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Published in: Journal of General Internal Medicine 10/2019

Open Access 01-10-2019 | Ultrasound | Original Research

Education Indicators for Internal Medicine Point-of-Care Ultrasound: a Consensus Report from the Canadian Internal Medicine Ultrasound (CIMUS) Group

Authors: Anshula Ambasta, Marko Balan, Michael Mayette, Alberto Goffi, Sharon Mulvagh, Brian Buchanan, Steven Montague, Shannon Ruzycki, Irene W. Y. Ma, On behalf of the Canadian Internal Medicine Ultrasound (CIMUS) Group

Published in: Journal of General Internal Medicine | Issue 10/2019

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Abstract

Background

Curriculum development and implementation for internal medicine point-of-care ultrasound (IM POCUS) continues to be a challenge for many residency training programs. Education indicators may provide a useful framework to support curriculum development and implementation efforts across programs in order to achieve a consistent high-quality educational experience.

Objective

This study seeks to establish consensus-based recommendations for education indicators for IM POCUS training programs in Canada.

Design

This consensus study uses a modified nominal group technique for voting in the initial round, followed by two additional rounds of online voting, with consensus defined as agreement by at least 80% of the participants.

Participants

Participants were 22 leaders with POCUS and/or education expertise from 13 Canadian internal medicine residency programs across 7 provinces.

Main Measures

Education indicators considered were those that related to aspects of the POCUS educational system, could be presented by a single statistical measure, were readily understood, could be reliably measured to provide a benchmark for measuring change, and represented a policy issue. We excluded a priori indicators with low feasibility, are impractical, or assess learner reactions. Candidate indicators were drafted by two academic internists with post-graduate training in POCUS and medical education. These indicators were reviewed by two internists with training in quality improvement prior to presentation to the expert participants.

Key Results

Of the 52 candidate education indicators considered, 6 reached consensus in the first round, 12 in the second, and 4 in the third round. Only 5 indicators reached consensus to be excluded; the remaining indicators did not reach consensus.

