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Published in: Journal of General Internal Medicine 9/2017

Open Access 01-09-2017 | Perspective

Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group

Authors: Irene W. Y. Ma, MD, PhD, FRCPC, FACP, RDMS, Shane Arishenkoff, MD, FRCPC, Jeffrey Wiseman, MD, MAEd, FRCPC, Janeve Desy, MD, FRCPC, Jonathan Ailon, MD, FRCPC, MSc, Leslie Martin, MD, FRCPC, Mirek Otremba, MD, FRCPC, Samantha Halman, MD, FRCPC, MMED, Patrick Willemot, MD, CM, Marcus Blouw, MD, MHA, FRCPC, On behalf of The Canadian Internal Medicine Ultrasound (CIMUS) Group*

Published in: Journal of General Internal Medicine | Issue 9/2017

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Abstract

Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1–3) and expanded (general internal medicine PGY 4–5) training programs. We recommend four POCUS applications for the core PGY 1–3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4–5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.
Literature
1.
go back to reference Afonso N, Amponsah D, Yang J, et al. Adding new tools to the black bag—introduction of ultrasound into the physical diagnosis course. J Gen Intern Med. 2010;25:1248–52.CrossRefPubMedPubMedCentral Afonso N, Amponsah D, Yang J, et al. Adding new tools to the black bag—introduction of ultrasound into the physical diagnosis course. J Gen Intern Med. 2010;25:1248–52.CrossRefPubMedPubMedCentral
2.
go back to reference Arishenkoff S, Eddy C, Roberts JM, et al. Accuracy of spleen measurement by medical residents using hand-carried ultrasound. J Ultrasound Med. 2015;34:2203–7.CrossRef Arishenkoff S, Eddy C, Roberts JM, et al. Accuracy of spleen measurement by medical residents using hand-carried ultrasound. J Ultrasound Med. 2015;34:2203–7.CrossRef
3.
go back to reference Kelm DJ, Ratelle JT, Azeem N, et al. Longitudinal ultrasound curriculum improves long-term retention among internal medicine residents. J Grad Med Educ. 2015;7:454–7.CrossRefPubMedPubMedCentral Kelm DJ, Ratelle JT, Azeem N, et al. Longitudinal ultrasound curriculum improves long-term retention among internal medicine residents. J Grad Med Educ. 2015;7:454–7.CrossRefPubMedPubMedCentral
4.
go back to reference Brennan JM, Blair JE, Goonewardena S, et al. A comparison by medicine residents of physical examination versus hand-carried ultrasound for estimation of right atrial pressure. Am J Cardiol. 2007;99:1614–6.CrossRef Brennan JM, Blair JE, Goonewardena S, et al. A comparison by medicine residents of physical examination versus hand-carried ultrasound for estimation of right atrial pressure. Am J Cardiol. 2007;99:1614–6.CrossRef
5.
go back to reference Barloon TJ, Brown BP, Abu-Yousef MM, et al. Teaching physical examination of the adult liver with use of real-time sonography. Acad Radiol. 1998;5:101–3.CrossRefPubMed Barloon TJ, Brown BP, Abu-Yousef MM, et al. Teaching physical examination of the adult liver with use of real-time sonography. Acad Radiol. 1998;5:101–3.CrossRefPubMed
6.
go back to reference Filopei J, Siedenburg H, Rattner P, Fukaya E, Kory P. Impact of pocket ultrasound use by internal medicine housestaff in the diagnosis of dyspnea. J Hosp Med. 2014;9:594–7.CrossRefPubMed Filopei J, Siedenburg H, Rattner P, Fukaya E, Kory P. Impact of pocket ultrasound use by internal medicine housestaff in the diagnosis of dyspnea. J Hosp Med. 2014;9:594–7.CrossRefPubMed
7.
go back to reference Low D, Vlasschaert M, Novak K, Chee A, Ma IWY. An argument for using additional bedside tools, such as bedside ultrasound, for volume status assessment in hospitalized medical patients: A needs assessment survey. J Hosp Med. 2014; 9:727–30.CrossRefPubMed Low D, Vlasschaert M, Novak K, Chee A, Ma IWY. An argument for using additional bedside tools, such as bedside ultrasound, for volume status assessment in hospitalized medical patients: A needs assessment survey. J Hosp Med. 2014; 9:727–30.CrossRefPubMed
8.
go back to reference Fink HA, Lederle FA, Roth CS, Bowles CA, Nelson DB, Haas MA. The accuracy of physical examination to detect abdominal aortic aneurysm. Arch Intern Med. 2000;160(6):833–6.CrossRefPubMed Fink HA, Lederle FA, Roth CS, Bowles CA, Nelson DB, Haas MA. The accuracy of physical examination to detect abdominal aortic aneurysm. Arch Intern Med. 2000;160(6):833–6.CrossRefPubMed
9.
go back to reference Pivetta E, Goffi A, Lupia E, et al. Lung ultrasound-implemented diagnosis of acute decompensated heart failure in the ED: a SIMEU multicenter study. Chest. 2015;148:202–10.CrossRefPubMed Pivetta E, Goffi A, Lupia E, et al. Lung ultrasound-implemented diagnosis of acute decompensated heart failure in the ED: a SIMEU multicenter study. Chest. 2015;148:202–10.CrossRefPubMed
10.
go back to reference Gargani L, Pang PS, Frassi F, et al. Persistent pulmonary congestion before discharge predicts rehospitalization in heart failure: a lung ultrasound study. Cardiovasc Ultrasound. 2015;13:40.CrossRefPubMedPubMedCentral Gargani L, Pang PS, Frassi F, et al. Persistent pulmonary congestion before discharge predicts rehospitalization in heart failure: a lung ultrasound study. Cardiovasc Ultrasound. 2015;13:40.CrossRefPubMedPubMedCentral
