Point of Care Ultrasound in Family Medicine Residency Programs: A CERA Study

SONOSIM SUMMARY:

Point-of-care (POC) ultrasound, or bedside ultrasound, is described as limited, defined ultrasound protocols integrated into routine examination practices and performed at the time of patient care. POC ultrasound has become prominent in Emergency Medicine, but appears to be currently uncommon in Family Medicine. To obtain first-of-its-kind data about POC ultrasound education and use in Family Medicine residencies, the Council of Academic Family Medicine Educational Research Alliance (CERA) sent a multi-faceted survey to Family Medicine residency program directors.

According to survey data, residency program directors are split on the perception of POC ultrasound and its place in Family Medicine. A large majority (97.8%) of residency programs do not have an established POC ultrasound curriculum in place, and 50% report that there isn’t significant interest in incorporating such a curriculum. On the other hand, a solid number have fledgling POC ultrasound programs in place (29%) or are in the process of introducing such training (11.2%).

Faculty with appropriate ultrasound expertise is reported by 98% as the greatest barrier to implementing POC ultrasound programs. However, a large number of program directors (61.1%) also reported unfamiliarity with literature supporting the use of POC ultrasound. Thus, to augment POC ultrasound use in Family Medicine residency programs, increased familiarity with ultrasound literature is likely needed, alongside collaborations with other ultrasound savvy departments or entities to help develop faculty ultrasound skills.

Background and Objectives

Point-of-care (POC) ultrasound is increasingly used by clinicians across multiple medical specialties. Current perceptions and prevalence of POC ultrasound practice and training in family medicine residency programs has not been described.

Methods

Questions were included in the 2014 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. The survey included questions regarding current use and current curricula regarding POC ultrasound. It also asked rank order questions of perceived benefits and perceived barriers to expanding such training.

Results

Fifty percent (n=224) of residency program directors completed the 2014 CERA survey. Few programs (2.2%) reported an established ultrasound curriculum. However, 29% indicated they have started a program within the past year, and 11.2% reported starting the process of establishing such training. Ultrasound assistance for procedural guidance was the most commonly reported (44%) use out of seven POC examples. The three leading perceived benefits of POC ultrasound were: making a more rapid diagnosis, the potential to save health care costs, and the potential to improve patient outcomes. The three leading barriers to expanding training were a lack of appropriately trained faculty, limited access to ultrasound equipment, and a lack of comfort in interpreting images without radiologist review.

Conclusions

A small, but rapidly growing, number of family medicine residencies currently use POC ultrasound. Further research is needed to explore how POC ultrasound can improve patient outcomes in the ambulatory setting and to develop appropriate training methods for this technology.

SonoSim Keywords: Point of Care Ultrasound, Family Medicine, Residency Program, Bedside Ultrasound