1887
Volume 2023, Issue 4
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Point-of-care ultrasound (POCUS) has been introduced in the training curricula of several residency programs. However, it is yet to be routinely integrated into general surgery (GS). This study aims to identify the attitudes of the GS Canadian academic community towards POCUS.

A multiple-choice survey was sent to all Canadian GS programs. The survey was comprised of three sections: baseline characteristics, current perceived knowledge of POCUS, and barriers to POCUS implementation.

The targeted sample included 609 surgeons and 593 residents (a total of 1202). Of these, 58 surgeons and 79 residents responded (11.3% response rate). Overall, only 5.2% reported using POCUS daily, and 44.8% of the staff surgeons reported never using POCUS. The most reported indications included extended focused assessment with sonography in trauma (eFAST) and the insertion of central lines. Staff surgeons were reluctant to operate solely on the findings of POCUS. The perceived sensitivity of POCUS for various surgical indications was significantly lower than that reported in the literature. Examples include diagnosing the etiology of shock where only 58.6% of staff and 50.6% of residents chose the correct answer reported in the literature for that indication. However, for diagnosing cholecystitis, only 46.6% of staff and 34% of residents responded correctly as per the literature. The majority of the residents (69.5%) believed that POCUS should be implemented in training programs. Perceived barriers to POCUS implementation included lack of time for training, lack of confidence in POCUS, and concerns about medicolegal consequences.

This study reveals the need to support POCUS training by GS residents despite their low current usage. Addressing barriers to its implementation and knowledge gaps regarding POCUS could lead to its wider adoption.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2023.36
2023-12-10
2024-11-04
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2023/4/jemtac.2023.36.html?itemId=/content/journals/10.5339/jemtac.2023.36&mimeType=html&fmt=ahah

