PURPOSE: We aimed to develop an introductory workshop to improve the knowledge and skills in abdominal critical care ultrasonography (abdominal CCUS) with use of a hand-held ultrasound machine.
METHODS: The study was conducted in a tertiary care center. One week prior to the hands-on training session, 90-minute web-based didactic lectures were provided to the 23 physicians (19 intensivists and 4 nephrologists). The training in the simulation center consisted of a 1-hour abdominal CCUS examination on volunteer models and a 20-minute interactive discussion with instructors. The content of the workshop included ultrasound physics, knobology, exam preparation, image acquisition, and interpretation. Pre- and post-workshop tests on knowledge and image interpretation were conducted on-line using 20 multiple-choice questions. Pre-and post-workshop tests on examination skills were all scenario-based and they were video-captured for evaluation by two blinded reviewers. The scores were calculated based on 16 pre-determined checklist items including physicians’ responses, machine control, and the adequacy of the ultrasound images obtained. A Bland-Altman plot was used to analyze agreement between two reviewers. Physicians’ confidence levels on image acquisition were assessed by ten-point Likert scale. The performance measures before and after the workshop were evaluated using a paired t-test.
RESULTS: The mean (± SD) pre- and post- scores on knowledge were 11±3 and 18±2, out of maximum 20, p<0.01. For the skill portion of the tests, the mean (± SD) pre- and post- scores for skill were 6±3 and 15±2, out of maximum 16, p<0.01. A Bland-Altman plot demonstrated that the scores by two reviewers were consistent and similar. Physicians’ confidence levels increased from 2±1 to 7±1, p<0.01.
CONCLUSION: Introductory abdominal CCUS course consisting of web-based learning followed by hands-on training improves the knowledge, skills, and confidence level of novice learners of hand-held CCUS.
CLINICAL IMPLICATIONS: Structured CCUS workshop is an attractive option particularly for busy ICU practitioners. The lack of performance standards and the absence of long term follow up to assess the retention of knowledge and skills limit clinical implications at this time.
DISCLOSURE: Hiroshi Sekiguchi, No Financial Disclosure Information; No Product/Research Disclosure Information