Sustainable Resuscitation Ultrasound Education in a Low-Resource Environment: The Kumasi Experience

J Emerg Med. 2017 May;52(5):723-730. doi: 10.1016/j.jemermed.2017.01.050. Epub 2017 Mar 9.

Abstract

Background: Point-of-care-ultrasound (POCUS) is an increasingly important tool for emergency physicians and has become a standard component of emergency medicine residency training in high-income countries. Cardiopulmonary ultrasound (CPUS) is emerging as an effective way to quickly and accurately assess patients who present to the emergency department with shock and dyspnea. Use of POCUS, including CPUS, is also becoming more prevalent in low- and middle-income countries (LMICs); however, formal ultrasound training for emergency medicine resident physicians in these settings is not widely available.

Objectives: To evaluate the feasibility of integrating a high-intensity ultrasound training program into the formal curriculum for emergency medicine resident physicians in an LMIC.

Methods: We conducted a pilot ultrasound training program focusing on CPUS for 20 emergency medicine resident physicians in Kumasi, Ghana, which consisted of didactic sessions and hands-on practice. Competency was assessed by comparing pretest and posttest scores and with an Objective Structured Clinical Examination (OSCE) performed after the final training session.

Results: The mean score on the pretest was 61%, and after training, the posttest score was 96%. All residents obtained passing scores above 70% on the OSCE.

Conclusion: A high-intensity ultrasound training program can be successfully integrated into an emergency medicine training curriculum in an LMIC.

Keywords: cardiopulmonary ultrasound; dyspnea; education; emergency medicine; low-resource; resuscitation; shock; training.

MeSH terms

  • Clinical Competence / standards
  • Curriculum / trends
  • Developing Countries / economics
  • Educational Measurement / methods
  • Emergency Medicine / economics*
  • Emergency Medicine / education*
  • Emergency Medicine / methods
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / organization & administration
  • Ghana
  • Humans
  • Point-of-Care Systems / standards
  • Point-of-Care Systems / trends*
  • Teaching / education
  • Teaching / standards*
  • Ultrasonography / methods*