Focused cardiac ultrasound: Competency among pre‐internship medical officers in diagnosing cardiac causes of dyspnea

Author:

Muriuki Daniel1ORCID,Kagima Jacqueline2,Mugera Anne3,Joekes Elizabeth4,Kwasa Thomas5,Joshi Mark David5

Affiliation:

1. Masters of Medicine Internal Medicine The University of Nairobi Nairobi Kenya

2. Department of Pulmonology and Critical Care Kenyatta National Hospital Nairobi Kenya

3. Department of Critical Care and Cardiology Kenyatta National Hospital Nairobi Kenya

4. Liverpool School of Tropical Medicine Liverpool United Kingdom

5. Faculty of Health Sciences Department of Clinical Medicine and Therapeutics The University of Nairobi Nairobi Kenya

Abstract

AbstractBackgroundDifferentiating cardiovascular causes of dyspnea in resource‐limited healthcare settings can be challenging. The use of easy‐to‐train, point‐of‐care, focused cardiac ultrasound (FoCUS) protocols may potentially alleviate this challenge.Research QuestionCan novices attain competency in FoCUS use after training using the cardiac ultrasound for resource‐limited settings (CURLS) protocol?MethodsA quasi‐experimental study was conducted at the Kenyatta National Hospital in Nairobi, Kenya. Forty‐five graduate medical pre‐interns, novices in cardiac ultrasound, received simulated didactic and hands‐on FoCUS skills training using the CURLS protocol and 2018 European Association of Cardiovascular Imaging (EACVI) FoCUS training and competence assessment recommendations. Competency was assessed in image interpretation, image acquisition, and image quality.ResultsAggregate image interpretation competency was attained by n = 38 (84%) of trainees with a median score of 80%. The proportion of trainees attaining category‐specific image interpretation competency was as follows: pericardial effusion n = 44 (98%), left atrial enlargement n = 40 (89%), cardiomyopathy n = 38 (84%), left ventricular hypertrophy n = 37 (82%), and right ventricular enlargement n = 29 (64%). Image acquisition skills competency was attained by n = 36 (80%) of trainees. Three‐quarters of trainee‐obtained images were of good quality.ConclusionMajority of the trainees attained competency. Training constraints limit the generalizability of our findings.

Publisher

Wiley

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