title: Institutional learning curve of surgeon-performed trauma ultrasound.
abstract: BACKGROUND
  Sonography has become the primary mode for the initial evaluation of abdominal injury in many trauma centers. However, the rate at which nonradiologists become proficient in this technique remains controversial.
  
  
  OBJECTIVE
  To assess the learning curve for this technique in a single institution.
  
  
  METHODS
  Retrospective review of sonographic examinations for trauma performed by senior surgical residents during a 24-month period at an American College of Surgeons-verified level I trauma center.
  
  
  METHODS
  University-affiliated private hospital.
  
  
  METHODS
  Before the initiation of a program of surgeon-performed trauma ultrasound, senior surgical residents (postgraduate years 4 and 5) received 11.5 hours of hands-on and didactic instruction in the focused ultrasound examination for trauma. This examination then became a standard component of the evaluation of injured patients. Subsequent groups of senior residents received 8 hours of instruction at the onset of new academic years, 6 and 18 months, respectively, after the initial course. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were then calculated for each 6-month period after the introduction of trauma sonography.
  
  
  RESULTS
  During the 24-month study period, 902 sonographic examinations were performed. No statistically significant differences were noted in sensitivity, specificity, accuracy, positive predictive value, or negative predictive value for any 6-month period of study when compared with the other 6-month periods or with the values calculated for the entire study period.
  
  
  CONCLUSIONS
  Senior surgical residents are capable of performing the focused ultrasound examination for trauma with a high level of skill after a concise introductory course. A learning curve was not apparent in our series. Criteria for being permitted to perform trauma sonography that include the requirement of a large number of examinations or extensive proctoring should be reassessed.
authors.affiliation: Department of Surgery, University of Kansas School of Medicine-Wichita 67214, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Smith
authors.forename: S J
authors.initials: SJ
authors.lastname: Kern
authors.forename: W R
authors.initials: WR
authors.lastname: Fry
authors.forename: S D
authors.initials: SD
authors.lastname: Helmer
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional