Critical care ultrasound training: a survey of US fellowship directors.
OBJECTIVE
The purpose of this study is to describe the current state of bedside ultrasound use and training among critical care (CC) training programs in the United States.


METHODS
This was a cross-sectional survey of all program directors for Accreditation Council for Graduate Medical Education accredited programs during the 2012 to 2013 academic year in CC medicine, surgical CC, pulmonary and critical care, and anesthesia CC. Availability, current use, and barriers to training in CC ultrasound were assessed.


RESULTS
Sixty of 195 (31%; 95% confidence interval [CI], 24%-38%) program directors responded. Most of the responding programs had an ultrasound system available for use (54/60, 90%; 95% CI, 79%-96%) and identified ultrasound training as useful (59/60, 98%; 95% CI, 91%-100%) but lacked a formal curriculum (25/60, 42%; 95% CI, 29%-55%) or trained faculty (mean percentage of faculty trained in ultrasound: pulmonary and critical care, 25%; surgical CC, 33%; anesthesia CC, 20%; CC medicine, 7%), and relied on informal teaching (45/60, 77%; 95% CI, 62%-85%). Faculty with expertise (53/60, 88%; 95% CI, 77%-95%), simulation training (60/60, 100%; 95% CI, 94%-100%), establishing and meeting required number of examinations (47/60, 78%; 95% CI, 66%-88%), and regular review sessions (49/60, 82%; 95% CI, 70%-90%) were identified as necessary to improve ultrasound training. Most responding programs (32/35 91%; 95% CI, 77%-98%) without a formal curriculum plan to create one in the next 5 years.


CONCLUSIONS
This study identified deficiencies in current training, suggesting a need for a formal curriculum for bedside ultrasound training in CC fellowship programs.
Section of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85721; Department of Emergency Medicine, University of Arizona, 1609 N. Warren Ave, Tucson, AZ 85724. Electronic address: jmosier@aemrc.arizona.edu.
Jarrod M
JM
Mosier
Section of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85721.
Josh
J
Malo
Department of Emergency Medicine, University of Arizona, 1609 N. Warren Ave, Tucson, AZ 85724.
Lori A
LA
Stolz
Section of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85721.
John W
JW
Bloom
Section of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85721.
Nathaniel A
NA
Reyes
Section of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85721.
Linda S
LS
Snyder
Department of Emergency Medicine, University of Arizona, 1609 N. Warren Ave, Tucson, AZ 85724.
Srikar
S
Adhikari
D000068:Accreditation; D003422:Critical Care; D003430:Cross-Sectional Studies; D003625:Data Collection; D005180:Faculty, Medical / Q000600:supply & distribution; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D019095:Point-of-Care Systems; D014465:Ultrasonics / Q000193:education* / Q000458:organization & administration / Q000706:statistics & numerical data; D014481:United States
Bedside ultrasound education; Bedside ultrasound training; Critical care fellowship; Curriculum; Fellowship training; Survey