Expanding Point-of-Care Ultrasound Training in a Low- and Middle-Income Country: Experiences From a Collaborative Short-Training Workshop in Kenya.

BACKGROUND AND OBJECTIVES: In Kenya, little data exists on point-of-care ultrasound (POCUS) training and use for family medicine physicians. In 2017, a 3-day POCUS workshop assembled most of the family medicine physicians in Kenya. Through surveys, we assessed how this workshop could affect the level of POCUS use, skill, and confidence in family medicine practitioners in the long term. METHODS: Structured surveys, distributed before, after, and 10 months postworkshop assessed demographics, POCUS use, barriers, comfort, and skills based on attendee self-assessment. We compared data from the preworkshop surveys to postsurveys and post-postsurveys to assess immediate and long-term differences. Wilcoxon signed-rank test was used to evaluate continuous data, and significance was based on a P value of <.05. RESULTS: The proportion of participants who self-reported using POCUS increased significantly between presurvey and post-postsurvey (29.7% to 63.2%, P=.0161). Mean confidence scores increased significantly from presurvey to postsurvey and post-postsurvey. For all body systems, self-reported mean skill scores increased significantly from presurvey to postsurvey and post-postsurvey. Lack of access to machines and mentorship are substantial barriers to increasing POCUS use. CONCLUSIONS: This study highlights the utility of one-time POCUS training in increasing long-term POCUS uptake by participants. While encouraging, our findings also show barriers to increasing POCUS use. These barriers must be addressed, potentially through intradepartmental and interorganizational exchanges of resources to ensure that future POCUS workshops are successful in supporting POCUS use in Kenya.

Point-of-Care Ultrasound in Resource-Limited Settings: Common Applications.

Point-of-care ultrasound (POCUS) is used increasingly in resource-limited settings (RLSs), particularly as inexpensive ultrasound machines and evidence-based protocols become more available. POCUS often is the only imaging modality available in such settings, and it has the potential to significantly affect patient care. This article discusses four case-based reviews of POCUS in RLSs for several common diseases: pediatric pneumonia; extrapulmonary tuberculosis; ectopic pregnancy; and tropical parasitic diseases, including echinococcus, schistosomiasis, and amebiasis. It concludes with a discussion of the logistical considerations specific to implementing POCUS in RLSs, particularly equipment and training. The literature reviewed suggests that POCUS has the potential to improve the diagnosis and management of multiple conditions in RLSs, although further research is needed.

Point-of-care ultrasound: Coming soon to primary care?

Point-of-care ultrasound (POCUS) has been gaining greater traction in recent years as a way to quickly (and cost-effectively) assess for conditions including systolic dysfunction, pleural effusion, abdominal aortic aneurysms (AAA), and deep vein thrombosis (DVT). It involves limited and specific ultrasound protocols performed at the bedside by the health care provider who is trying to answer a specific question and, thus, help guide treatment of the patient. In this article, we will review the evidence for the use of POCUS in 4 areas: the cardiovascular exam, the lung exam, the screening exam for AAAs, and the evaluation for DVT. For all of these applications, POCUS is safe, accurate, and beneficial and can be performed with a relatively small amount of training by non-radiology specialists, including family physicians.

Family Medicine Global Health Fellowship Competencies: A Modified Delphi Study.

BACKGROUND AND OBJECTIVES: Many US medical schools and family medicine departments have responded to a growing interest in global health by developing global health fellowships. However, there are no guidelines or consensus statements outlining competencies for global health fellows. Our objective was to develop a mission and core competencies for Family Medicine Global Health Fellowships. METHODS: A modified Delphi technique was used to develop consensus on fellowship competencies. A panel, comprised of 13 members with dual expertise in global health and medical education, undertook an iterative consensus process, followed by peer review, from April to December 2014. RESULTS: The panel developed a mission statement and identified six domains for family medicine global health fellowships: patient care, medical knowledge, professionalism, communication and leadership, teaching, and scholarship. Each domain includes a set of core and program-specific competencies. CONCLUSION: The family medicine global health competencies are intended to serve as an educational framework for the design, implementation, and evaluation of individual family medicine global health fellowship programs.