References

  1. Mok D, Schwarz SKW, Rondi K. Point-of-care ultrasonography in Canadian anesthesiology residency programs: a national survey of program directors. Can J Anaesth. 2017; 64:(10):1023–36.
    [Google Scholar]
  2. Steinmetz P, Dobrescu O, Oleskevich S, Lewis J. Bedside ultrasound education in Canadian medical schools: a national survey. Can Med Educ J. 2016; 7:(1):e78–86.
    [Google Scholar]
  3. Micks T, Braganza D, Peng S, McCarthy P, Sue K, Doran P, et al. Canadian national survey of point-of-care ultrasound training in family medicine residency programs. Can Fam Physician. 2018; 64:(10):e462–7.
    [Google Scholar]
  4. Leschyna M, Hatam E, Britton S, Myslik F, Thompson D, Sedran R, et al. Current state of point-of-care ultrasound usage in Canadian Emergency Departments. Cureus. 2019; 11:(3):e4246.
    [Google Scholar]
  5. Arntfield R, Millington S, Ainsworth C, Arora R, Boyd J, Finlayson G, et al. Canadian recommendations for critical care ultrasound training and competency. Can Respir J. 2014; 21:(6):341–5.
    [Google Scholar]
  6. Clunie M, O’Brien J, Olszynski P, Bajwa J, Perverseff R. Competence of anesthesiology residents following a longitudinal point-of-care ultrasound curriculum. Can J Anaesth. 2022; 69:(4):460–71.
    [Google Scholar]
  7. LoPresti CM, Schnobrich DJ, Dversdal RK, Schembri F. A road map for point-of-care ultrasound training in internal medicine residency. Ultrasound J. 2019; 11:(1):10.
    [Google Scholar]
  8. [Google Scholar]
  9. Australia TRCoEMo. The use of focused ultrasound in emergency medicine. Canberra: Australia TRCoEMo; 2022. https://acem.org.au/getmedia/000b84ee-378f-4b65-a9a7-c174651c2542/Feb_16_P21_Use_of_Focussed_US_in_EM.aspx
    [Google Scholar]
  10. [Google Scholar]
  11. Gustafsson C, Lindelius A, Torngren S, Jarnbert-Pettersson H, Sonden A. Surgeon-performed ultrasound in diagnosing acute cholecystitis and appendicitis. World J Surg. 2018; 42:(11):3551–9.
    [Google Scholar]
  12. Carroll PJ, Gibson D, El-Faedy O, Dunne C, Coffey C, Hannigan A, et al. Surgeon-performed ultrasound at the bedside for the detection of appendicitis and gallstones: systematic review and meta-analysis. Am J Surg. 2013; 205:(1):102–8.
    [Google Scholar]
  13. Canada TRCoPaSo. General Surgery Competencies. Ottawa: Canada TRCoPaSo; 2023. https://www.royalcollege.ca/rcsite/documents/ibd/general-surgery-competencies-e.pdf
    [Google Scholar]
  14. Keikha M, Salehi-Marzijarani M, Soldoozi Nejat R, Sheikh Motahar Vahedi H, Mirrezaie SM. Diagnostic accuracy of rapid ultrasound in shock (RUSH) exam: a systematic review and meta-analysis. Bull Emerg Trauma. 2018; 6:(4):271–8.
    [Google Scholar]
  15. Gustafsson C, McNicholas A, Sonden A, Torngren S, Jarnbert-Pettersson H, Lindelius A. Accuracy of surgeon-performed ultrasound in detecting gallstones: a validation study. World J Surg. 2016; 40:(7):1688–94.
    [Google Scholar]
  16. Summers SM, Scruggs W, Menchine MD, Lahham S, Anderson C, Amr O, et al. A prospective evaluation of emergency department bedside ultrasonography for the detection of acute cholecystitis. Ann Emerg Med. 2010; 56:(2):114–22.
    [Google Scholar]
  17. Sharif S, Skitch S, Vlahaki D, Healey A. Point-of-care ultrasound to diagnose appendicitis in a Canadian emergency department. CJEM. 2018; 20:(5):732–5.
    [Google Scholar]
  18. Pourmand A, Dimbil U, Drake A, Shokoohi H. The Accuracy of Point-of-care ultrasound in detecting small bowel obstruction in emergency department. Emerg Med Int. 2018; 2018::3684081.
    [Google Scholar]
  19. Subramaniam S, Bober J, Chao J, Zehtabchi S. Point-of-care ultrasound for diagnosis of abscess in skin and soft tissue infections. Acad Emerg Med. 2016; 23:(11):1298–306.
    [Google Scholar]
  20. Catena F, De Simone B, Coccolini F, Di Saverio S, Sartelli M, Ansaloni L. Bowel obstruction: a narrative review for all physicians. World J Emerg Surg. 2019; 14::20.
    [Google Scholar]
  21. Pereira J, Bass GA, Mariani D, Dumbrava BD, Casamassima A, da Silva AR, et al. Surgeon-performed point-of-care ultrasound for acute cholecystitis: indications and limitations: a European Society for Trauma and Emergency Surgery (ESTES) consensus statement. Eur J Trauma Emerg Surg. 2020; 46:(1):173–83.
    [Google Scholar]
  22. Russ B, Arthur J, Lewis Z, Snead G. A review of lawsuits related to point-of-care emergency ultrasound applications. J Emerg Med. 2022; 63:(5):661–72.
    [Google Scholar]
  23. Freitas ML, Frangos SG, Frankel HL. The status of ultrasonography training and use in general surgery residency programs. J Am Coll Surg. 2006; 202:(3):453–8.
    [Google Scholar]
  24. Beal EW, Sigmond BR, Sage-Silski L, Lahey S, Nguyen V, Bahner DP. Point-of-care ultrasound in general surgery residency training: a proposal for milestones in graduate medical education ultrasound. J Ultrasound Med. 2017; 36:(12):2577–84.
    [Google Scholar]
  25. Koichopolos J, Hilsden R, Myslik F, Thompson D, Vandelinde J, Leeper R. Surgeon attitudes toward point of care ultrasound for biliary disease: a nationwide Canadian survey. Can J Surg. 2020; 63:(1):E9–12.
    [Google Scholar]
/content/journals/10.5339/jemtac.2023.36
Loading
/content/journals/10.5339/jemtac.2023.36
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error