Emergency Physicians as Interdisciplinary Educators in Point of Care Ultrasound for Paracentesis

Background: There are increasing numbers of hospital-based point of care US divisions led by emergency medicine physicians. Cross specialty training and education are intrinsic to the existence of such interdisciplinary... [ view full abstract ]

Background: There are increasing numbers of hospital-based point of care US divisions led by emergency medicine physicians. Cross specialty training and education are intrinsic to the existence of such interdisciplinary models. Limited data exists regarding the ability of emergency physicians to serve as educators to other physician specialists in the use of bedside US.

Objectives: To determine the efficacy of emergency medicine physicians in training internists on the use of point of care US for paracentesis.

Methods: A before and after survey was conducted at a tertiary hospital. Internal medicine faculty and residents who voluntarily attended a training session on bedside US were asked to participate. Three emergency physicians experienced in point of care US led the session, which consisted of didactics and hands on scanning focused on sonoanatomy relevant to a paracentesis. Participants completed surveys before and after the training session. The surveys assessed previous US exposure and also utilized a five-point Likert scale to evaluate participants’ self-perceptions of their ability to perform a paracentesis with bedside US.

Results: All internal medicine faculty (n=12) and residents (n=19) who attended the training session completed both surveys. Eleven participants had previously utilized bedside US for paracentesis, and 24 participants had prior exposure to US through other procedures. Paired sample t-tests revealed that following the training session, participants were significantly more confident in their ability to identify intraperitoneal free fluid, relevant intra-abdominal organs, and overlying vasculature (p < 0.001). Participants also reported overall greater comfort in utilizing US for a paracentesis and in performing the procedure under real time guidance (p < 0.001). Twenty-eight of the 31 subjects felt the training session was useful and increased the likelihood that they would utilize bedside US for identification of ascites in the future.

Conclusion: Emergency medicine physicians are capable of training other physician specialists in point of care US for paracentesis.