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344 Point of Care Ultrasonography Training in Bogotá Emergency Medicine Residencies: The Unmet Need
Título de la revista
Autores
Henwood, P.C.
Norwood, B.R.
Genthon, A.A.
Silva, D.
Martinez, Y.B.
Granada, J.
Torres, J.
Romero, M.G.
Arbelaez, C.
Fecha
2012-10
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The American College of Emergency Physicians
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Abstract
Background: As ultrasonography equipment has evolved toward increased portability, higher quality and lower cost, the field of point-of-care ultrasonography has grown, with numerous applications for emergency medicine practitioners. Competence in goal-directed ultrasonography image acquisition and interpretation is now a mandatory part of emergency medicine residency training in the United States and the United Kingdom. Appropriate training is a key component to the safe and effective use of this technology. In Colombia, emergency medicine is a relatively new specialty and leaders in the field have expressed interest in further integrating pointof-care ultrasonography into emergency medicine practice and resident training. Study Objectives: The objective of this study was to conduct a needs assessment to better understand the current state of point-of-care ultrasonography practice among all emergency medicine residency programs in Bogotá, Colombia. Methods: An ultrasonography needs assessment survey tool was distributed to all available residents of the 3 emergency medicine residency programs in Bogotá. The emergency medicine program directors, other physicians staffing the emergency departments, and several medical students rotating in the emergency departments were also surveyed. The needs assessment survey tool assessed the population’s experience with point-of-care ultrasonography, formal ultrasonography education, and interest in educational initiatives. Focus group sessions with 50% of emergency medicine residents in Bogotá were subsequently conducted to further qualify their perspective on the current state of diagnostic ultrasonography at each residency training site as it relates to their clinical and procedural practice. Partners Health care institutional review board exemption was obtained for this research. Results: Fifty four total clinicians (43 emergency physicians, 5 non-emergency physicians and 6 medical students) completed the survey. Twenty-nine participants (54%) had previously used an ultrasonography machine. Of all emergency medicine respondents, 24 had used ultrasonography, and trauma was the most common application. However, 52% of those who had used ultrasonography had performed less than 10 independent scans. Thirty-nine participants (72%) had received no formal ultrasonography training. Of respondents, 94% total (100% of emergency physicians) reported a high level of interest in learning point-of-care ultrasonography, particularly trauma and vascular access applications. The major barriers identified by those surveyed were the absence of teachers (83%), the absence of ultrasonography equipment (65%), and time limitations (39%). Focus group discussions revealed that the scope of clinical practice, especially regarding procedures performed by emergency physicians, varied between emergency departments and residencies, but all reported they wanted more training in the use of point-of-care ultrasonography to improve their practice and patient care. Conclusion: Emergency ultrasonography training and use in clinical practice among emergency medicine residencies in Bogotá is currently limited by the lack of ultrasonography equipment and educators. However, there is significant interest in educational initiatives among all residents and program directors. Further research into how to best integrate point-of-care ultrasonography into emergency medicine practice and resident training in Colombia is needed.
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Medical and Health Sciences , Clinical Sciences
