title: Barriers to ultrasound training in critical care medicine fellowships: a survey of program directors.
abstract: OBJECTIVE
  Ultrasonography is an effective tool for making quick diagnoses and guiding therapeutic procedures. National organizations have advocated increasing the use of critical care ultrasonography. The purpose of this study was to investigate the prevalence of teaching of critical care ultrasonography in fellowship programs. In addition, we hoped to identify barriers to establishment of ultrasound training programs.
  
  
  METHODS
  All pulmonary/critical care and critical care medicine (CCM) program directors in the United States were invited to participate in an online survey. We asked respondents for demographic information about their programs and perceived barriers to training, as well as current training opportunities for their fellows in five aspects of critical care ultrasonography. A five-point Likert scale was used for survey answers.
  
  
  METHODS
  Web-based survey.
  
  
  METHODS
  Pulmonary/critical care and CCM program directors in the United States.
  
  
  METHODS
  Web-based survey.
  
  
  RESULTS
  Ninety (66%) of 136 program directors responded. Ultrasonography training was offered by fellowship programs in the following areas: vascular access (98%), lung and pleural (74%), cardiac (55%), vascular diagnostic (33%), and abdominal (37%). Ninety-two percent of respondents agreed or strongly agreed that ultrasound training is useful, and 80% were interested in getting their fellows trained. Forty-one percent indicated that they lacked sufficient faculty trained in ultrasound use. Eighty-four percent agreed or strongly agreed that fellow turnover was an impediment to training. Forty-eight percent believed that cardiac echocardiography required a long training time.
  
  
  CONCLUSIONS
  Although ultrasound training in vascular access was nearly universal, training in other aspects of ultrasound was less prevalent. We identified several barriers, including fellow turnover, insufficient faculty training, and perceived length of time required for echocardiography training.
authors.affiliation: Division of Critical Care Medicine, Department of Medicine, Albert Einstein College of Medicine, Jay B. Langner Critical Care Service, Montefiore Medical Center, Bronx, NY, USA. leisen@gmail.com
authors.forename: Lewis A
authors.initials: LA
authors.lastname: Eisen
authors.forename: Sharon
authors.initials: S
authors.lastname: Leung
authors.forename: Annemarie E
authors.initials: AE
authors.lastname: Gallagher
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kvetan
mesh_terms: D003422:Critical Care / Q000458:organization & administration; D003625:Data Collection; D004502:Education, Medical, Continuing / Q000458:organization & administration; D005180:Faculty, Medical; D005257:Fellowships and Scholarships / Q000458:organization & administration; D006801:Humans; D010563:Personnel Turnover; D014463:Ultrasonography; D014481:United States