title: Experience of a tutor centric model for sonography training of emergency department registrars in an Australian urban emergency department 2009-2012.
abstract: Purpose:To assess the impact of a regular sonographer proctored training program for emergency medicine trainees in the use of Emergency Department bedside ultrasoundMethods:Emergency Department (ED) Registrars in the Swan District Hospital ED were provided with proctored instruction in bedside ultrasound in performance of extended focused assessment sonography in trauma (eFAST) and abdominal aortic aneurysm (AAA) detection. Training was conducted by credentialed sonographers for individual trainees in a 1:1 or 1:2 setting for 1 hour on a weekly basis. Registrars who trained in the Department between Jan 2009 to Dec 2012 were invited to participate in a survey conducted between June-August 2013 designed to assess the impact of training on their confidence and use of bedside sonography.Results:Registrars reported increased perception of their skill level in AAA and eFAST post-training. High levels of confidence in their ability to adjust machine settings for image optimisation, recognition of free fluid in the abdomen and ability to recognise an AAA were also reported. The participants who completed at least 10 hours of training and at least 20 scans showed significantly greater improvement in their perception of skill and confidence levels than those with less time. Registrars reported training was of significant benefit, improving their confidence in obtaining good quality images and their understanding of the equipment, which contributed to them obtaining accreditation. Benefits were ongoing and 50% of participants reported using ultrasound in clinical practice at least 3 times per week and a further 30% at least weekly after leaving ED.Conclusion:Proctored training in the clinical context for ED registrars resulted in improvement in skills, confidence and willingness to maintain skills through practice in the clinical context over the long-term.
authors.affiliation: Emergency Department Swan Districts HospitalWA Department of HealthMiddle SwanWestern AustraliaAustralia; School of Medicine University of Notre Dame AustraliaFremantleWestern AustraliaAustralia.
authors.forename: Greg
authors.initials: G
authors.lastname: Sweetman
authors.affiliation: Burn Injury Research Unit School of Surgery University of Western Australia Perth Western Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Fear
authors.affiliation: School of Medicine University of Notre Dame Australia Fremantle Western Australia Australia.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hird
keywords: Australia; education; emergency medicine; registrars; sonography