Prospective evaluation of cardiac ultrasound performance by general internal medicine physicians during a 6-month faculty development curriculum.

Christopher J Smith, Abdulrahman Morad, Christopher Balwanz, Elizabeth Lyden, Tabatha Matthias
Author Information
  1. Christopher J Smith: Section of Hospital Medicine, Division of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986430 Nebraska Medical Center, Omaha, NE, USA. csmithj@unmc.edu.
  2. Abdulrahman Morad: Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
  3. Christopher Balwanz: Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
  4. Elizabeth Lyden: Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.
  5. Tabatha Matthias: Section of Hospital Medicine, Division of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986430 Nebraska Medical Center, Omaha, NE, USA.

Abstract

BACKGROUND: Point-of-care (POCUS) education is rapidly expanding within medical schools and internal medicine residency programs, but lack of trained faculty is a major barrier. While POCUS training can improve short-term outcomes, knowledge and skills rapidly decay without deliberate practice and feedback. The purpose of this study was to evaluate the performance of focused cardiac ultrasound (FCU) by volunteer general internal medicine (GIM) faculty participating in a longitudinal POCUS curriculum.
METHODS: Participants: Nine GIM clinician-educators participated in a 6-month POCUS curriculum. Faculty performance was compared to three cardiology fellows. Three diagnostic cardiac sonographers (DCS) were also evaluated and served as the gold standard.
EVALUATION: the primary outcome was a FCU efficiency score, calculated by dividing image quality score by exam duration. FCU exams were conducted on three standardized patients after completion of an introductory workshop, at 3 months, and at 6 months. Two blinded cardiologists scored the exams.
ANALYSIS: mean efficiency scores were compared using a linear mixed effects model, followed by pairwise comparisons using Tukey's test.
RESULTS: GIM faculty's FCU efficiency scores were maintained over the 6-month period (2.2, SE 1.0 vs. 3.8, SE 1.0, p = 0.076). Their scores at each session were similar to cardiology fellows (p > 0.69), but inferior to DCSs (p < 0.0001).
CONCLUSION: GIM faculty participating in a POCUS curriculum maintained their FCU performance over 6 months with efficiency scores comparable to experienced cardiology fellows.

Keywords

References

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Word Cloud

Created with Highcharts 10.0.0POCUSFCUfacultyperformanceGIMcurriculumefficiencyscoresinternalmedicinecardiacultrasound6-monthcardiologyfellowsPoint-of-carerapidlygeneralparticipatingFacultycomparedthreescoreexams6 monthsusingmaintained2SE10developmentBACKGROUND:educationexpandingwithinmedicalschoolsresidencyprogramslacktrainedmajorbarriertrainingcanimproveshort-termoutcomesknowledgeskillsdecaywithoutdeliberatepracticefeedbackpurposestudyevaluatefocusedvolunteerlongitudinalMETHODS:Participants:Nineclinician-educatorsparticipatedThreediagnosticsonographersDCSalsoevaluatedservedgoldstandardEVALUATION:primaryoutcomecalculateddividingimagequalityexamdurationconductedstandardizedpatientscompletionintroductoryworkshop3 monthsTwoblindedcardiologistsscoredANALYSIS:meanlinearmixedeffectsmodelfollowedpairwisecomparisonsTukey'stestRESULTS:faculty'speriodvs38p = 0076sessionsimilarp > 069inferiorDCSsp < 00001CONCLUSION:comparableexperiencedProspectiveevaluationphysiciansInternalMedicine

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