Conclusions

The Canadian Internal Medicine Ultrasound (CIMUS) group recommends 22 education indicators be used to guide and monitor internal medicine POCUS curriculum development efforts in Canada.
Appendix
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Literature
1.
go back to reference Smallwood N, Dachsel M. Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine? Clin Med. 2018;18:219–24.CrossRef Smallwood N, Dachsel M. Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine? Clin Med. 2018;18:219–24.CrossRef
2.
go back to reference Liu RB, Donroe JH, McNamara RL, Forman HP, Moore CL. The practice and implications of finding fluid during point-of-care ultrasonography: A review. JAMA Intern Med. 2017;177:1818–25.CrossRef Liu RB, Donroe JH, McNamara RL, Forman HP, Moore CL. The practice and implications of finding fluid during point-of-care ultrasonography: A review. JAMA Intern Med. 2017;177:1818–25.CrossRef
3.
go back to reference Moore CL, Copel JA. Point-of-Care Ultrasonography. N Engl J Med. 2011;364:749–57.CrossRef Moore CL, Copel JA. Point-of-Care Ultrasonography. N Engl J Med. 2011;364:749–57.CrossRef
5.
go back to reference Ma IWY, Cogliati C, Bosch FH, et al. Point-of-care ultrasound for internal medicine: an international perspective. South Med J. 2018;111(7):439–43.CrossRef Ma IWY, Cogliati C, Bosch FH, et al. Point-of-care ultrasound for internal medicine: an international perspective. South Med J. 2018;111(7):439–43.CrossRef
6.
go back to reference Blans MJ, Bosch FH. Ultrasound in acute internal medicine; time to set a European standard. Eur J Intern Med. 2017;45:51–53.CrossRef Blans MJ, Bosch FH. Ultrasound in acute internal medicine; time to set a European standard. Eur J Intern Med. 2017;45:51–53.CrossRef
7.
go back to reference Salmon M, Landes M, Hunchak C, et al. Getting it right the first time: defining regionally relevant training curricula and provider core competencies for point-of-care ultrasound education on the African continent. Ann Emerg Med. 2017;69:218–26.CrossRef Salmon M, Landes M, Hunchak C, et al. Getting it right the first time: defining regionally relevant training curricula and provider core competencies for point-of-care ultrasound education on the African continent. Ann Emerg Med. 2017;69:218–26.CrossRef
8.
go back to reference Soni NJ, Schnobrich D, Matthews BK, et al. Point-of-care ultrasound for hospitalists: a position statement of the Society of Hospital Medicine. J Hosp Med. 2019;14:E1-E6.CrossRef Soni NJ, Schnobrich D, Matthews BK, et al. Point-of-care ultrasound for hospitalists: a position statement of the Society of Hospital Medicine. J Hosp Med. 2019;14:E1-E6.CrossRef
9.
go back to reference Schnobrich DJ, Gladding S, Olson APJ, Duran-Nelson A. Point-of-care ultrasound in internal medicine: a national survey of educational leadership. J Grad Med Educ. 2013;5(3):498–502.CrossRef Schnobrich DJ, Gladding S, Olson APJ, Duran-Nelson A. Point-of-care ultrasound in internal medicine: a national survey of educational leadership. J Grad Med Educ. 2013;5(3):498–502.CrossRef
10.
go back to reference Clay RD, Lee EC, Kurtzman MF, Dversdal RK. Teaching the internist to see: effectiveness of a 1-day workshop in bedside ultrasound for internal medicine residents. Crit Ultrasound J. 2016;8(1):11.CrossRef Clay RD, Lee EC, Kurtzman MF, Dversdal RK. Teaching the internist to see: effectiveness of a 1-day workshop in bedside ultrasound for internal medicine residents. Crit Ultrasound J. 2016;8(1):11.CrossRef
11.
go back to reference Town JA, Bergl PA, Narang A, McConville JF. Internal medicine residents’ retention of knowledge and skills in bedside ultrasound. J Grad Med Educ. 2016;8(4):553–7.CrossRef Town JA, Bergl PA, Narang A, McConville JF. Internal medicine residents’ retention of knowledge and skills in bedside ultrasound. J Grad Med Educ. 2016;8(4):553–7.CrossRef
12.
go back to reference Kelm DJ, Ratelle JT, Azeem N, Bonnes SL, et al. Longitudinal ultrasound curriculum improves long-term retention among internal medicine residents. J Grad Med Educ. 2015;7(3):454–7.CrossRef Kelm DJ, Ratelle JT, Azeem N, Bonnes SL, et al. Longitudinal ultrasound curriculum improves long-term retention among internal medicine residents. J Grad Med Educ. 2015;7(3):454–7.CrossRef
13.
go back to reference Schnobrich DJ, Mathews BK, Trappey BE, Muthyala BK, Olson AP. Entrusting internal medicine residents to use point of care ultrasound: Towards improved assessment and supervision. Med Teach. 2018:1–6. Schnobrich DJ, Mathews BK, Trappey BE, Muthyala BK, Olson AP. Entrusting internal medicine residents to use point of care ultrasound: Towards improved assessment and supervision. Med Teach. 2018:1–6.
14.
go back to reference Kimura BJ, Amundson SA, Phan JN, Agan DL, Shaw DJ. Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination. J Hosp Med. 2012;7(7):537–42.CrossRef Kimura BJ, Amundson SA, Phan JN, Agan DL, Shaw DJ. Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination. J Hosp Med. 2012;7(7):537–42.CrossRef
15.
go back to reference Kessler C, Bhandarkar S. Ultrasound training for medical students and internal medicine residents—A needs assessment. J Clin Ultrasound 2010;38(8):401–8.CrossRef Kessler C, Bhandarkar S. Ultrasound training for medical students and internal medicine residents—A needs assessment. J Clin Ultrasound 2010;38(8):401–8.CrossRef
16.
go back to reference Watson K, Lam A, Arishenkoff S, et al. Point of care ultrasound training for internal medicine: a Canadian multi-centre learner needs assessment study. BMC Med Educ. 2018;18(1):217.CrossRef Watson K, Lam A, Arishenkoff S, et al. Point of care ultrasound training for internal medicine: a Canadian multi-centre learner needs assessment study. BMC Med Educ. 2018;18(1):217.CrossRef
17.
