A mixed-methods evaluation of a multidisciplinary point of care ultrasound program

Abstract

Background: Point of Care Ultrasound (PoCUS) is well established within emergency medicine, however, the availability of formal training for other clinical disciplines is limited. Memorial University has established a cost-efficient, multidisciplinary PoCUS training program focusing on training residents’ discipline-specific ultrasound skills. This study evaluates the skills, knowledge, and attitudes of residents who participated in the program.

Methods: Analysis was conducted using a mixed-methods, sequential exploratory approach. Initially, a focus group of seven first year residents was conducted to generate themes that were used to guide development of a survey administered to residents over a two-year period.

Results: Thirty residents responded to the survey (response rate 63.8%) with 53.3% meeting the training requirements for focused assessment using sonography in trauma, 43.3% for pleural effusion, 40.0% for aortic aneurysms, and 40.0% for cardiac scans. Early pregnancy assessment was the skill of least interest with 46.6% not interested. Over half the residents (53.6%) agreed or strongly agreed that a multidisciplinary program met their needs while 21.4% disagreed. The focus group found the multidisciplinary approach adequate.

Conclusions: A single PoCUS curriculum has been shown to meet the needs and expectations of a majority of residents from multiple disciplines. It can enhance collaboration and bridge gaps between increasingly compartmentalized practices of medicine.

Glossary

PoCUS – Point of Care Ultrasound: Is clinician generated scan performed immediately at the bedside in order to provide an immediate answer to a clinical question (Blaivas 2012).

FAST – Focused Assessment using Sonography in Trauma: Is an ultrasound examination of the abdomen and heart seeking to detect free fluid (blood) (Soundappan et al. 2005).

Acknowledgments

The authors would like to acknowledge the Medical Education Scholarship Centre – specifically Jacinta Reddigan, Donna-Marie Khalili, and Dr. Heidi Coombs-Thorne for support and guidance over the course of this project.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Notes on contributors

Andrew Smith

Dr. Andrew Smith, MD CCFP(EM), MEng, is a family/ER physician and Associate Professor with Memorial University’s Faculty of Medicine and is cross-appointed to the Faculty of Engineering. Dr. Smith served as director of Memorial’s PoCUS program until 2015 and oversaw the rapid integration of portable ultrasound into both medical education and clinical care.

Michael Parsons

Dr. Michael Parsons, MD, CCFP(EM), completed EM training in 2007, currently is an Assistant Professor in the Discipline of EM and is a full time ER physician in St. John's, NL. He is the EM Assistant Program Director, Master Instructor by CPoCUS standards and regularly teaches PoCUS at undergraduate, postgraduate, and CME levels.

Tia Renouf

Dr. Tia Renouf, MD, FCFP (EM), is Inaugural Chair of Emergency Medicine at MUN. Her diverse research interests include medical education, specifically clinical reasoning and simulation. She has 46 peer-reviewed publications, and 50 local national and international presentations. She was awarded the 2017 CAME Wooster Family grant for her study of rural/urban communications.

Sarah Boyd

Ms. Sarah Boyd, MSc, received a Master’s degree in Clinical Epidemiology at Memorial University for researching the timeliness of HIV diagnosis in Newfoundland. Sarah also works at the Primary Healthcare Research Unit researching the internal jugular vein as a predictor for adverse congestive heart failure outcomes.

Peter Rogers

Dr. Peter Rogers, MD, CCFP(EM), is an ER physician and Assistant Professor with the Discipline of Emergency Medicine. He is cross-appointed to the Discipline of Family Medicine and is a Program Director for the 3rd year emergency medicine training program. His research interests include point of care ultrasound, simulation, and procedural skills training.