Poor return on investment: investigating the barriers that cause low credentialing yields in a resource-limited clinical ultrasound training programme.

Published on Feb 21, 2018in International Journal of Emergency Medicine
· DOI :10.1186/S12245-018-0168-9
Hein Lamprecht6
Estimated H-index: 6
(UCT: University of Cape Town),
Gustav Lemke1
Estimated H-index: 1
(UCT: University of Cape Town)
+ 2 AuthorsLee A. Wallis32
Estimated H-index: 32
(UCT: University of Cape Town)
Sources
Abstract
Clinical ultrasound is commonly used in medical practices worldwide due to the multiple benefits the modality offers clinicians. Rigorous credentialing standards are necessary to safeguard patients against operator errors. The purpose of the study was to establish and analyse the barriers that specifically lead to poor credentialing success within a resource-limited clinical ultrasound training programme. An electronic cross-sectional survey was e-mailed to all trainees who attended the introductory clinical ultrasound courses held in Cape Town since its inception in 2009 to 2013. All trainees were followed until they completed their training programme in 2015. Only one fifth of trainees (n = 43, 19.7%), who entered the Cape Town training programme, credentialed successfully. Ninety (n = 90, 41.3%) trainees responded to the survey. Eighty-six (n = 86) surveys were included for analysis. Time constraints were the highest ranked barrier amongst all trainees. Access barriers (to trainers and ultrasound machines) were the second highest ranked amongst the non-credentialed group. A combination between access and logistical barriers (e.g. difficulty in finding patients with pathology to scan) were the second highest ranked in the credentialed group. Access barriers conspire to burden the Cape Town clinical ultrasound training programme. Novel solutions are necessary to overcome these access barriers to improve future credentialing success.
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References17
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#2Blaise A. Bellows (UW: University of Washington)H-Index: 1
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84 CitationsSource
#1Paul Atkinson (Dal: Dalhousie University)H-Index: 66
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To meet a critical and growing need for a standardized approach to emergency point of care ultrasound (PoCUS) worldwide, emergency physicians must be trained to deliver and teach this skill in an accepted and reliable format. Currently, there is no globally recognized, standard PoCUS curriculum that defines the accepted applications, as well as standards for training and practice of PoCUS by specialists and trainees in emergency medicine. To address this deficit, the International Federation for...
59 CitationsSource
#1Yanick BeaulieuH-Index: 16
#2Réjean Laprise (UdeM: Université de Montréal)H-Index: 4
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Background Focused bedside ultrasound is rapidly becoming a standard of care to decrease the risks of complications related to invasive procedures. The purpose of this study was to assess whether adding to the curriculum of junior residents an educational intervention combining web-based e-learning and hands-on training would improve the residents’ proficiency in different clinical applications of bedside ultrasound as compared to using the traditional apprenticeship teaching method alone.
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Abstract Purpose The purpose of the study was to compare the effect of limited echocardiography (LE)–guided therapy to standard management on 28-day mortality, intravenous fluid prescription, and inotropic dosing following early resuscitation for shock. Materials and methods Two hundred twenty critically ill patients with undifferentiated shock from a quaternary intensive care unit were included in the study. The LE group consisted of 110 consecutive patients prospectively studied over a 12-mont...
111 CitationsSource
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10 CitationsSource
#1Gavin Budhram (Tufts University)H-Index: 7
#2Tala R. Elia (Tufts University)H-Index: 6
Last. Niels K. Rathlev (Tufts University)H-Index: 27
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Author(s): Budhram, Gavin; Elia, Tala; Rathlev, Niels | Abstract: Introducion: With the rapid expansion of emergency ultrasound, resident education in ultrasound has become more clearly developed and broadly integrated. However, there still exists a lack of guidance in the training of physicians already in practice to become competent in this valuable skill. We sought to employ a step-wise, goal-directed, incentive-based credentialing program to educate emergency physicians in the use of emergen...
15 CitationsSource
#1Resa E. Lewiss (Mount Sinai St. Luke's and Mount Sinai Roosevelt)H-Index: 19
#2Turandot Saul (Mount Sinai St. Luke's and Mount Sinai Roosevelt)H-Index: 11
Last. Marina Del Rios (UIC: University of Illinois at Chicago)H-Index: 9
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Objective Although there are training guidelines to credential emergency physicians in bedside ultrasound, many faculty groups have members who completed residency without a mandatory curriculum. These physicians are therefore required to learn bedside ultrasound while out in practice. The objective of this descriptive report is to illustrate a single academic facility9s experience with acquiring credentials for emergency physicians in bedside ultrasound and the faculty9s impressions on the moti...
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#1John M. Wrightson (Churchill Hospital)
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Funding/Support: Dr Restrepo is partially funded by the National Heart, Lung, and Blood Institute [K23HL096054]. Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Restrepo is a former participant in advisory boards for Theravance Inc; Forest Laboratories, Inc; Johnson & Johnson Services, Inc; Trius Therapeutics; and Novartis AG and has been a consultant for Theravance Inc; Trius Therapeutics; and Pfizer, Inc. Drs Fernandez and Levine h...
3 CitationsSource
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Objective To review the current training opportunities for ultrasound use for health workers practising in low- and middle-income countries (LMICs). Methods A PubMed search using terms ultrasound, sonography, echocardiography, developing country/countries, developing world, low resource settings, low income country/countries, training and education was conducted. Articles from 2000 to 2011 that included data on ultrasonography training were eligible for inclusion. Results This review shows that ...
66 CitationsSource
Cited By1
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#1Andrew Toffoli (Fiona Stanley Hospital)
#2Leanne Hartnett (Fiona Stanley Hospital)
Last. Adrian Goudie (Fiona Stanley Hospital)H-Index: 8
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OBJECTIVE The Australasian College for Emergency Medicine Curriculum Framework contains numerous mentions of point-of-care ultrasound (PoCUS). However, obtaining formal PoCUS credentials is often problematic. The Fiona Stanley Hospital ED PoCUS training programme was devised to assist emergency medicine trainees to meet the credentialing requirements of the Australasian College for Emergency Medicine and the Australasian Society for Ultrasound in Medicine. METHODS Six emergency medicine registra...
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