University of North Carolina
Chapel Hill, NC
Program Description
Pulmonary and Critical Care Medicine fellowship at large academic medical center
Type of Program
Pulmonary and Critical Care
Number of Fellows in Program
10
Abstract Authors
Cidney Hulett MD MPH, Lydia Chang MD, Jason Katz, Sean Montgomery
Submitter(s) of Abstract
Cidney Hulett, MDD
PURPOSE
The focused ultrasound examination has become increasingly recognized as a safe and valuable diagnostic tool for the bedside assessment of the critically ill patient. It offers a number of advantages: it can be performed promptly by the treating physician, it does not involve transport of the unstable patient, and it does not involve ionizing radiation. National critical care organizations have advocated for its utilization in ICU care. There remain significant perceived barriers to integration of ultrasound training into a critical care fellowship as most programs do not offer focused training which leaves these skills to be acquired informally during training. We implemented a dedicated on-site critical care ultrasonography curriculum with a goal to developing a model for teaching ultrasound skills to critical care medicine fellows.
METHODS
The program was comprised of blended didactic and bedside sessions in the following areas: fundamentals, vascular access and diagnosis, abdominal, thoracic, and cardiac ultrasonography. Formal knowledge and image acquisition assessments were performed prior and following the program to assess success in meeting predefined learning objectives. Additionally, participants completed surveys (on Likert scale 1 to 5)prior and following the program to assess confidence in ultrasonography knowledge and skills as well as their perception as to training effectiveness.
RESULTS
The pre-intervention knowledge and bedside image acquisition scores were 71.4%and 31.5% respectively. The global pre-intervention score was 51.4%. All post-intervention measures demonstrated significant improvement: 89.1% (p = 0.00119), 85.6% (p < 0.0001), and 87.3% (p = 0.0001). The pre-intervention confidence score was 2.96/5 which improved to 4.35/5 (p = 0.0072) post-intervention. Participants rated course objectives being as a mean of 4.82/5.
CONCLUSIONS
Pulmonary and Critical Care Fellow knowledge of Critical Care Ultrasound is high at baseline but image acquisition skills are poor. A dedicated educational intervention resulted in highly significant improvements in both subject knowledge and image acquisition skills.
CLINICAL IMPLICATIONS
A formal curriculum dedicated to critical care ultrasonography can be developed de novo on site in an fellowship training program. It can be effectively improve knowledge and skills. This model could be used in development of a national model for similar instruction.
DISCLOSURES
The following authors have nothing to disclose: Cidney Hulett MD MPH, Lydia Chang MD, Jason Katz MD, SeanMontgomery MD
