A review of training opportunities for ultrasonography in low and middle income countries.
OBJECTIVE
To review the current training opportunities for ultrasound use for health workers practising in low- and middle-income countries (LMICs).


METHODS
A PubMed search using terms ultrasound, sonography, echocardiography, developing country/countries, developing world, low resource settings, low income country/countries, training and education was conducted. Articles from 2000 to 2011 that included data on ultrasonography training were eligible for inclusion.


RESULTS
This review shows that most ultrasound scans are performed by generalist and obstetric physicians and even non-medical personnel with little to no formal training in ultrasonography. The spectrum of ultrasonography training described spanned from no formal training to formal certification and residency programmes. All courses included some component of didactics and hands-on training. Follow-up of trainee skills ranged from none, to telemedicine case review, to formal re-evaluations and intensive refresher courses. Ultrasonographic training in LMICs often does not meet the WHO criteria such as the number of scans under supervision and length of training programme recommended by WHO. Nevertheless, some programmes manage to have excellent outcomes with regard to diagnostic accuracy and retention of knowledge by trained personnel.


CONCLUSIONS
Regulation and quality control of training in ultrasound skills for those working in LMICs can be improved. Research on effective training and follow-up should be encouraged.
Department of Surgery, University of Washington, Seattle, WA, USA.
Lacey N
LN
LaGrone
Vijay
V
Sadasivam
Adam L
AL
Kushner
Reinou S
RS
Groen
D003906:Developing Countries; D004501:Education, Medical / Q000592:standards*; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007318:Inservice Training / Q000592:standards; D012923:Social Class; D014463:Ultrasonography / Q000592:standards*