Canadian National Survey on Point-of-Care Ultrasound Training in Family Medicine Residency Programs

Context: Point-of-care ultrasound (POCUS) use by family physicians in the office setting has been shown to be accurate and cost effective. In the United States there is now a clear trend towards incorporating POCUS training... [ view full abstract ]

Context: Point-of-care ultrasound (POCUS) use by family physicians in the office setting has been shown to be accurate and cost effective. In the United States there is now a clear trend towards incorporating POCUS training into postgraduate family medicine residency. Despite this, little is known about the extent of POCUS training in postgraduate family medicine programs in Canada.

Objective: In our study we aim to assess the current state of POCUS training in Canadian family medicine residency programs. We also hope to determine the opinions of current leaders in family medicine education (program directors) on the future of POCUS and its relevance in the context of family medicine.

Design: We carried out a cross-sectional survey evaluation of ultrasound education in accredited Canadian family medicine residency programs. The web-based anonymous survey consisted of 27 multiple-choice questions and was completed during the months of March and April 2016.

Participants: The population studied includes the 17 accredited Canadian Family Medicine residency programs represented by their program director or their proxy. Only one completed survey was accepted per residency program.

Intervention: Our data was collected using “FluidSurveys” and data were entered into an electronic database using Microsoft Excel. Using aggregated data, gap analysis and descriptive statistic were reported.

Results: We received responses from 14 of the 17 program directors for a response rate of 82.3%. 21.4% of respondents reported an established ultrasound curriculum and 35.7% are in the process of establishing or are considering establishing ultrasound training to their core curriculum. 92.9% believed that POCUS teaching should be integrated into family medicine residency. A majority, 57.1% do not consider themselves familiar with the literature on POCUS. Barriers to establish training included: lack of adequate equipment (57.1%), lack of instructors (57.1%), lack of available time in the curriculum (57.1%), and lack of funding available to support training (71.4%). A majority (71.4%) of respondents believe that POCUS can be used in outpatient family medicine to alter clinical decision-making. Some potential benefits associated with POCUS use in primary care include: more rapid diagnosis (85.7%), useful adjunct to physical exam (85.7%), improved patient outcomes (71.4%) and potential to reduce health care cost (71.4%).

Conclusions: Although few Canadian family medicine residency programs reported an established ultrasound curriculum, the majority of program directors believe that POCUS training should be offered to trainees and that ultrasound use can positively impact primary care practice. A growing number of residency programs are considering incorporating ultrasound training, but resource availability remains a major barrier to implementation.