Intensive point-of-care ultrasound training with long-term follow-up in a cohort of Rwandan physicians

被引:27
作者
Henwood, Patricia C. [1 ,2 ]
Mackenzie, David C. [2 ,3 ]
Rempell, Joshua S. [1 ,2 ]
Douglass, Emily [2 ]
Dukundane, Damas [2 ,4 ]
Liteplo, Andrew S. [5 ]
Leo, Megan M. [2 ,6 ]
Murray, Alice F. [2 ,6 ]
Vaillancourt, Samuel [2 ,7 ]
Dean, Anthony J. [2 ,8 ]
Lewiss, Resa E. [2 ,9 ]
Rulisa, Stephen [4 ]
Krebs, Elizabeth [10 ]
Rao, A. K. Raja [2 ]
Rudakemwa, Emmanuel [11 ]
Rusanganwa, Vincent [12 ]
Kyanmanywa, Patrick [13 ]
Noble, Vicki E. [2 ,5 ]
机构
[1] Brigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA
[2] Point Of Care Ultrasound Resource Ltd Environm, Boston, MA USA
[3] Maine Med Ctr, Dept Emergency Med, Portland, OR USA
[4] Univ Teaching Hosp Kigali, Kigali, Rwanda
[5] Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA 02114 USA
[6] Boston Med Ctr, Dept Emergency Med, Boston, MA USA
[7] St Michaels Hosp, Dept Emergency Med, Toronto, ON, Canada
[8] Univ Penn, Dept Emergency Med, Philadelphia, PA 19104 USA
[9] Univ Colorado, Dept Emergency Med, Denver, CO 80202 USA
[10] Duke Univ, Med Ctr, Dept Emergency Med, Durham, NC USA
[11] King Faisal Specialist Hosp & Res Ctr, Kigali, Rwanda
[12] Minist Hlth, Kigali, Rwanda
[13] Univ Rwanda, Butare, Rwanda
关键词
ultrasound; global health; Rwanda; curriculum; education; SETTINGS;
D O I
10.1111/tmi.12780
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
objective We delivered a point-of-care ultrasound training programme in a resource-limited setting in Rwanda, and sought to determine participants' knowledge and skill retention. We also measured trainees' assessment of the usefulness of ultrasound in clinical practice. methods This was a prospective cohort study of 17 Rwandan physicians participating in a point-ofcare ultrasound training programme. The follow-up period was 1 year. Participants completed a 10day ultrasound course, with follow-up training delivered over the subsequent 12 months. Trainee knowledge acquisition and skill retention were assessed via observed structured clinical examinations (OSCEs) administered at six points during the study, and an image-based assessment completed at three points. results Trainees reported minimal structured ultrasound education and little confidence using point-of-care ultrasound before the training. Mean scores on the image-based assessment increased from 36.9% (95% CI 32-41.8%) before the initial 10-day training to 74.3% afterwards (95% CI 69.4-79.2; P < 0.001). The mean score on the initial OSCE after the introductory course was 81.7% (95% CI 78-85.4%). The mean OSCE performance at each subsequent evaluation was at least 75%, and the mean OSCE score at the 58-week follow up was 84.9% (95% CI 80.9-88.9%). conclusions Physicians providing acute care in a resource-limited setting demonstrated sustained improvement in their ultrasound knowledge and skill 1 year after completing a clinical ultrasound training programme. They also reported improvements in their ability to provide patient care and in job satisfaction.
引用
收藏
页码:1531 / 1538
页数:8
相关论文
共 21 条
  • [1] Adler D, 2008, INT J EMERG MED, V1, P261, DOI 10.1007/s12245-008-0074-7
  • [2] Resident Training in Emergency Ultrasound: Consensus Recommendations from the 2008 Council of Emergency Medicine Residency Directors Conference
    Akhtar, Saadia
    Theodoro, Dan
    Gaspari, Romolo
    Tayal, Vivek
    Sierzenski, Paul
    LaMantia, Joseph
    Stahmer, Sarah
    Raio, Chris
    [J]. ACADEMIC EMERGENCY MEDICINE, 2009, 16 (12) : S32 - S36
  • [3] The Human Resources for Health Program in Rwanda - A New Partnership
    Binagwaho, Agnes
    Kyamanywa, Patrick
    Farmer, Paul E.
    Nuthulaganti, Tej
    Umubyeyi, Benoite
    Nyemazi, Jean Pierre
    Mugeni, Soline Dusabeyesu
    Asiimwe, Anita
    Ndagijimana, Uzziel
    McPherson, Helen Lamphere
    Ngirabega, Jean de Dieu
    Sliney, Anne
    Uwayezu, Agnes
    Rusanganwa, Vincent
    Wagner, Claire M.
    Nutt, Cameron T.
    Eldon-Edington, Mark
    Cancedda, Corrado
    Magaziner, Ira C.
    Goosby, Eric
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2013, 369 (21) : 2054 - 2059
  • [4] Cosby KS, 2014, PRACTICAL GUIDE EMER
  • [5] Dean Anthony J, 2007, Am J Disaster Med, V2, P249
  • [6] Review: indications for ultrasound use in low- and middle-income countries
    Groen, Reinou S.
    Leow, Jeffrey J.
    Sadasivam, Vijay
    Kushner, Adam L.
    [J]. TROPICAL MEDICINE & INTERNATIONAL HEALTH, 2011, 16 (12) : 1525 - 1535
  • [7] Donation and Training of Medical Personnel in Compact Ultrasound in Low-Resource Settings How We Do It
    Harris, Robert D.
    Marks, William M.
    [J]. ULTRASOUND QUARTERLY, 2011, 27 (01) : 3 - 6
  • [8] Short Report: Short Course for Focused Assessment with Sonography for Human Immunodeficiency Virus/Tuberculosis: Preliminary Results in a Rural Setting in South Africa with High Prevalence of Human Immunodeficiency Virus and Tuberculosis
    Heller, Tom
    Wallrauch, Claudia
    Lessells, Richard J.
    Goblirsch, Sam
    Brunetti, Enrico
    [J]. AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 2010, 82 (03) : 512 - 515
  • [9] A Practical Guide to Self-Sustaining Point-of-Care Ultrasound Education Programs in Resource-Limited Settings
    Henwood, Patricia C.
    Mackenzie, David C.
    Rempell, Joshua S.
    Murray, Alice F.
    Leo, Megan M.
    Dean, Anthony J.
    Liteplo, Andrew S.
    Noble, Vicki E.
    [J]. ANNALS OF EMERGENCY MEDICINE, 2014, 64 (03) : 277 - 285
  • [10] Challenges in International Medicine: Ethical Dilemmas, Unanticipated Consequences, and Accepting Limitations
    Iserson, Kenneth V.
    Biros, Michelle H.
    Holliman, C. James
    [J]. ACADEMIC EMERGENCY MEDICINE, 2012, 19 (06) : 683 - 692