Ailon Jonathan, Mourad Ophyr, Nadjafi Maral, Cavalcanti Rodrigo
General Internal Medicine & Palliative Care, Saint Michael's Hospital, Toronto, ON.
General Internal Medicine, Saint Michael's Hospital, Toronto, ON.
Can Med Educ J. 2016 Oct 18;7(2):e51-e69. eCollection 2016 Oct.
Point-of-care ultrasound (POCUS) is increasingly used on General Internal Medicine (GIM) inpatient services, creating a need for defined competencies and formalized training. We evaluated the extent of training in POCUS and the clinical use of POCUS among Canadian GIM residency programs.
Internal Medicine trainees and GIM Faculty at the University of Toronto were surveyed on their clinical use of POCUS and the extent of their training. We separately surveyed Canadian IM Program Directors and Division Directors on the extent of POCUS training in their programs, barriers in the implementation of POCUS curricula, and recommendations for POCUS competencies in IM.
A majority of IM trainees (90/118, 76%) and GIM Faculty (15/29, 52%) used POCUS clinically. However, the vast majority of resident (111/117, 95%) and GIM Faculty (18/28, 64%) had received limited training. Of the Program Leaders surveyed, half (9/17, 53%) reported POCUS clinical use by their trainees; however only one quarter (4/16, 25%) reported offering formal curricula. Most respondents agreed that POCUS training should be incorporated into IM residency curricula, specifically for procedural guidance.
A considerable discrepancy exists between the clinical use of POCUS and the extent of formal training among Canadian IM residents and GIM Faculty. We propose that formalized POCUS training should be incorporated into IM residency programs, GIM fellowships, and Faculty development sessions, and identify POCUS skills that could be incorporated into future IM curricula.
床旁超声(POCUS)在普通内科(GIM)住院服务中的应用越来越广泛,因此需要明确的能力要求和正规培训。我们评估了加拿大GIM住院医师培训项目中POCUS的培训程度以及POCUS的临床应用情况。
对多伦多大学的内科住院医师和GIM教员进行了关于POCUS临床应用及培训程度的调查。我们还分别就其项目中POCUS培训的程度、POCUS课程实施中的障碍以及IM中POCUS能力的建议,对加拿大内科项目主任和科室主任进行了调查。
大多数内科住院医师(90/118,76%)和GIM教员(15/29,52%)在临床中使用POCUS。然而,绝大多数住院医师(111/117,95%)和GIM教员(18/28,64%)接受的培训有限。在接受调查的项目负责人中,有一半(9/17,53%)报告其学员临床使用POCUS;但只有四分之一(4/16,25%)报告提供了正规课程。大多数受访者认为POCUS培训应纳入IM住院医师课程,特别是用于操作指导。
加拿大IM住院医师和GIM教员在POCUS的临床应用和正规培训程度之间存在相当大的差异。我们建议将正规的POCUS培训纳入IM住院医师项目、GIM进修项目和教员发展课程,并确定可纳入未来IM课程的POCUS技能。