Point-of-Care Ultrasound Needs Assessment, Curriculum Design, and Curriculum Assessment in a Large Academic Internal Medicine Residency Program
| Autor: | James E. Anstey, Trevor Jensen, Nima Afshar |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Cross-sectional study Point-of-Care Systems education MEDLINE 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Multidisciplinary approach Internal medicine Internal Medicine Humans Medicine 030212 general & internal medicine Curriculum Ultrasonography business.industry Internship and Residency General Medicine Residency program Confidence interval Test (assessment) Cross-Sectional Studies Needs assessment Clinical Competence business Needs Assessment |
| Zdroj: | Southern Medical Journal. 111:444-448 |
| ISSN: | 1541-8243 0038-4348 |
| DOI: | 10.14423/smj.0000000000000831 |
| Popis: | OBJECTIVES Internal medicine (IM) residency point-of-care ultrasound (POCUS) curricula are being developed but often are limited in scope or components. In this article, we discuss the demonstration of a need for POCUS training in our large academic IM residency program; the development of a longitudinal curriculum; and the impact of the curriculum on POCUS knowledge, use, and confidence. METHODS In 2014, we designed a cross-sectional POCUS survey and knowledge test for all IM residents at the University of California, San Francisco. The results of this assessment drove the design of a longitudinal POCUS curriculum that included a 2-hour workshop for all IM interns and a 1-month elective offered to all IM residents. Residents were tested on their POCUS knowledge and image interpretation before the elective and were given the same test 6 months after the elective. The posttest included a survey of self-reported POCUS use and confidence. RESULTS In the needs assessment, residents scored a mean of 27% on the knowledge test, and across all applications the percentage of residents reporting confidence in their POCUS skills was lower than the percentage reporting use of the application in clinical practice. Residents scored a mean of 37% on the elective pretest and 74% on the posttest, an increase of 37% (95% confidence interval 31.6-42.8, P < 0.001), with improvements seen across all applications. After the elective, self-reported use of POCUS and confidence in POCUS skills were increased for the applications, using the needs assessment as an approximate baseline. For core cardiac and pulmonary applications, 76% to 95% of residents, depending on application, reported "high" or "very high" use and 79% to 100% reported "high" or "very high" confidence in their POCUS skills. CONCLUSIONS We used a needs assessment to guide the development of a longitudinal, multidisciplinary POCUS curriculum. Residents who completed all components showed substantial long-term gains in knowledge in all major applications and high use of and confidence in cardiac and pulmonary applications. |
| Databáze: | OpenAIRE |
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