Mamdouh Souleymane1, Rajkumar Rajendram2,3, Naveed Mahmood1,4, Amro M T Ghazi5, Yousuf M S Kharal6, Arif Hussain7. 1. Department of Medicine, King Abdulaziz Medical City, King Abdulaziz International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia. 2. Department of Medicine, King Abdulaziz Medical City, King Abdulaziz International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia. rajkumarrajendram@doctors.org.uk. 3. College of Medicine, King Saud Bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia. rajkumarrajendram@doctors.org.uk. 4. College of Medicine, King Saud Bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia. 5. Department of Intensive Care, King Abdulaziz Medical City, King Abdulaziz International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia. 6. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. 7. Department of Cardiac Sciences, King Abdulaziz Medical City, King Abdulaziz International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
Abstract
BACKGROUND: Training in procedural skills is often suboptimal. The aim of this study was to quantify the needs of residents in internal medicine (IM), critical care (CC), and emergency medicine (EM) for instruction in ultrasound-guided procedures. METHODS: All IM, EM and CC residents (n = 200) at King Abdulaziz Medical City, Riyadh, Saudi Arabia, were invited to participate in a questionnaire-based survey to identify skill and experience gaps. The contribution of procedural skills to patient care (i.e. applicability) and proficiency in the sterile technique required to perform ultrasound-guided procedures were rated on Likert scales. Data on training, accreditation, and experience with and without ultrasound were collected. RESULTS: The overall response rate was 72% (IM 91%, CC 100%, EM 40%). Although the sample reported that procedural skills were very applicable, 19% (IM n = 25, EM n = 2) had not performed any procedures. However, five residents were accredited in point-of-care ultrasound, 61% of the sample had performed ultrasound-guided procedures and 65% had used landmark techniques. Whilst more internists had performed procedures using landmark techniques, CC and EM residents had performed more ultrasound-guided procedures. Whilst CC residents had not missed any opportunities to perform procedures because supervisors were less available, EM (6) and IM (89) residents had. Whilst skill gaps were only identified in the IM residency programme, experience gaps were present in all three residency programmes. The IM residency programme had larger experience gaps than the CC and EM programmes for all procedural skills. DISCUSSION: Residents in IM, CC and EM perceive that ultrasound-guided procedures are relevant to their practice. However, the IM residents performed fewer procedures than CC residents and EM residents at least partly because internists also lack skills in ultrasound. Training in ultrasound-guided procedures may reduce the use of landmark techniques and improve patient safety. Residents in IM, CC and EM therefore require training in ultrasound-guided procedures.
BACKGROUND: Training in procedural skills is often suboptimal. The aim of this study was to quantify the needs of residents in internal medicine (IM), critical care (CC), and emergency medicine (EM) for instruction in ultrasound-guided procedures. METHODS: All IM, EM and CC residents (n = 200) at King Abdulaziz Medical City, Riyadh, Saudi Arabia, were invited to participate in a questionnaire-based survey to identify skill and experience gaps. The contribution of procedural skills to patient care (i.e. applicability) and proficiency in the sterile technique required to perform ultrasound-guided procedures were rated on Likert scales. Data on training, accreditation, and experience with and without ultrasound were collected. RESULTS: The overall response rate was 72% (IM 91%, CC 100%, EM 40%). Although the sample reported that procedural skills were very applicable, 19% (IM n = 25, EM n = 2) had not performed any procedures. However, five residents were accredited in point-of-care ultrasound, 61% of the sample had performed ultrasound-guided procedures and 65% had used landmark techniques. Whilst more internists had performed procedures using landmark techniques, CC and EM residents had performed more ultrasound-guided procedures. Whilst CC residents had not missed any opportunities to perform procedures because supervisors were less available, EM (6) and IM (89) residents had. Whilst skill gaps were only identified in the IM residency programme, experience gaps were present in all three residency programmes. The IM residency programme had larger experience gaps than the CC and EM programmes for all procedural skills. DISCUSSION: Residents in IM, CC and EM perceive that ultrasound-guided procedures are relevant to their practice. However, the IM residents performed fewer procedures than CC residents and EM residents at least partly because internists also lack skills in ultrasound. Training in ultrasound-guided procedures may reduce the use of landmark techniques and improve patient safety. Residents in IM, CC and EM therefore require training in ultrasound-guided procedures.
Authors: Nilam J Soni; Ricardo Franco-Sadud; Ketino Kobaidze; Daniel Schnobrich; Gerard Salame; Joshua Lenchus; Venkat Kalidindi; Michael J Mader; Elizabeth K Haro; Ria Dancel; Joel Cho; Loretta Grikis; Brian P Lucas Journal: J Hosp Med Date: 2019-06-10 Impact factor: 2.960
Authors: Rajkumar Rajendram; Abdullah O Alrasheed; Abdulaziz A Boqaeid; Faris K Alkharashi; Salman S Qasim; Arif Hussain Journal: J Family Community Med Date: 2022-01-19