Intensive point-of-care ultrasound training with long-term follow-up in a cohort of Rwandan physicians

• Published in: Tropical medicine & international health 2016-12, Vol.21 (12), p.1531
• Main Authors: Henwood, Patricia C, Mackenzie, David C, Rempell, Joshua S, Douglass, Emily, Dukundane, Damas, Liteplo, Andrew S, Leo, Megan M, Murray, Alice F, Vaillancourt, Samuel, Dean, Anthony J, Lewiss, Resa E, Rulisa, Stephen, Krebs, Elizabeth, Raja Rao, A K, Rudakemwa, Emmanuel, Rusanganwa, Vincent, Kyanmanywa, Patrick, Noble, Vicki E
• Format: Article
• Language: English
• Subjects: Clinical medicine; Occupational training; Physicians; Ultrasonic imaging
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.12780

Objective We delivered a point-of-care ultrasound training programme in a resource-limited setting in Rwanda, and sought to determine participants' knowledge and skill retention. We also measured trainees' assessment of the usefulness of ultrasound in clinical practice. Methods This was a prospective cohort study of 17 Rwandan physicians participating in a point-of-care ultrasound training programme. The follow-up period was 1 year. Participants completed a 10-day ultrasound course, with follow-up training delivered over the subsequent 12 months. Trainee knowledge acquisition and skill retention were assessed via observed structured clinical examinations (OSCEs) administered at six points during the study, and an image-based assessment completed at three points. Results Trainees reported minimal structured ultrasound education and little confidence using point-of-care ultrasound before the training. Mean scores on the image-based assessment increased from 36.9% (95% CI 32-41.8%) before the initial 10-day training to 74.3% afterwards (95% CI 69.4-79.2; P < 0.001). The mean score on the initial OSCE after the introductory course was 81.7% (95% CI 78-85.4%). The mean OSCE performance at each subsequent evaluation was at least 75%, and the mean OSCE score at the 58-week follow up was 84.9% (95% CI 80.9-88.9%). Conclusions Physicians providing acute care in a resource-limited setting demonstrated sustained improvement in their ultrasound knowledge and skill 1 year after completing a clinical ultrasound training programme. They also reported improvements in their ability to provide patient care and in job satisfaction. Objectif Nous avons mené un programme de formation en échographie au point des soins dans un cadre à ressources limitées au Rwanda et avons cherché à déterminer les connaissances et les compétences acquises des participants. Nous avons également mesuré l'évaluation par les stagiaires de l'utilité de l'échographie dans la pratique clinique. Méthodes Il s'agit d'une étude de cohorte prospective sur 17 médecins rwandais participant à un programme de formation en échographie au point des soins. La période de suivi a été d'un an. Les participants ont complété un cours de 10 jours sur l'échographie, avec une formation de suivi assurée au cours des 12 mois suivants. L'acquisition des connaissances et la rétention des compétences par les stagiaires ont été évaluées par des observations d'examens cliniques structurés (OSCE) effectuées lors de 6 périodes au