DEDICATED EMERGENCY DEPARTMENT ULTRASOUND ROTATION IMPROVES RESIDENTS' ULTRASOUND KNOWLEDGE AND INTERPRETATION SKILLS

Background: Graduates of Emergency Medicine (EM) residency training programs are expected to be proficient in ultrasound. However, best practices for teaching residents ultrasonography has yet to be determined. Study Objectives: To determine if a dedicated Emergency Department (ED) ultrasound rotation objectively improves residents' EM ultrasound knowledge, interpretation accuracy, and clinical decision-making based on ultrasound findings. Methods: EM residents completing a required ED-based ultrasound rotation were prospectively studied. Before the start of the rotation, each resident completed a 20-question pre-test. At the end of the rotation, residents completed a 20-question post-test. Both tests covered physics, trauma (focused assessment with sonography for trauma), first-trimester pregnancy, aorta, biliary, echocardiography, and vascular sonography, using a multiple-choice format. In both tests, ultrasound images were included in 11 of the 20 questions. The questions were divided into three categories: knowledge-based (8 questions), interpretation (9 questions), and clinical decision-making (3 questions), for both tests. Scores on pre-tests and post-tests were compared using a Wilcoxon signed-rank test. Results: During the 2-year study period, 21 residents completed the rotation. The median pre-test score was 16 (interquartile range [IQR] 14.5-17), compared to a median post-test score of 19 (IQR 18-20), p < 0.001. Conclusions: A dedicated ED ultrasound rotation improves residents' EM ultrasound knowledge and interpretation accuracy based on ultrasound findings, as measured by improvement on ultrasound test scores. (C) 2012 Elsevier Inc.