scholarly journals Point-of-care ultrasound in urology: Design and evaluation of a feasible introductory training program for Canadian residents

2020 ◽  
Vol 15 (4) ◽  
Author(s):  
Michael Uy ◽  
Catherine A. Lovatt ◽  
Jen Hoogenes ◽  
Carol Bernacci ◽  
Edward Matsumoto
Keyword(s):  
Training Program ◽  
Point Of Care ◽  
Low Cost ◽  
Acute Scrotum ◽  
Point Of Care Ultrasound ◽  
Theoretical Knowledge ◽  
Suprapubic Catheter ◽  
National Guidelines ◽  
Course Material ◽  
Competency Based

Introduction: Point-of-care ultrasound (POCUS) is an increasingly used bedside tool. Applications in urology include the assessment of an undifferentiated acute scrotum, renal colic, and the guidance of suprapubic catheter placement. However, the user-dependent nature of this modality necessitates appropriate use and competence. The objective of this study was to develop and evaluate a low-cost, feasible, and guideline-based introductory POCUS program for Canadian urology residents. Methods: Residents from McMaster University’s urology program completed a three-hour online course, followed by a three-hour hands-on seminar. Course material was developed by ultrasound educators based on national guidelines. Low-cost testicular phantoms and suprapubic catheter insertion models were constructed. Pre- and post-course surveys focused on participant skill confidence, while multiple-choice questionnaires assessed theoretical knowledge. Results: Fourteen residents participated in the course. Theoretical knowledge in POCUS improved significantly (p<0.001, d=2.2) and mean confidence scores improved for all skills, including performing kidney, bladder, and testicular POCUS (all p<0.001; d=3.4, 1.9, 2.9, respectively). Participants indicated that the course increased their confidence and likelihood of using POCUS in clinical practice, and that POCUS training should be integrated into urology training curricula. Conclusions: This novel study included the development of an inexpensive, feasible, guideline-based introductory training program for urological POCUS, developed in collaboration with ultrasound educators. Participants significantly improved in theoretical knowledge and skill confidence. Although this study was limited to one residency program, the basis of this course may serve as a foundation for the development of competency-based training for urological POCUS in Canada.

scholarly journals Comprehensive residency-based point-of-care ultrasound training program increases ultrasound utilization in the emergency department

2020 ◽  
Author(s):  
Wei-Lung Chen ◽  
Chan-Peng Hsu ◽  
Po-Han Wu ◽  
Jiann-Hwa Chen ◽  
Chien-Cheng Huang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Training Program ◽  
Test Score ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Studies ◽  
Training Course ◽  
Hemodynamic Assessment ◽  
Procedural Guidance

Abstract Background: Point-of-care ultrasonography (POCUS) is a prompt and simple tool for the urgent diagnosis and treatment of patients in the emergency department (ED). It has contributed to improvements in patient treatment quality, procedural safety, timeliness of care, diagnostic accuracy, and cost reduction. We developed a comprehensive residency-based POCUS training program for ED residents and determined its effect on ultrasound utilization in the ED.Methods: We conducted a retrospective cohort study in the ED of a university-affiliated medical center, evaluating a centralized residency-based POCUS training course from July 2017 to June 2018 for ED residents that included 12 core ultrasound applications: trauma, intrauterine pregnancy, abdominal aortic aneurysm, echocardiography and hemodynamic assessment, hepatobiliary system, urinary tract, deep vein thrombosis, soft tissue and musculoskeletal, thoracic-airway, ocular, bowel, and procedural guidance. Each application comprised a combined lecture and hands-on practice session that lasted for 2 hours. Pre-tests and post-tests, including still image and video interpretation, were performed. Utilization of POCUS among ED residents before and after the POCUS training course (July 2016–June 2017 and July 2018–June 2019) was calculated and analyzed using the Wilcoxon signed-rank test.Results: In total, 16 residents participated and completed the entire training course. The post-test score improved significantly compared to the pre-test score by a median of 12 points (p = 0.04). Utilization of POCUS among the ED residents increased significantly from 0.15 ultrasound studies per patient per year to 0.41 ultrasound studies per patient per year (p < 0.01) after completion of the entire training course. Increased POCUS scanning percentages over the cardiac, soft tissue, abdominal region, vascular system, procedural guidance, and ocular regions were also noted after providing the curriculum.Conclusions: There was a significant increase in POCUS utilization among ED residents after a comprehensive residency-based POCUS training program.

