title: Getting It Right the First Time: Defining Regionally Relevant Training Curricula and Provider Core Competencies for Point-of-Care Ultrasound Education on the African Continent.
abstract: Significant evidence identifies point-of-care ultrasound (PoCUS) as an important diagnostic and therapeutic tool in resource-limited settings. Despite this evidence, local health care providers on the African continent continue to have limited access to and use of ultrasound, even in potentially high-impact fields such as obstetrics and trauma. Dedicated postgraduate emergency medicine residency training programs now exist in 8 countries, yet no current consensus exists in regard to core PoCUS competencies. The current practice of transferring resource-rich PoCUS curricula and delivery methods to resource-limited health systems fails to acknowledge the unique challenges, needs, and disease burdens of recipient systems. As emergency medicine leaders from 8 African countries, we introduce a practical algorithmic approach, based on the local epidemiology and resource constraints, to curriculum development and implementation. We describe an organizational structure composed of nexus learning centers for PoCUS learners and champions on the continent to keep credentialing rigorous and standardized. Finally, we put forth 5 key strategic considerations: to link training programs to hospital systems, to prioritize longitudinal learning models, to share resources to promote health equity, to maximize access, and to develop a regional consensus on training standards and credentialing.
authors.affiliation: InnovationsCZ, San Fransisco, CA; Global Health Emergency Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada; Eastern Congo Ultrasound Initiative, Goma, Democratic Republic of Congo; African Federation of Emergency Medicine Ultrasound Section. Electronic address: margiesalmon@gmail.com.
authors.forename: Margaret
authors.initials: M
authors.lastname: Salmon
authors.affiliation: Global Health Emergency Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada; Toronto-Addis Ababa Academic Collaboration in Emergency Medicine, Toronto, Ontario, Canada.
authors.forename: Megan
authors.initials: M
authors.lastname: Landes
authors.affiliation: Global Health Emergency Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada; Toronto-Addis Ababa Academic Collaboration in Emergency Medicine, Toronto, Ontario, Canada; Schwartz/Reisman Emergency Medicine Centre, Mt. Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Hunchak
authors.affiliation: Department of Obstetrics, HEAL Africa Hospital, Goma, Democratic Republic of Congo.
authors.forename: Justin
authors.initials: J
authors.lastname: Paluku
authors.affiliation: Department of Surgery and Trauma and the Department of Emergency Medicine, HEAL Africa Hospital, Goma, Democratic Republic of Congo.
authors.forename: Luc
authors.initials: L
authors.lastname: Malemo Kalisya
authors.affiliation: InnovationsCZ, San Fransisco, CA; Department of Industrial Engineering, Western New England University, Springfield, MA.
authors.forename: Christian
authors.initials: C
authors.lastname: Salmon
authors.affiliation: Department of Emergency Medicine, African Federation of Emergency Medicine, Muhimbili National Hospital, Dar Es Salaam, Tanzania.
authors.forename: Mundenga Mutendi
authors.initials: MM
authors.lastname: Muller
authors.affiliation: Emergency Medicine Kenya Foundation and Aga Khan University, Nairobi, Kenya.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wachira
authors.affiliation: Department of Emergency Medicine, Mount Sinai St. Luke's Mount Sinai West, New York, NY.
authors.forename: James
authors.initials: J
authors.lastname: Mangan
authors.affiliation: Center of Research for Infectious Diseases, Faculty of Health Science, and Pediatrics, Universidade Catolica de Mocamabique, Beira, Mocambique.
authors.forename: Kajal
authors.initials: K
authors.lastname: Chhaganlal
authors.affiliation: Uganda National Ambulance Services, Ministry of Health, Kampala, Uganda.
authors.forename: Joseph
authors.initials: J
authors.lastname: Kalanzi
authors.affiliation: Tikur Anbessa Specialized Hospital Emergency Department, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Toronto-Addis Ababa Academic Collaboration in Emergency Medicine, Toronto, Ontario, Canada.
authors.forename: Aklilu
authors.initials: A
authors.lastname: Azazh
authors.affiliation: Global Health Emergency Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada; Toronto-Addis Ababa Academic Collaboration in Emergency Medicine, Toronto, Ontario, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: Berman
authors.affiliation: Department of Emergency Medicine, Suez Canal University, Ismailia, Egypt.
authors.forename: El-Sayed
authors.initials: ES
authors.lastname: Zied
authors.affiliation: Division of Emergency Medicine Faculties of Medicine and Health Sciences, Stellenbosch University of Cape Town, South Africa.
authors.forename: Hein
authors.initials: H
authors.lastname: Lamprecht
mesh_terms: D000349:Africa; D000465:Algorithms; D002983:Clinical Competence; D003479:Curriculum; D003906:Developing Countries; D004635:Emergency Medicine / Q000193:education / Q000458:organization & administration; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards; D019095:Point-of-Care Systems; D014463:Ultrasonography