Effectiveness of a multicenter training programme to teach point-of-care vascular ultrasound for the detection of peripheral arterial disease in people with diabetes

Abstract

Background: The primary aim of this study was to evaluate the effectiveness of a training programme to teach a focused bedside ultrasound scan (PAD-scan; Podiatry Ankle Duplex Scan) for the detection of arterial disease in people with diabetes. Methods: Five podiatrists and one diabetologist across two hospitals were enrolled in a structured training programme consisting of a training course (1-day), supervised scanning (5-weeks), independent scanning (3-weeks) and a final evaluation of performance (1-day). Time, technical skills (Duplex Ultrasound Objective Structured Assessment of Technical Skills tool (DUOSATS); minimum score = 6, maximum score = 26) and accuracy (level of agreement with vascular scientist PAD-scan assessment) were assessed for every supervised scan and again for the final evaluation of performance. Results: A total of 90 PAD-scans in 65 patients were performed during the supervised phase. Participants demonstrated significant improvements in median time (19 min(IQR 13.9-25.5) vs 9.3 min (IQR 7.3-10.5) ; p = 0.028) and DUOSATS scores (17.5 (IQR 16.8-21) vs 25 (IQR 24-25.3); p = 0.027). At the final evaluation, participants completed scans in 5.4 min (IQR 5.3-5.9), achieved full DUOSAT scores and perfect agreement with the vascular scientist. Conclusion: A structured training programme, integrated into diabetic foot clinics, was effective in teaching the PAD-scan