Ultrasonagraphy is an effective tool for making quick diagnoses and guiding therapeutic procedures. National organizations have pushed for increasing the use of critical care ultrasonagraphy. The ABIM now recommends that critical care fellows be trained in pleural and vascular ultrasonagraphy. The purpose of this study was to investigate the prevalence of teaching of critical care ultrasonagraphy to fellows. In addition, we hoped to identify barriers to establishment of training programs.
All pulmonary/critical care and critical care medicine(CCM) program directors in the United States were invited to participate in an online survey. We asked respondents for demographic information about their programs, perceived barriers to training, as well as current training opportunities for their fellows in 5 aspects of critical care ultrasonagraphy. A 5-point Likert scale was used for survey answers.
Sixty-four (47%) of the 136 program directors responded. Eighty-four percent were university based hospital and 90% were pulmonary and CCM programs. The median number of fellows and faculty were 4 (range 1 to 18), and 11.5(range 2 to 50), respectively. Ultrasonagraphy training was offered in the following areas by fellowship programs: vascular access(97% of programs), vascular diagnostic(74%), lung and pleural (33%), cardiac (57%) and abdominal (36%). Ninety-two percent of respondents agreed or strongly agreed that ultrasound training is useful and 80% are interested in getting their fellows trained. Forty-one percent indicated that they lacked sufficient faculty trained in ultrasound use. Thirteen percent of programs indicated that their division did not have an ultrasound machine. Eighty-four percent agreed or strongly agreed that fellow turnover was an impediment to training. Forty-eight percent felt that cardiac echocardiography required long training time.
While ultrasound training of in vascular access was nearly universal, training in other aspects of ultrasound was less prevalent. We identified several barriers including fellow turnover, insufficient faculty training, and perceived length of time required for echocardiography training.
We identified barriers to ultrasound training, which lays the groundwork for strategies and studies designed to overcome these barriers and improve training opportunities.
Sharon Leung, No Financial Disclosure Information; No Product/Research Disclosure Information