, doi:10.1136/thx.2010.153239.CrossRefGoogle ScholarPubMed
41.Blaivas, M. Point-of-care ultrasonographic deep venous thrombosis evaluation after just ten minutes training: is this offer too good to be true? Ann Emerg Med 2010;56:611–613, doi:10.1016/j.annemergmed.2010.08.014.Google Scholar
42.Blaivas, M. Ultrasound in the detection of venous throm-boembolism. Crit Care Med 2007;35(5 Suppl):S224–34, doi:10.1097/01.CCM.0000260672.13913.FD.CrossRefGoogle Scholar