Background: Point-of-care (POC) ultrasonography (US) is the concept of ultrasound brought to the patient’s bedside and performed “real-time” by the provider. The utility of POC US to facilitate the management of the acutely ill patient has been demonstrated for multiple pathologies and across multiple hospital environments. However, the level of training across all acute care specialties, including: Anesthesiology, Anesthesiology–Cardiac, Anesthesiology- Critical Care, Emergency Medicine, Emergency Medicine -Critical Care, Family Medicine, Internal Medicine, Internal Medicine- Critical Care, Pulmonary Critical Care, Pediatrics, Pediatric Emergency Medicine, Pediatric Critical Care, Surgery and Surgery Critical Care, is thought to be quite different. This is despite the fact that each of these specialties may encounter the same acute management situations. To discover some clarity on this topic we designed a survey that was distributed to all program directors of the various specialties listed above in the United States. The survey was designed to evaluate the common examination techniques utilized for common acute care situations as well as evaluate the training and utilization of POC US.
Methods: After IRB approval, a list of all program directors (PD) for the specialties listed above was created from the accreditation council for graduate medical education website (http://www.acgme.org). The survey was distributed electronically via Qualtrics (Provo, Utah) survey system. The survey consisted of 11 questions evaluating the primary bedside assessment tool used for various common acute care situations, as well as to evaluate which topics in POC US the PDs felt comfortable practicing, and which topics they felt were useful for their specialty. In addition, the topics of barriers to POC US use, certification, and documentation were also surveyed utilizing a Likert scale.
Results. Preliminary results show a large degree of variability between the primary assessment tools amongst specialties for the four common acute care situations (Table 1)(Figures Removed). In addition, the level of comfort, education, and usefulness for ones particular specialty, was also variable across various POC US topics and amongst specialties (Table 1)(Figures Removed). Interestingly most specialties demonstrated a large difference between POC US topics PD reported to have received education vs. topics that they identified to be useful for their specialty (Table 2)(Figures Removed). Majority of PD reported a lack of educational opportunities as the barrier to learn POC US (48 %) and the vast majority of PD reported that a POC US exam should be documented (95%). Finally, the majority of PD (42%) reported that departmental certification would be sufficient to perform POC US examinations. Data collection is currently ongoing.
Conclusions: Currently, there is a large variability in the way POC US is utilized in the acute care setting. Further research should evaluate methods to educate and standardize POC US training across all acute care specialties.