13.
go back to reference Havelock T, Teoh R, Laws D, Gleeson F. Pleural procedures and thoracic ultrasound: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):i61-i76.CrossRef Havelock T, Teoh R, Laws D, Gleeson F. Pleural procedures and thoracic ultrasound: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):i61-i76.CrossRef
14.
go back to reference Testa A, Francesconi A, Giannuzzi R, Berardi S, Sbraccia P. Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department. Intern Emerg Med. 2015;10:1015–24.CrossRefPubMed Testa A, Francesconi A, Giannuzzi R, Berardi S, Sbraccia P. Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department. Intern Emerg Med. 2015;10:1015–24.CrossRefPubMed
17.
go back to reference Ailon J, Nadjafi M, Mourad O, Cavalcanti R. Point-of-care ultrasound as a competency for general internists: a survey of internal medicine training programs in Canada. Can Med Educ J 2016;7(2):19. Ailon J, Nadjafi M, Mourad O, Cavalcanti R. Point-of-care ultrasound as a competency for general internists: a survey of internal medicine training programs in Canada. Can Med Educ J 2016;7(2):19.
18.
go back to reference Smallwood N, Matsa R, Lawrenson P, Messenger J, Walden A. A UK wide survey on attitudes to point of care ultrasound training amongst clinicians working on the Acute Medical Unit. Acute Med. 2015;14:159–64.PubMed Smallwood N, Matsa R, Lawrenson P, Messenger J, Walden A. A UK wide survey on attitudes to point of care ultrasound training amongst clinicians working on the Acute Medical Unit. Acute Med. 2015;14:159–64.PubMed
19.
go back to reference Kern DE, Thomas PA, Hughes MT. Curriculum Development for Medical Education. A Six-Step Approach. 2nd ed. Baltimore: The Johns Hopkins University Press; 2009. Kern DE, Thomas PA, Hughes MT. Curriculum Development for Medical Education. A Six-Step Approach. 2nd ed. Baltimore: The Johns Hopkins University Press; 2009.
22.
go back to reference Humphrey-Murto S, Varpio L, Gonsalves C, Wood TJ. Using consensus group methods such as Delphi and Nominal Group in medical education research. Med Teach. 2016; 39: 1–6. Humphrey-Murto S, Varpio L, Gonsalves C, Wood TJ. Using consensus group methods such as Delphi and Nominal Group in medical education research. Med Teach. 2016; 39: 1–6.
23.
go back to reference American College of Emergency Physicians. Emergency ultrasound guidelines. Ann Emerg Med. 2009;53:550.CrossRef American College of Emergency Physicians. Emergency ultrasound guidelines. Ann Emerg Med. 2009;53:550.CrossRef
24.
go back to reference Akhtar S, Theodoro D, Gaspari R, et al. Resident training in emergency ultrasound: consensus recommendations from the 2008 Council of Emergency Medicine Residency Directors Conference. Acad Emerg Med. 2009;16:S32-S6.CrossRefPubMed Akhtar S, Theodoro D, Gaspari R, et al. Resident training in emergency ultrasound: consensus recommendations from the 2008 Council of Emergency Medicine Residency Directors Conference. Acad Emerg Med. 2009;16:S32-S6.CrossRefPubMed
25.
go back to reference Labovitz AJ, Noble VE, Bierig M, et al. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr. 2010;23:1225–30.CrossRefPubMed Labovitz AJ, Noble VE, Bierig M, et al. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr. 2010;23:1225–30.CrossRefPubMed
26.
go back to reference Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38:577–91.CrossRef Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38:577–91.CrossRef
29.
go back to reference Diamond IR, Grant RC, Feldman BM, et al. Defining consensus: A systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67:401–9.CrossRef Diamond IR, Grant RC, Feldman BM, et al. Defining consensus: A systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67:401–9.CrossRef
30.
go back to reference Alba GA, Kelmenson DA, Noble VE, Murray AF, Currier PF. Faculty staff-guided versus self-guided ultrasound training for internal medicine residents. Med Educ. 2013;47:1099–108.CrossRefPubMed Alba GA, Kelmenson DA, Noble VE, Murray AF, Currier PF. Faculty staff-guided versus self-guided ultrasound training for internal medicine residents. Med Educ. 2013;47:1099–108.CrossRefPubMed
31.
go back to reference Baltarowich OH, Di Salvo DN, Scoutt LM, et al. National ultrasound curriculum for medical students. Ultrasound Q. 2014;30:13–9.CrossRefPubMed Baltarowich OH, Di Salvo DN, Scoutt LM, et al. National ultrasound curriculum for medical students. Ultrasound Q. 2014;30:13–9.CrossRefPubMed
Metadata
Title
Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group
Authors
Irene W. Y. Ma, MD, PhD, FRCPC, FACP, RDMS
Shane Arishenkoff, MD, FRCPC
Jeffrey Wiseman, MD, MAEd, FRCPC
Janeve Desy, MD, FRCPC
Jonathan Ailon, MD, FRCPC, MSc
Leslie Martin, MD, FRCPC
Mirek Otremba, MD, FRCPC
Samantha Halman, MD, FRCPC, MMED
Patrick Willemot, MD, CM
Marcus Blouw, MD, MHA, FRCPC
On behalf of The Canadian Internal Medicine Ultrasound (CIMUS) Group*
Publication date
01-09-2017
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 9/2017
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-017-4071-5

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