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Ultrasound. 2019 Feb;27(1):38-44. doi: 10.1177/1742271X18791317. Epub 2018 Jul 25.

Implementation of a point-of-care ultrasound skills practicum for hospitalists.

Author information

1
Division of Pulmonary, Critical Care, Allergy, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

Abstract

Introduction:

Point-of-care ultrasound is recognized as a safe and valuable diagnostic tool for patient evaluation. Hospitalists are prime candidates for advancing the point-of-care ultrasound field given their crucial role in inpatient medicine. Despite this, there is a notable lack of evidence-based ultrasound training for hospitalists. Most research focuses on diagnostic accuracy rather than the training required to achieve it. This study aims to improve hospitalists' point-of-care ultrasound knowledge and skills through a hands-on skills practicum.

Methods:

Four skill practicums were conducted with pre-course, post-course, and six-month evaluations and knowledge assessments.

Results:

The mean pre- vs. post-course knowledge assessment scores significantly improved, 41.7% vs. 75.9% (SD 16.1% and 12.7%, respectively, p < 0.0001). The mean ultrasound skills confidence ratings on a 10-point Likert scale significantly increased post-course (2.60 ± 1.66 vs. 6.33 ± 1.63, p < 0.0001), but decreased at six months (6.33 ± 1.63 vs. 4.10 ± 2.22, p < 0.0001). The greatest limitations to usage pre-course and at six months were knowledge/skills and lack of machine access. While knowledge/skills decreased from pre-course (82.0%) as compared to six-months (64.3%), lack of machine access increased from pre-course (15.8%) to six-months (28.6%) (p = 0.28).

Conclusion:

Hospitalists agree that point-of-care ultrasound has utility in the diagnostic and therapeutic management of patients, though the lack of training is a significant limitation. Our study demonstrated that a brief skills practicum significantly improves hospitalists' confidence and knowledge regarding ultrasound image acquisition and interpretation in the short term. Long-term confidence and usage wanes, which appears to be due to the lack of machine access.

KEYWORDS:

Bedside ultrasound; diagnostic ultrasound; ultrasound training

PMID:
30774697
PMCID:
PMC6362537
[Available on 2020-02-01]
DOI:
10.1177/1742271X18791317

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