Retention of Point-of-Care Ultrasound Skills Among Practicing Physicians: Findings of the VA National POCUS Training Program

2020 ◽  
Author(s):  
Christopher K. Schott ◽  
Charles M. LoPresti ◽  
Jeremy S. Boyd ◽  
Megan Core ◽  
Elizabeth K. Haro ◽  
...  
Keyword(s):  
Training Program ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Practicing Physicians

scholarly journals Evaluation of a novel handheld point-of-care ultrasound device in an African emergency department

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Samuel L. Burleson ◽  
Jonathan F. Swanson ◽  
Erin F. Shufflebarger ◽  
Douglas W. Wallace ◽  
Matthew A. Heimann ◽  
...  
Keyword(s):  
Emergency Department ◽  
Image Quality ◽  
Point Of Care ◽  
Low Cost ◽  
Clinical Care ◽  
Point Of Care Ultrasound ◽  
Emergency Setting ◽  
Low Resource ◽  
Ultrasound Device ◽  
High Acuity

Abstract Background Many point-of-care ultrasound devices are now “pocket-sized” or handheld, allowing easy transport during travel and facilitating use in crowded spaces or in austere low-resource settings. Concerns remain about their durability, image quality, and clinical utility in those environments. Method Five emergency physicians with training in point-of-care ultrasound employed the Butterfly iQ, a novel handheld ultrasound device, in routine clinical care in a busy, high-acuity African emergency department over a period of 10 weeks. We retrospectively evaluated the performance of the Butterfly iQ from the perspectives of both the clinicians using the device and expert ultrasound faculty reviewing the images. Results We found advantages of the Butterfly iQ in a high-acuity African emergency department include its use of a single probe for multiple functions, small size, ease of transport, relatively low cost, and good image quality in most functions. Disadvantages include large probe footprint, lower, though still adequate, cardiac imaging quality, frequent overheating, and reliance on internet-based cloud storage, but these were surmountable. We also report a wide variety of patient presentations, pathology, and procedures to which the device was used. Conclusion We conclude the Butterfly iQ is an effective, though imperfect, point-of-care ultrasound device in a low-resource emergency setting. We will continue to employ the device in clinical emergency care and teaching in this setting.

scholarly journals Suprapubic Catheter Migration: A Review of a Rare Complication

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Amr Elmoheen ◽  
Mahmoud Saqr ◽  
Waleed Salem ◽  
Khalid Bashir ◽  
Ayman Hagras
Keyword(s):  
Ureteral Obstruction ◽  
Point Of Care ◽  
Rare Complication ◽  
Urethral Injury ◽  
Unusual Complication ◽  
Point Of Care Ultrasound ◽  
Suprapubic Catheter ◽  
Catheter Migration ◽  
Pelvicalyceal System

Background. Suprapubic catheter migration to the vesicoureteral junction is an unusual complication, causing an obstruction that led to hydronephrosis and dilation of the pelvicalyceal system. Case presentation. A 30-year-old man with a suprapubic catheter (SPC) that was inserted one month before this current Emergency Department (ED) visit had severe left flank pain for 48 hours. The SPC was inserted in the context of urethral injury after falling astride. Point-of-Care Ultrasound (POCUS) showed a semifilled urinary bladder and moderate hydronephrosis on the left side. A computed tomography scan (CT scan) of the abdomen was performed and showed migration of the suprapubic catheter’s tip into the left vesicoureteral junction, causing ureteral obstruction dilation of the ipsilateral pelvicalyceal system. The suprapubic catheter was changed in the ED, causing relief of symptoms, and the patient was referred to the urology department for follow-up. It was uneventful on the follow-up from the SPC clinic. Conclusions. This case report describes a rare complication of migration of the suprapubic catheter to the vesicoureteral junction causing acute ureteral obstruction and hydronephrosis.

scholarly journals Comprehensive residency-based point-of-care ultrasound training program increases ultrasound utilization in the emergency department

Medicine ◽  
2021 ◽  
Vol 100 (5) ◽  
pp. e24644
Author(s):  
Wei-Lung Chen ◽  
Chan-Peng Hsu ◽  
Po-Han Wu ◽  
Jiann-Hwa Chen ◽  
Chien-Cheng Huang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Training Program ◽  
Point Of Care ◽  
Point Of Care Ultrasound

scholarly journals Medical Education in Internal Medicine

2021 ◽  
Vol 16 (1) ◽  
pp. 38-42
Author(s):  
Daniel Brandt Vegas ◽  
Leslie Martin ◽  
Irene W.Y. Ma ◽  
Philip Hui ◽  
Ford Bursey
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Clinical Reasoning ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
National Meeting ◽  
Competency Based Medical Education ◽  
Teaching Point ◽  
Competency Based ◽  
Competency Program

The 2019 CSIM national meeting included a workshop focused on current topics related to medical education across Canada. The workshop topics included leadership in education, teaching point of care ultrasound, teaching clinical reasoning, and using competency based medical education to design a maintenance of competency program for practicing specialists. This article reflects the experience and discussions from the session, with the goal of stimulating national conversations and collaborations betweenCSIM members.  

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