Developing a Longitudinal Post-Critical Care Ultrasound (CCUS) Course Curriculum: Identifying Barriers and Determining Interest
CCCF ePoster library. Jaidka A. Oct 2, 2017; 198166; 13
Dr. Atul Jaidka
Dr. Atul Jaidka
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Developing a Longitudinal Post-Critical Care Ultrasound (CCUS) Course Curriculum: Identifying Barriers and Determining Interest

Jaidka, Atul1; Arntfield, Robert2

1 Department of Medicine, Western University, London, Canada; 2 Department of Critical Care, Western University, London, Canada

Point-of care-ultrasound has become an invaluable tool for the critical care physician. A Canadian Consensus Group have laid the framework for standards of training (Arntfield et al. 2014). This training statement provides a framework for achieving proficiency that includes: a formal course (hands-on and didactic), portfolio development, competency assessment, and long-term quality assurance practices to maintain skills. Courses have become popular among those wishing to develop ultrasound skills but post-course training is complicated by limited access to expert supervision.
The primary objective of this study was to complete a needs assessment and determine interest for a longitudinal post-critical care ultrasound (CCUS) course curriculum.
Surveys were sent to 145 past attendees of a large Canadian CCUS course run in 2015 and 2016. Attendees were a mix of residents and staff in Intensive Care, Emergency Medicine, and Internal Medicine. Curriculum was based on the Canadian CCUS training statement and was identical in both years and no support for post-course training was provided.  The survey focused on post-course ultrasound training with attention to barriers to its use as well as if access to mentorship following the course would have enriched their CCUS skill retention and application. 
Fifty-eight attendees completed surveys (40%). Thirty-six respondents (62.5%) reported having difficulty maintaining CCUS skills after taking the course. Of those that had difficulty, 75% reported lack of mentorship or supervision to evaluate images, 33.3% reported lack of machine availability, 30.6 reported forgetting technical skills, and 8.3% reported local culture as the reason.
Attendees reported completing more CCUS exams per week immediately post-course and at long term follow-up, compared to pre-course, but the number of exams per week showed trends toward decline at long term follow-up, compared to post-course.
Thirty-seven respondents (63.8%) reported they did not log their CCUS exams, but 79.3% would use one if they were provided a convenient option.
In considering ways to support CCUS skills post-course, attendees ranked possible solutions  as follows: ongoing access to modules (75.9%), virtual attendance to ultrasound image review sessions at an academic hospital ICU (69%), ultrasound image review/quality assurance (65.5%), video conference with course faculty (39.7%).
In our examination of participant outcomes following CCUS course attendance, we found that despite CCUS uptake increasing, the absence of ongoing supervision and mentorship imposes a problematic barrier for participants seeking proficiency with the modality.  Based on survey results, significant opportunity for and interest in post-course educational support exists. Given limited access to expert support, efforts should focus on delivering virtual support via video conferenced access to course faculty, case review and quality assurance of images.


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