title: Intensive point-of-care ultrasound training with long-term follow-up in a cohort of Rwandan physicians.
abstract: We delivered a point-of-care ultrasound training programme in a resource-limited setting in Rwanda, and sought to determine participants' knowledge and skill retention. We also measured trainees' assessment of the usefulness of ultrasound in clinical practice.
  
  
  
  This was a prospective cohort study of 17 Rwandan physicians participating in a point-of-care ultrasound training programme. The follow-up period was 1 year. Participants completed a 10-day ultrasound course, with follow-up training delivered over the subsequent 12 months. Trainee knowledge acquisition and skill retention were assessed via observed structured clinical examinations (OSCEs) administered at six points during the study, and an image-based assessment completed at three points.
  
  
  
  Trainees reported minimal structured ultrasound education and little confidence using point-of-care ultrasound before the training. Mean scores on the image-based assessment increased from 36.9% (95% CI 32-41.8%) before the initial 10-day training to 74.3% afterwards (95% CI 69.4-79.2; P < 0.001). The mean score on the initial OSCE after the introductory course was 81.7% (95% CI 78-85.4%). The mean OSCE performance at each subsequent evaluation was at least 75%, and the mean OSCE score at the 58-week follow up was 84.9% (95% CI 80.9-88.9%).
  
  
  
  Physicians providing acute care in a resource-limited setting demonstrated sustained improvement in their ultrasound knowledge and skill 1 year after completing a clinical ultrasound training programme. They also reported improvements in their ability to provide patient care and in job satisfaction.
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.|Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Henwood
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.|Department of Emergency Medicine, Maine Medical Center, Portland, OR, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Mackenzie
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.|Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Rempell
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Douglass
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.|University Teaching Hospital of Kigali, Kigali, Rwanda.
authors.forename: Damas
authors.initials: D
authors.lastname: Dukundane
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Liteplo
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.|Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA.
authors.forename: Megan M
authors.initials: MM
authors.lastname: Leo
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.|Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA.
authors.forename: Alice F
authors.initials: AF
authors.lastname: Murray
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.|Department of Emergency Medicine, St. Michael's Hospital, Toronto, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Vaillancourt
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.|Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Dean
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.|Department of Emergency Medicine, University of Colorado, Denver, CO, USA.
authors.forename: Resa E
authors.initials: RE
authors.lastname: Lewiss
authors.affiliation: University Teaching Hospital of Kigali, Kigali, Rwanda.
authors.forename: Stephen
authors.initials: S
authors.lastname: Rulisa
authors.affiliation: Department of Emergency Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Krebs
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Raja Rao
authors.affiliation: King Faisal Specialist Hospital, Kigali, Rwanda.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Rudakemwa
authors.affiliation: Ministry of Health, Kigali, Rwanda.
authors.forename: Vincent
authors.initials: V
authors.lastname: Rusanganwa
authors.affiliation: University of Rwanda, Butare, Rwanda.
authors.forename: Patrick
authors.initials: P
authors.lastname: Kyanmanywa
authors.affiliation: Point-of-Care Ultrasound in Resource Limited Environments, Boston, MA, USA.|Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Vicki E
authors.initials: VE
authors.lastname: Noble
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004493:Education; D004521:Educational Measurement; D006801:Humans; D007588:Job Satisfaction; D010808:Physical Examination; D010820:Physicians; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012432:Rwanda; D014463:Ultrasonography
keywords: Ruanda; Rwanda; curriculum; educación; education; global health; salud global; santé mondiale; ultrasonido; ultrasound; échographie; éducation