scholarly journals Internal medicine residents’ point-of-care ultrasound skills and need assessment and the role of medical school training

2019 ◽  
Vol Volume 10 ◽  
pp. 379-386 ◽  
Author(s):  
Mohammed Elhassan ◽  
Kevin D Gandhi ◽  
Charnjeet Sandhu ◽  
Mohammad Hashmi ◽  
Sameer Bahl
Keyword(s):  
Internal Medicine ◽  
Medical School ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Need Assessment ◽  
Internal Medicine Residents ◽  
Medical School Training ◽  
School Training

Entrusting internal medicine residents to use point of care ultrasound: Towards improved assessment and supervision

2018 ◽  
Vol 40 (11) ◽  
pp. 1130-1135 ◽  
Author(s):  
Daniel J. Schnobrich ◽  
Benji K. Mathews ◽  
Bernard E. Trappey ◽  
Brian K. Muthyala ◽  
Andrew P. J. Olson
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Residents

scholarly journals 1080: DESIGNING A POINT-OF-CARE ULTRASOUND CURRICULUM FOR OUR TRAINING AS INTERNAL MEDICINE RESIDENTS

2021 ◽  
Vol 50 (1) ◽  
pp. 538-538
Author(s):  
Ubaldo Madera Sanchez ◽  
Keila Díaz Rodriguez ◽  
Janice Cuevas Rivera ◽  
Javier Ortega Belasquide ◽  
Maria Cochran Perez ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Residents

scholarly journals The Role of the Medical School Training on Physician Opioid Prescribing Practices: Evidence from Ontario, Canada: Le rôle de la formation à la faculté de médecine à l’égard des pratiques de prescription d’opioïdes des médecins: données probantes d’Ontario, Canada

2020 ◽  
Vol 65 (10) ◽  
pp. 710-720
Author(s):  
Claire de Oliveira ◽  
Tomisin Iwajomo ◽  
Tara Gomes ◽  
Paul Kurdyak
Keyword(s):  
United States ◽  
Medical School ◽  
Medical Schools ◽  
The United States ◽  
Prescribing Patterns ◽  
Opioid Epidemic ◽  
Opioid Prescribing ◽  
Medical School Training ◽  
School Training

Background: Recent research found that physicians who completed medical school training at top-ranked U.S. medical schools prescribed fewer opioids than those trained at lower ranked schools, suggesting that physician training may play a role in the opioid epidemic. We replicated this analysis to understand whether this finding holds for Ontario, Canada. Methods: We used data on all opioid prescriptions written by Ontario physicians between 2013 and 2017 from the Narcotics Monitoring System. Using the Corporate Provider Database and ICES Physician Database, which contain medical school of training, we linked patients who filled opioid prescriptions with their respective prescribing physician. Available data on Canadian medical school rankings were obtained from Maclean’s news magazine. We used regression analysis to assess the relationship between number of opioid prescriptions and medical school ranking. Results: Compared to the United States, average annual number of opioid prescriptions per physician was lower in Ontario (236 vs. 78). Unlike the United States, we found little evidence that physicians trained at lower ranked medical schools prescribed more than their top-ranked school counterparts after controlling for specialty and location of practice. However, primary care physicians trained at non-English-speaking foreign schools prescribed the most opioids even after excluding opioid maintenance therapy–related prescriptions. Conclusion: The role of medical school training on opioid prescribing patterns among Ontario physicians differs from that in the United States likely due to greater homogeneity of curricula among Canadian schools. Ensuring physicians trained abroad receive additional pain management/addiction training may help address part of the opioid epidemic in Ontario.

scholarly journals Point-of-Care Ultrasound in Internal Medicine

2017 ◽  
Vol 12 (2) ◽  
Author(s):  
Mitch Levine
Keyword(s):  
Internal Medicine ◽  
Needs Assessment ◽  
Point Of Care ◽  
Digital Health ◽  
Pericardial Tamponade ◽  
Point Of Care Ultrasound ◽  
Residency Programs ◽  
Technological Advances ◽  
Internal Medicine Residents ◽  
Similar Survey

Over the past few decades a variety of technological advances have dramatically change the manner in which physicians practice medicine. Both clinically and administratively the practice of medicine is in evolution – for example; stents instead of surgery and digital health records instead of paper charts. For internal medicine physicians one of the biggest transformations with respect to how we will practice medicine is just on the horizon. The routine use of point-of-care ultrasound (PoCUS) will become an essential skill for the practicing internist. The application for PoCUS in the field of internal medicine is immense – accurately assessing the JVP in critically ill patients, performing arterial and venipunctures, diagnosing pericardial tamponade or determining the likelihood of a pulmonary embolus, or the diagnostic and therapeutic removal of body fluids, to name a few.While some of our colleagues have adopted this technology as an adjunct to the clinical examination or as an aid to conducting bedside procedures most have not adopted this as a routine skill set. Some of the barriers include insufficient training and a lack of readily accessible equipment in all clinical settings. But this will change, and the use of PoCUS will eventually become a required skill of all practicing internists.In the current issue of CJGIM Lewis et al have conducted a needs assessment of PoCUS in answering either a clinical question or in guiding a procedure. As the Royal College of Physicians and Surgeons does not yet require all internal medicine residency programs to provide a formal PoCUS curriculum, the objective of their study was to conduct a systematic needs assessment for the introduction of a PoCUS curriculum to an internal medicine program. The results showed that some internal medicine residents were already using PoCUS yet they had never been formal trained in the skill. One is left to wonder what a similar survey would find if conducted amongst practicing internists.While each residency programs will inevitably develop a PoCUS curriculum for their trainees, it will remain a continuing education challenge for internists already in practice. The importance of this skill cannot be under estimated and it will require the leadership in the internal medicine community to ensure that they create the opportunity for all internists to master the use of PoCUS.