go back to reference Peh WM, Kang ML. A pilot survey on an understanding of point of care bedside ultrasound (POCUS) among medical doctors in internal medicine: exposure, perceptions, interest and barriers to training. Proc Singap Healthc. 2018;27:85–95.CrossRef Peh WM, Kang ML. A pilot survey on an understanding of point of care bedside ultrasound (POCUS) among medical doctors in internal medicine: exposure, perceptions, interest and barriers to training. Proc Singap Healthc. 2018;27:85–95.CrossRef
18.
go back to reference Levine M. Point-of-care ultrasound in internal medicine. Can J Gen Intern Med 2017;12:6. Levine M. Point-of-care ultrasound in internal medicine. Can J Gen Intern Med 2017;12:6.
19.
go back to reference Bhagra A, Tierney DM, Sekiguchi H, Soni NJ. Point-of-care ultrasonography for primary care physicians and general internists. Mayo Clin Proc. 2016;91:1811–27.CrossRef Bhagra A, Tierney DM, Sekiguchi H, Soni NJ. Point-of-care ultrasonography for primary care physicians and general internists. Mayo Clin Proc. 2016;91:1811–27.CrossRef
20.
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):e51-e69.CrossRef 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):e51-e69.CrossRef
23.
go back to reference Riley KA, Nuttall DL. Measuring quality. Education Indicators - United Kingdon and International Perspectives. New York: Routledge; 1994. Riley KA, Nuttall DL. Measuring quality. Education Indicators - United Kingdon and International Perspectives. New York: Routledge; 1994.
24.
go back to reference Cooke M, Irby DM, Sullivan W, Ludmerer KM. American medical education 100 years after the Flexner Report. N Engl J Med. 2006;355:1339–44.CrossRef Cooke M, Irby DM, Sullivan W, Ludmerer KM. American medical education 100 years after the Flexner Report. N Engl J Med. 2006;355:1339–44.CrossRef
25.
go back to reference Christensen CM, Bohmer R, Kenagy J. Will disruptive innovations cure health care? Harvard Bus Rev. 2000;78:102–12. Christensen CM, Bohmer R, Kenagy J. Will disruptive innovations cure health care? Harvard Bus Rev. 2000;78:102–12.
26.
go back to reference Lin M, Thoma B, Trueger NS, Ankel F, Sherbino J, Chan T. Quality indicators for blogs and podcasts used in medical education: modified Delphi consensus recommendations by an international cohort of health professions educators. Postgrad Med J. 2015;91:546–50.CrossRef Lin M, Thoma B, Trueger NS, Ankel F, Sherbino J, Chan T. Quality indicators for blogs and podcasts used in medical education: modified Delphi consensus recommendations by an international cohort of health professions educators. Postgrad Med J. 2015;91:546–50.CrossRef
27.
go back to reference Ma IWY, Arishenkoff S, Wiseman J, et al. Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group. J Gen Intern Med. 2017;32(9):1052–57.CrossRef Ma IWY, Arishenkoff S, Wiseman J, et al. Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group. J Gen Intern Med. 2017;32(9):1052–57.CrossRef
28.
go back to reference Kuh GD, Pace CR, Vesper N. The development of process indicators to estimate student gains associated with good practices in undergraduate education. Res High Educ. 1997;38:435–54.CrossRef Kuh GD, Pace CR, Vesper N. The development of process indicators to estimate student gains associated with good practices in undergraduate education. Res High Educ. 1997;38:435–54.CrossRef
29.
go back to reference Blank RK. Developing a system of education indicators: selecting, implementing, and reporting indicators. Educ Eval Policy Anal. 1993;15:65–80.CrossRef Blank RK. Developing a system of education indicators: selecting, implementing, and reporting indicators. Educ Eval Policy Anal. 1993;15:65–80.CrossRef
31.
go back to reference Stern JD, Hall G. Education development at the federal Level. . In: CES O, USA Department of Education, ed.; 1987. Stern JD, Hall G. Education development at the federal Level. . In: CES O, USA Department of Education, ed.; 1987.
34.
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. 2017;39(1);14–19.CrossRef 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. 2017;39(1);14–19.CrossRef
35.
go back to reference Kirkpatrick DL, Kirkpatrick JD. Evaluating Training Programs: The Four Levels. 3rd ed. San Francisco: Berrett-Koehler Publishers, Inc; 2006. Kirkpatrick DL, Kirkpatrick JD. Evaluating Training Programs: The Four Levels. 3rd ed. San Francisco: Berrett-Koehler Publishers, Inc; 2006.
36.
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(4):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(4):401–9.CrossRef
37.
go back to reference Ultrasound guidelines: emergency, point-of-care and clinical ultrasound guidelines in medicine. Ann Emerg Med. 2017;69(5):e27-e54. Ultrasound guidelines: emergency, point-of-care and clinical ultrasound guidelines in medicine. Ann Emerg Med. 2017;69(5):e27-e54.
40.
go back to reference Arntfield RT, Millington SJ, Ainsworth CD, et al. Canadian recommendations for critical care ultrasound training and competency. Can Respir J. 2014;21:341–5.CrossRef Arntfield RT, Millington SJ, Ainsworth CD, et al. Canadian recommendations for critical care ultrasound training and competency. Can Respir J. 2014;21:341–5.CrossRef
41.
go back to reference Mukherjee N, Huge J, Sutherland WJ, et al. The Delphi technique in ecology and biological conservation: applications and guidelines. Methods Ecol Evol. 2015;6:1097–109.CrossRef Mukherjee N, Huge J, Sutherland WJ, et al. The Delphi technique in ecology and biological conservation: applications and guidelines. Methods Ecol Evol. 2015;6:1097–109.CrossRef
Metadata
Title
Education Indicators for Internal Medicine Point-of-Care Ultrasound: a Consensus Report from the Canadian Internal Medicine Ultrasound (CIMUS) Group
Authors
Anshula Ambasta
Marko Balan
Michael Mayette
Alberto Goffi
Sharon Mulvagh
Brian Buchanan
Steven Montague
Shannon Ruzycki
Irene W. Y. Ma
On behalf of the Canadian Internal Medicine Ultrasound (CIMUS) Group
Publication date
01-10-2019
Publisher
Springer International Publishing
Published in
Journal of General Internal Medicine / Issue 10/2019
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-019-05124-1

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