Effectiveness of a Critical Care Ultrasound (CCUS) Curriculum in a Critical Care Medicine Fellowship Program

Abstract

PURPOSE: The focused ultrasound examination has become increasingly recognized as a valuable tool for the assessment of the critically ill patient. It offers a number of advantages: it can be performed promptly by the treating physician, it does not involve patient transport, and there is no associated radiation exposure. National critical care organizations have advocated for its utilization in patient care. There remain significant barriers to integration of training into fellowship as most programs do not offer focused training thereby leaving these skills to be acquired informally. We implemented a dedicated CCUS curriculum with a goal to developing a model for teaching critical care medicine fellows. METHODS: The program was comprised of didactic/bedside sessions in the following areas: fundamentals, vascular access/diagnosis, abdominal, thoracic, and cardiac ultrasonography. Knowledge/image acquisition assessments were performed prior/following the program to assess success in meeting predefined learning objectives. Additionally, participants completed surveys (Likert scale 1-5) prior/following the program to assess confidence in ultrasonography knowledge/skills as well as their perception as to training effectiveness. RESULTS: The pre-intervention knowledge/bedside image acquisition scores were 71.4% +/- 10% and 31.5% +/- 10%. The global pre-intervention score was 51.4% +/- 7.3%. All post-intervention measures demonstrated significant improvement: 89.1% +/- 10% (p = 0.00119), 85.6% +/- 9.2% (p < 0.0001), and 87.3% +/- 8.2% (p = 0.0001). The pre-intervention confidence score was 2.96 +/- 0.58 which improved to 4.35 +/- 0.65 (p = 0.0072) post-intervention. Participants rated course objectives being met as a mean of 4.81 +/- 0.22. CONCLUSIONS: Critical Care Fellow knowledge of CCUS is high at baseline but image acquisition skills are poor. An educational intervention resulted in significant improvements in both subject knowledge and image acquisition skills.