scholarly journals First year internal medicine residents’ self-report point-of-care ultrasound knowledge and skills: what (Little) difference three years make

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tanner Chahley ◽  
Ada W Lam ◽  
Samantha Halman ◽  
Kathryn Watson ◽  
Irene WY Ma
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Internal Medicine Residency ◽  
Self Report ◽  
First Year ◽  
Learning Needs ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Residents ◽  
Study Support ◽  
B Lines

Abstract Background With increasing availability of point-of-care ultrasound (POCUS) education in medical schools, it is unclear whether or not learning needs of junior medical residents have evolved over time. Methods We invited all postgraduate year (PGY)-1 residents at three Canadian internal medicine residency training programs in 2019 to complete a survey previously completed by 47 Canadian Internal Medicine PGY-1 s in 2016. Using a five-point Likert scale, participants rated perceived applicability of POCUS to the practice of internal medicine and self-reported skills in 15 diagnostic POCUS applications and 9 procedures. Results Of the 97 invited residents, 58 (60 %) completed the survey in 2019. Participants reported high applicability but low skills across all POCUS applications and procedures. The 2019 cohort reported higher skills in assessing pulmonary B lines than the 2016 cohort (2.3 ± SD 1.0 vs. 1.5 ± SD 0.7, adjusted p-value = 0.01). No other differences were noted. Conclusions POCUS educational needs continue to be high in Canadian internal medicine learners. The results of this needs assessment study support ongoing inclusion of basic POCUS elements in the current internal medicine residency curriculum.

scholarly journals Feasibility and Acceptability of a Structured Curriculum in Teaching Procedural and Basic Diagnostic Ultrasound Skills to Internal Medicine Residents

2013 ◽  
Vol 5 (3) ◽  
pp. 493-497 ◽  
Author(s):  
Daniel J. Schnobrich ◽  
Andrew P. J. Olson ◽  
Alain Broccard ◽  
Alisa Duran-Nelson
Keyword(s):  
Internal Medicine ◽  
Medical Decision Making ◽  
Point Of Care ◽  
Image Acquisition ◽  
Abdominal Ultrasound ◽  
Medical Decision ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Residents ◽  
Teaching Interventions ◽  
Future Work

Abstract Background Point-of-care ultrasound has emerged as a powerful diagnostic tool and is also being increasingly used by clinicians to guide procedures. Many current and future internists desire training, yet no formal, multiple-application, program-wide teaching interventions have been described. Intervention We describe a structured 30-hour ultrasound training course in diagnostic and procedural ultrasound implemented during intern orientation. Internal medicine interns learned basic ultrasound physics and machine skills; focused cardiac, great vessel, pulmonary, and abdominal ultrasound diagnostic examinations; and procedural applications. Results In postcourse testing, learners demonstrated the ability to acquire images, had significantly increased knowledge scores (P < .001), and demonstrated good performance on practical scenarios designed to test abilities in image acquisition, interpretation, and incorporation into medical decision making. In the postcourse survey, learners strongly agreed (4.6 of 5.0) that ultrasound skills would be valuable during residency and in their careers. Conclusions A structured ultrasound course can increase knowledge and can result in learners who have skills in image acquisition, interpretation, and integration in management. Future work will focus on refining and improving these skills to allow these learners to be entrusted with the use of ultrasound independently for patient care decisions.

Preparation of residents for death pronouncement: A sensitive and supportive method

2005 ◽  
Vol 3 (2) ◽  
pp. 107-114 ◽  
Author(s):  
F. AMOS BAILEY ◽  
BEVERLY ROSA WILLIAMS
Keyword(s):  
Internal Medicine ◽  
Medical School ◽  
Training Experience ◽  
Post Intervention ◽  
Self Assessment ◽  
Chi Square ◽  
Factors Associated ◽  
Medical School Training ◽  
Close Supervision ◽  
School Training

Objective: To identify factors associated with internal medicine interns' self-assessed competency in death pronouncement and to evaluate the effectiveness of a 10-minute death pronouncement module and pocket card guidelines.Methods: In June 2003 at the Birmingham VAMC, Alabama, 48 internal medicine interns completed a survey of medical school education, training, and experience in death pronouncement and a self-assessment of death pronouncement competency. In September 2003, 33 of the 48 interns completed a follow-up training/education survey and rated their post-intervention competency. Using chi-square and paired t-tests, we identified factors associated with variations among baseline and post-intervention variables and examined pre-post changes in self-assessed competency levels.Results: At baseline, less than 30% of the interns had medical school instruction in the process of death pronouncement. More than 70% reported needing basic instruction/close supervision. Post-intervention, close to 90% interns needed minimal or no assistance. Over 50% reported using pocket card guidelines. We found significant pre-post increases in mean rankings in each of the 5 self-assessed competencies (p < .001). Factors associated with differences in baseline and post-intervention assessments included medical school training/experience and use of the pocket card guidelines.Significance of results: When interns began training, most had no instruction in death pronouncement and felt unprepared for this task. With brief instruction, pocket card guidelines, and 3-months experience, the majority of interns reported needing minimal/no assistance in pronouncing death. A larger sample from multiple sites is needed to confirm these findings.

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