Dataset Information

Recommendations for Lung Ultrasound in Internal Medicine.

ABSTRACT: A growing amount of evidence prompts us to update the first version of recommendations for lung ultrasound in internal medicine (POLLUS-IM) that was published in 2018. The recommendations were established in several stages, consisting of: literature review, assessment of literature data quality (with the application of QUADAS, QUADAS-2 and GRADE criteria) and expert evaluation carried out consistently with the modified Delphi method (three rounds of on-line discussions, followed by a secret ballot by the panel of experts after each completed discussion). Publications to be analyzed were selected from the following databases: Pubmed, Medline, OVID, and Embase. New reports published as of October 2019 were added to the existing POLLUS-IM database used for the original publication of 2018. Altogether, 528 publications were systematically reviewed, including 253 new reports published between September 2017 and October 2019. The new recommendations concern the following conditions and issues: pneumonia, heart failure, monitoring dialyzed patients' hydration status, assessment of pleural effusion, pulmonary embolism and diaphragm function assessment. POLLUS-IM 2020 recommendations were established primarily for clinicians who utilize lung ultrasound in their everyday clinical work.

SUBMITTER: Buda N

PROVIDER: S-EPMC7460159 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Recommendations for Lung Ultrasound in Internal Medicine.

Buda Natalia N Kosiak Wojciech W Wełnicki Marcin M Skoczylas Agnieszka A Olszewski Robert R Piotrkowski Jakub J Skoczyński Szymon S Radzikowska Elżbieta E Jassem Ewa E Grabczak Elżbieta Magdalena EM Kwaśniewicz Piotr P Mathis Gebhard G Toma Tudor P TP

Diagnostics (Basel, Switzerland) 20200816 8

A growing amount of evidence prompts us to update the first version of recommendations for lung ultrasound in internal medicine (POLLUS-IM) that was published in 2018. The recommendations were established in several stages, consisting of: literature review, assessment of literature data quality (with the application of QUADAS, QUADAS-2 and GRADE criteria) and expert evaluation carried out consistently with the modified Delphi method (three rounds of on-line discussions, followed by a secret ball ...[more]

PMID: 32824302

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Project description:BackgroundCurriculum development and implementation for internal medicine point-of-care ultrasound (IM POCUS) continues to be a challenge for many residency training programs. Education indicators may provide a useful framework to support curriculum development and implementation efforts across programs in order to achieve a consistent high-quality educational experience.ObjectiveThis study seeks to establish consensus-based recommendations for education indicators for IM POCUS training programs in Canada.DesignThis consensus study uses a modified nominal group technique for voting in the initial round, followed by two additional rounds of online voting, with consensus defined as agreement by at least 80% of the participants.ParticipantsParticipants were 22 leaders with POCUS and/or education expertise from 13 Canadian internal medicine residency programs across 7 provinces.Main measuresEducation indicators considered were those that related to aspects of the POCUS educational system, could be presented by a single statistical measure, were readily understood, could be reliably measured to provide a benchmark for measuring change, and represented a policy issue. We excluded a priori indicators with low feasibility, are impractical, or assess learner reactions. Candidate indicators were drafted by two academic internists with post-graduate training in POCUS and medical education. These indicators were reviewed by two internists with training in quality improvement prior to presentation to the expert participants.Key resultsOf the 52 candidate education indicators considered, 6 reached consensus in the first round, 12 in the second, and 4 in the third round. Only 5 indicators reached consensus to be excluded; the remaining indicators did not reach consensus.ConclusionsThe Canadian Internal Medicine Ultrasound (CIMUS) group recommends 22 education indicators be used to guide and monitor internal medicine POCUS curriculum development efforts in Canada.

Project description:BackgroundIncorporating ultrasound into the clinical curriculum of undergraduate medical education has been limited by a need for faculty support. Without integration into the clinical learning environment, ultrasound skills become a stand-alone skill and may decline by the time of matriculation into residency. A less time intensive ultrasound curriculum is needed to preserve skills acquired in preclinical years. We aimed to create a self-directed ultrasound curriculum to support and assess students' ability to acquire ultrasound images and to utilize ultrasound to inform clinical decision-making.MethodsThird year students completed the self-directed ultrasound curriculum during their required internal medicine clerkship. Students used Butterfly iQ+ portable ultrasound probes. The curriculum included online modules that focused on clinical application of ultrasound as well as image acquisition technique. Students were graded on image acquisition quality and setting, a patient write-up focused on clinical decision-making, and a multiple-choice quiz. Student feedback was gathered with an end-of-course survey. Faculty time was tracked.ResultsOne hundred and ten students participated. Students averaged 1.79 (scale 0-2; SD = 0.21) on image acquisition, 78% (SD = 15%) on the quiz, and all students passed the patient write-up. Most reported the curriculum improved their clinical reasoning (72%), learning of pathophysiology (69%), and patient care (55%). Faculty time to create the curriculum was approximately 45 h. Faculty time to grade student assignments was 38.5 h per year.ConclusionsStudents were able to demonstrate adequate image acquisition, use of ultrasound to aid in clinical decision-making, and interpretation of ultrasound pathology with no in-person faculty instruction. Additionally, students reported improved learning of pathophysiology, clinical reasoning, and rapport with patients. The self-directed curriculum required less faculty time than prior descriptions of ultrasound curricula in the clinical years and could be considered at institutions that have limited faculty support.

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Recommendations for Lung Ultrasound in Internal Medicine.

Publications

Recommendations for Lung Ultrasound in Internal Medicine.

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