Abstract: SA-PO913

Integrative Point-of-Care Ultrasound (POCUS) Curriculum Imparts Diagnostic Skills Relevant to Nephrology

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research

Authors

  • Mullangi, Surekha Uma, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Sozio, Stephen M., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Menez, Steven, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Shafi, Tariq, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Background

The utility of POCUS has been expanding as a multipurpose diagnostic tool for nephrologists. However, a clear, nephrology-specific, curriculum has not been established. We have developed and implemented a POCUS curriculum that teaches focused skills to nephrology fellows. The goal of our study is to describe our initial experience with this innovative program.

Methods

The Johns Hopkins Renal Fellowship POCUS curriculum is a two-week elective that provides focused training to assess the following: heart (ejection fraction, pericardial effusion, chamber size), lungs (pulmonary edema, effusion, pneumothorax), inferior vena cava (diameter, collapsibility), kidney (size, echogenicity, hydronephrosis), bladder (volume), and fistula (depth, diameter). We teach these skills using a combination of didactic lectures, guided scanning, and independent scanning. We grade both image interpretation skills using a Qualtrics-based test and image acquisition skills using an POCUS-Objective Structured Clinical Examination (OSCE). Pre-tests and post-tests were administrated prior to and after completion of the program. Comfort with ultrasound skills was gauged using a 5-point Likert scale.

Results

12 fellows and trainees have so far started the course; 4 have completed all modules and the remaining are continuing training. Of the 4 who completed training, fellows were mean (sd) 7.3 (2.2) years after graduation from medical school. 25% of fellows had used POCUS before for diagnostic purposes, but none were formally trained in use. The fellows that completed the course reported significant improvement (p < 0.05) in assessing kidney pathology, bladder volume, ejection fraction, and pericardial effusion. Comparing pre-test to post-test scores, fellows felt significantly more comfortable identifying and assessing pathology across all domains following the course (2.40 (0.87) to 4.20 (0.65), p < 0.001). At the end of the course, 100% of fellows agreed or strongly agreed that POCUS was easy to obtain, improved assessment of patients, should be a part of the fellowship, and that other nephrology colleagues and faculty should be trained.

Conclusion

A 2-week nephrology-specific POCUS curriculum is feasible and enhances fellows’ learning experience.