Ultrasound competency assessment in emergency medicine residency programs

Richard Amini, Srikar R Adhikari, Albert Fiorello

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objectives In the Model of the Clinical Practice of Emergency Medicine (EM), bedside ultrasound (US) is listed as one of the essential procedural skills. EM milestones released by Accreditation Council for Graduate Medical Education and American Board of Emergency Medicine require residents to demonstrate competency in bedside US. The purpose of this study was to assess the current methods used by EM residency training programs to evaluate resident competency in bedside US. Methods This was a cross-sectional survey study. A questionnaire on US education and competency assessment was electronically sent to all EM residency program directors and emergency US directors. The survey consisted of questions regarding the US rotation, structure of US curriculum, presence of US fellowship, image archiving, quality assurance methods, feedback, competency assessment tools, and frequency of assessment. The survey responses are reported as the percentages of total respondents along with 95% confidence intervals (CIs). Results A total of 124 of 161 EM residency programs participated in this study, representing a 77% response rate. Twenty-six percent (95% CI = 18% to 34%) of programs assess competency only at the end of the US rotation. Eight percent (95% CI = 3% to 13%) assess competency only every 6 months, and 13% (95% CI = 7% to 19%) assess competency only annually. Eight percent (95% CI = 3% to 13%) assess competency only during the final year of training. Thirty percent (95% CI = 22% to 38%) of programs assess competency with a combination of the above intervals, and 16% (95% CI = 10% to 22%) do not assess US competency. Fourteen percent (95% CI = 8% to 20%) use objective structured clinical examinations (OSCEs), and 21% (95% CI = 14% to 28%) use standardized direct observation tools (SDOTs) to assess resident competency in US. Approximately one-third (33%, 95% CI = 24% to 41%) of standardized testing for US competency is conducted with multiple-choice questions. Thirty percent (95% CI = 21% to 38%) administer practical examinations to assess US skills. Conclusions Currently, a majority of EM residency programs assess resident competency in bedside US. However, there is significant variation in the methods of competency assessment.

Original languageEnglish (US)
Pages (from-to)799-801
Number of pages3
JournalAcademic Emergency Medicine
Volume21
Issue number7
DOIs
StatePublished - 2014

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Emergency Medicine
Internship and Residency
Confidence Intervals
Cross-Sectional Studies
Graduate Medical Education
Education
Accreditation
Curriculum
Emergencies
Observation

ASJC Scopus subject areas

  • Emergency Medicine

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Ultrasound competency assessment in emergency medicine residency programs. / Amini, Richard; Adhikari, Srikar R; Fiorello, Albert.

In: Academic Emergency Medicine, Vol. 21, No. 7, 2014, p. 799-801.

Research output: Contribution to journalArticle

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abstract = "Objectives In the Model of the Clinical Practice of Emergency Medicine (EM), bedside ultrasound (US) is listed as one of the essential procedural skills. EM milestones released by Accreditation Council for Graduate Medical Education and American Board of Emergency Medicine require residents to demonstrate competency in bedside US. The purpose of this study was to assess the current methods used by EM residency training programs to evaluate resident competency in bedside US. Methods This was a cross-sectional survey study. A questionnaire on US education and competency assessment was electronically sent to all EM residency program directors and emergency US directors. The survey consisted of questions regarding the US rotation, structure of US curriculum, presence of US fellowship, image archiving, quality assurance methods, feedback, competency assessment tools, and frequency of assessment. The survey responses are reported as the percentages of total respondents along with 95{\%} confidence intervals (CIs). Results A total of 124 of 161 EM residency programs participated in this study, representing a 77{\%} response rate. Twenty-six percent (95{\%} CI = 18{\%} to 34{\%}) of programs assess competency only at the end of the US rotation. Eight percent (95{\%} CI = 3{\%} to 13{\%}) assess competency only every 6 months, and 13{\%} (95{\%} CI = 7{\%} to 19{\%}) assess competency only annually. Eight percent (95{\%} CI = 3{\%} to 13{\%}) assess competency only during the final year of training. Thirty percent (95{\%} CI = 22{\%} to 38{\%}) of programs assess competency with a combination of the above intervals, and 16{\%} (95{\%} CI = 10{\%} to 22{\%}) do not assess US competency. Fourteen percent (95{\%} CI = 8{\%} to 20{\%}) use objective structured clinical examinations (OSCEs), and 21{\%} (95{\%} CI = 14{\%} to 28{\%}) use standardized direct observation tools (SDOTs) to assess resident competency in US. Approximately one-third (33{\%}, 95{\%} CI = 24{\%} to 41{\%}) of standardized testing for US competency is conducted with multiple-choice questions. Thirty percent (95{\%} CI = 21{\%} to 38{\%}) administer practical examinations to assess US skills. Conclusions Currently, a majority of EM residency programs assess resident competency in bedside US. However, there is significant variation in the methods of competency assessment.",
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