Surgical Intensivist-Led Training in Critical Care Ultrasound Improves Performance

Am Surg. 2021 Aug;87(8):1238-1244. doi: 10.1177/0003134820972984. Epub 2020 Dec 19.

Abstract

Background: Critical care ultrasound (CCUS) is essential in modern practice, with CCUS including cardiac and noncardiac ultrasound. The most effective CCUS training is unknown, with a diverse skill set and knowledge needed for competence. The objective of this project was to evaluate the effect of a surgical intensivist-led training program on CCUS competence in critical care fellows.

Methods: This was a single institution retrospective review from 2016 to 2018 at the R Adams Cowley Shock Trauma Center. Our yearlong surgical intensivist (SI)-led CCUS training program for critical care fellows includes a daylong CCUS training class, CCUS lectures, a CCUS rotation, and bedside CCUS instruction during rotations. Fellows take a knowledge test and skills test before (pretest) and after (posttest) this program. Critical care ultrasound skill was graded on a scale from 1-5, with 4 (minimal help) or 5 (no help) considered competent. Emergency medicine, surgery, and medicine-trained critical care fellows were included.

Results: Forty-two critical care fellows were included. Mean posttest scores increased significantly for 21/22 (96%) of skills tested and for 14/30 (47%) of knowledge questions compared to pretest scores. The mean composite skill score increased from 3.25 to 4.82 from pretest to posttest (P < .001). The mean composite knowledge score increased from 60% to 80% from pretest to posttest (P < .001).

Conclusion: SI-led training improves CCUS competence and knowledge despite the breadth of CCUS.

Keywords: critical care fellow education; critical care ultrasound; point of care ultrasound; surgical education.

MeSH terms

  • Clinical Competence
  • Critical Care*
  • Fellowships and Scholarships
  • Humans
  • Internship and Residency*
  • Point-of-Care Testing
  • Retrospective Studies
  • Specialties, Surgical / education*
  • Ultrasonography*