title: Ultrasound Skill and Application of Knowledge Assessment using an Innovative OSCE Competition-Based Simulation Approach.
abstract: BACKGROUND
  Despite Point-of Care Ultrasound (PoC US) rapidly becoming an important tool in perioperative medicine structured education, PoC US is currently rarely integrated into the anesthesiology residency curriculum. The aim of this project was to assess the current ultrasound skills of anesthesiology residents at one institution and evaluate the needs for development of a formal ultrasound curriculum.
  
  
  METHODS
  A event containing 6 different OSCE PoC US stations was developed with following stations: vascular, peripheral nerve block, lung ultrasound, transthoracic echocardiography (TTE) human model, pathologic TTE (simulator), and inferior vena cava (IVC) evaluation (simulator). The ability to obtain an US image or to interpret the US information was evaluated using a checklist and global rating scale. After IRB approval, anesthesiology residents participated in this event (n=30; PGY 2-4).
  
  
  RESULTS
  All residents were able to identify vascular structures and demonstrated sufficient ultrasound skill for lung anatomy IVC assessment. The lowest scores were observed for performing and interpreting TTE. There were no differences in resident ultrasound skills for all OSCE stations except minor differences between PGY 2 and PGY 4 in TTE pathology station. While more advanced residents had more clinical exposure to ultrasound for procedures and point-of-care diagnosis, we did not find growth in ultrasound skill level. Despite performing sufficient ultrasound guided peripheral nerve blocks, PGY 4 residents were not able to consistently identify common nerve block targets.
  
  
  CONCLUSIONS
  Our findings indicate that exposure and clinical use of ultrasound for procedures and point-of-care diagnosis is not sufficient for developing competency in PoC US and that a formal curriculum throughout the entire anesthesiology residency is needed to ensure PoC US competency.
authors.affiliation: Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: Rebel
authors.affiliation: Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
authors.forename: Habib
authors.initials: H
authors.lastname: Srour
authors.affiliation: Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: DiLorenzo
authors.affiliation: Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
authors.forename: Dung
authors.initials: D
authors.lastname: Nguyen
authors.affiliation: Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
authors.forename: Shelly
authors.initials: S
authors.lastname: Ferrell
authors.affiliation: Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Dwarakanatli
authors.affiliation: Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Haas
authors.affiliation: Department of Anesthesiology, University of Kentucky Medical Center, Lexington, KY, USA.
authors.forename: Randall M
authors.initials: RM
authors.lastname: Schell
keywords: Invasive Procedures; Objective Assessment; Objective Structured Clinical Examination; Resident Education; Transthoracic Ultrasound; Ultrasound