Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2018 Sep 20;18(1):217.
doi: 10.1186/s12909-018-1326-8.

Point of care ultrasound training for internal medicine: a Canadian multi-centre learner needs assessment study

Kathryn Watson  1 , Ada Lam  2 , Shane Arishenkoff  3 , Samantha Halman  4 , Neil E Gibson  2 , Jeffrey Yu  5 , Kathryn Myers  5 , Marcy Mintz  1 , Irene W Y Ma  6   7
Affiliations
Multicenter Study

Point of care ultrasound training for internal medicine: a Canadian multi-centre learner needs assessment study

Kathryn Watson et al. BMC Med Educ. .

Abstract

Background: Significant gaps currently exist in the Canadian internal medicine point-of-care ultrasound (POCUS) curriculum. From a learner's perspective, it remains unknown what key POCUS skills should be prioritized. This needs assessment study seeks to establish educational priorities for POCUS for internal medicine residents at five Canadian residency training programs.

Methods: All internal medicine trainees [postgraduate year (PGY) 1-5] from five internal medicine residency training programs in Canada (n = 598) were invited to complete an online survey on 15 diagnostic POCUS applications, 9 bedside procedures, and 18 POCUS knowledge items. For POCUS applications and procedures, participants were asked how applicable they are to patient care in internal medicine and the participants' reported skills in those domains. Self-reported knowledge and skills were rated on a 5-point Likert scale, where 1 = very poor and 5 = very good. Applicability was rated, where 1 = not at all applicable and 5 = very applicable.

Results: A total of 253 of 598 residents (42%) participated in our study. Data from one centre (n = 15) was removed because of low response rate (15%) and significant baseline differences between those trainees and the remaining participants. Of the remaining analyzable data from four training programs (n = 238), participants reported highest applicability to internal medicine for the following applications and procedures: identifying ascites/free fluid [mean applicability score of 4.9 ± standard deviation (SD) 0.4]; gross left ventricular function (mean 4.8 ± SD 0.5) and pericardial effusion (mean 4.7 ± SD 0.5); thoracentesis (mean score 4.9 ± SD 0.3), central line insertion (mean 4.9 ± SD 0.3), and paracentesis (mean 4.9 ± SD 0.3), respectively. Overall reported knowledge/skills was low, with skill gaps being the highest for identifying deep vein thrombosis (mean gap 2.7 ± SD 1.1), right ventricular strain (mean 2.7 ± SD 1.1), and gross left ventricular function (mean 2.7 ± SD 1.0).

Conclusions: Many POCUS applications and procedures were felt to be applicable to the practice of internal medicine. Significant skill gaps exist in the four Canadian training programs included in the study. POCUS curriculum development efforts should target training based on these perceived skill gaps.

Keywords: Curriculum development; Education needs assessment; Internal medicine; Point-of-care ultrasound.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Implied consent was obtained for all participants included in this study. This study was approved by the University of Calgary Conjoint Health Research Ethics Board (Ethics ID number: REB 15–2054), University of Alberta Research Ethics Office (ID: Pro00058881), University of British Columbia Behavioural Research Ethics Board (H15–01955), Ottawa Health Science Network Research Ethics Board (Protocol #20160025-O1H), and Western University Office of Research Ethics (HSREB 107616).

Consent for publication

Not applicable

Competing interests

SA has received stock options for an advisory role in Clarius, outside the submitted work. The remaining authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Diagnostic applications and their perceived applicability to the practice of internal medicine (rated on a 5-point Likert scale, where 1 = very not applicable and 5 = very applicable, black solid bars) and participants’ reported skill level (where 1 = very poor and 5 = very good, dashed bars)
Fig. 2
Fig. 2
Bedside ultrasound-guided procedures and the perceived applicability to the practice of internal medicine (rated on a 5-point Likert scale, where 1 = very not applicable and 5 = very applicable, black solid bars) and participants’ reported skill level (where 1 = very poor and 5 = very good, dashed bars)
Fig. 3
Fig. 3
Self-report knowledge level in items related to point-of-care ultrasound knowledge (rated on a 5-point Likert scale, where 1 = very poor and 5 = very good)
See this image and copyright information in PMC

References

    1. Arienti V, Camaggi V. Clinical applications of bedside ultrasonography in internal and emergency medicine. Intern Emerg Med. 2010;6:195–201. doi: 10.1007/s11739-010-0424-3. - DOI - PubMed
    1. 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. - DOI - PubMed
    1. Havelock T, Teoh R, Laws D, Gleeson F. Pleural procedures and thoracic ultrasound: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65(Suppl 2):61–76. doi: 10.1136/thx.2010.137026. - DOI - PubMed
    1. Rupp SM, Apfelbaum JL, Blitt C, Caplan RA, Connis RT, Domino KB, et al. Practice guidelines for central venous access: a report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology. 2012;116:539–573. doi: 10.1097/ALN.0b013e31823c9569. - DOI - PubMed
    1. American College of Surgeons. Revised statement on recommendations for use of real-time ultrasound guidance for placement of central venous catheters. 2011. https://www.facs.org/about-acs/statements/60-real-time-ultrasound. Assessed 3 Jan 2018. - PubMed

Publication types

LinkOut - more resources