Systematic Review of Critical Care Ultrasound (CCUS) Training Literature

Abstract

Purpose: Only a minority of U.S pulmonary and critical care (PCCM) training programs currently offer a formal curriculum in critical care ultrasound (CCUS) and it is unknown how many adhere to published national, international or societal guideline recommendations. A systematic review of the literature was performed to identify the evidence base supporting PCCM fellowship curriculums in CCUS. Methods: A PubMed search was performed to identify publications on training in critical care ultrasound. The search strategy targeted publications that referenced: competency or quality assurance, consensus statement, practice guideline, societal recommendations and curriculum or training. Subsequently, bibliographies of identified articles were searched for relevant publications and experts in the field of CCUS training were also contacted to identify relevant publications. Results: 25 relevant publications were identified; 8 addressed competency or quality assurance, 6 were societal consensus statements, practice guideline or recommendations and 8 were on established curriculum or training protocols. 3 CCUS pathways for competency were found among international specialty organizations. Curriculum components most commonly identified were as follows; need for introductory hands-on training courses in CCUS, self-directed electronic learning modules, dedicated CCUS electives, portfolio development with required minimum studies, and supervised performance of CCUS exams by expert faculty. Other components utilized were textbook and journal article reviews, expert faculty lectures, simulation exams, archive database for CCUS quality assurance, and the need for institutional support. Conclusions: Multiple investigators and professional societies have identified important elements for effective CCUS training curriculums within fellowship and have published consensus statements establishing requirements for achieving and defining competence in CCUS. Clinical Implications: Sub-specialty training programs seeking to develop a CCUS training curriculum should rely on the growing body of concensus findings and recommendations. Further investigation into component efficacy and curriculum development should lead to standardization of training methods in the field of CCUS.