Sustained knowledge acquisition among Rwandan physicians participating in six-month ultrasound training program

• Main Authors: P.C. Henwood*, E.R. Douglass, J.S. Rempell, A.F. Murray, A.S. Liteplo, D.C. Mackenzie, M.M. Leo, A.J. Dean, S. Vaillancourt, E. Krebs, D. Dukundane, S. Rulisa, V.E. Noble
• Format: Article
• Language: English
• Published: Elsevier 2013-12-01
• Series: African Journal of Emergency Medicine
• Online Access: http://www.sciencedirect.com/science/article/pii/S2211419X13001614

Point-of-care ultrasound (POCUS) is ideal for diagnostic use in resource-limited environments, but its use is often limited by lack of local expertise. Some training courses have been established to bridge this knowledge gap, but little is known about the efficacy of these courses. This study evaluated the effectiveness and sustainability of a six-month POCUS training program for Rwandan physicians. Methods: A prospective observational cohort study of Rwandan physicians was conducted over six-months. Participants completed a ten-day course introducing ultrasound skills, followed by a six-month clinical phase. Trainees used ultrasound independently with remote image review, completed regular observed structured clinical examinations (OSCE) in POCUS, and received ongoing feedback and web-based mentorship. An image-based assessment (IBA) was administered before and after the ten-day course, and again after six months. Hands-on image acquisition skills were assessed via OSCEs administered at four time points. All calculations were by paired t-test. Results: Seventeen Rwandan physicians completed the initial course. All completed the IBA prior to and at the completion of the training phase. Seven trainees were lost to follow up at the six-month mark due to reassignment. Ten trainees completed the six-month IBA. Mean scores on the IBA increased from 36.9% to 74.3% after the training phase (p = < .001) and to 85% (p = 0.04) at the end of the clinical phase. Ten trainees completed at least three OSCEs. The average score on the initial OSCE was 81.7%. Of ten trainees who completed at least three OSCEs, scores were preserved (mean 82.9%). Conclusions: Trainees demonstrated significant knowledge improvement after an intensive introductory ultrasound course, which increased through the training program. Mean OSCE scores remained above 80% throughout the course. Participants in an ultrasound training program with an initial training phase and periodic skill reinforcement can acquire and retain ultrasound knowledge and scanning skills.