Boniface Keith S, Drake Aaran, Pyle Matthew, Moideen Fabith, Mehta Sanjay, Poovathumparambil Venugopal, Shokoohi Hamid, Douglass Katherine
Department of Emergency Medicine The George Washington University Washington DC.
Department of Emergency Medicine Baby Memorial Hospital Calicut Kerala India.
AEM Educ Train. 2019 Dec 27;4(4):387-394. doi: 10.1002/aet2.10423. eCollection 2020 Oct.
Point-of-care ultrasound (POCUS) is important to the practice of emergency medicine (EM), but requires training to achieve competence. The purpose of this study was to describe the current state of POCUS practice and perceived barriers to the implementation in EM training programs in India.
A cross-sectional survey consisting of 28 questions was administered to 378 faculty and residents in postgraduate EM training programs across India.
Data were collected from 159 physicians from 16 institutions; 76% of them were EM residents, with a response rate of 42%. Respondents overwhelmingly reported high interest (91%) in learning POCUS topics. Respondents identified highest levels of comfort with the performance and interpretation of trauma ultrasound (US) and echocardiography. Conversely, there was a scarce interest and low levels of competence in performing obstetric US, which may be a result of the practice of triaging these complaints to obstetricians and gynecologists. Lack of US equipment and dedicated training were the highest rated barriers by a significant margin, which 56% of respondents ranked as "very important."
While significant interest in POCUS exists among the Indian EM physicians, comfort and competence were limited to trauma and echocardiography applications. Expansion of and comfort with POCUS use in these settings may be sought through improvement of access to US equipment and a dedicated US curriculum.
床旁超声(POCUS)对急诊医学(EM)实践很重要,但需要培训才能达到胜任水平。本研究的目的是描述印度POCUS实践的现状以及在EM培训项目中实施的感知障碍。
对印度各地研究生EM培训项目中的378名教员和住院医师进行了一项包含28个问题的横断面调查。
从16个机构的159名医生那里收集了数据;其中76%是EM住院医师,回复率为42%。绝大多数受访者(91%)表示对学习POCUS主题有很高的兴趣。受访者表示对创伤超声(US)和超声心动图的操作及解读最为得心应手。相反,对产科超声检查的兴趣稀缺且能力水平较低,这可能是因为将这些主诉分诊给妇产科医生的做法所致。缺乏超声设备和专门培训是被列为最高级别的障碍,56%的受访者将其列为“非常重要”。
虽然印度EM医生对POCUS有浓厚兴趣,但熟练程度和能力仅限于创伤和超声心动图应用。可通过改善超声设备的获取和专门的超声课程,来寻求在这些环境中扩大POCUS的使用并提高熟练程度。