Development of a critical care ultrasound curriculum using a mixed-methods needs assessment and engagement of frontline
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Development of a critical care ultrasound curriculum using a mixed-methods needs assessment and engagement of frontline healthcare professionals E´laboration d’un curriculum d’e´chographie pour les soins intensifs fonde´ sur l’e´valuation des besoins par me´thodes mixtes et l’implication des professionnels de la sante´ de premie`re ligne . Peter G. Brindley, MD . Sean M. Bagshaw, MD, MSc . Brian M. Buchanan, MD Aws Alherbish, MD . Vijay J. Daniels, MD, MSc Received: 22 April 2020 / Revised: 27 July 2020 / Accepted: 5 August 2020 Ó Canadian Anesthesiologists’ Society 2020
Abstract Purpose Experts recommend that critical care medicine (CCM) practitioners should be adept at critical care ultrasound (CCUS). Published surveys highlight that many institutions have no deliberate strategy, no formalized curriculum, and insufficient engagement of CCM faculty and trainees. Consequently, proficiency is non-uniform. Accordingly, we performed a needs assessment to develop an inter-professional standardized CCUS curriculum as a foundation towards universal basic fluency. Methods Mixed-methods study of CCM trainees, attendings, and nurse practitioners working across five academic and community medical-surgical intensive care units in Edmonton, Alberta. We used qualitative focus groups followed by quantitative surveys to explore, refine, and integrate results into a curriculum framework. Results Focus groups with 19 inter-professional practitioners identified major themes including perceived benefits, learning limitations, priorities, perceived risks, characteristics of effective instruction, ensuring long-term Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-020-01829-8) contains supplementary material, which is available to authorized users. B. M. Buchanan, MD (&) P. G. Brindley, MD S. M. Bagshaw, MD, MSc A. Alherbish, MD Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada e-mail: [email protected] V. J. Daniels, MD, MSc Department of Medicine, University of Alberta, Edmonton, AB, Canada
success, and achieving competency. Sub-themes highlighted rapid attrition of skill following one- to twoday workshops, lack of skilled faculty, lack of longitudinal training, and the need for site-based mentorship. Thirtyfive practitioners (35/70: 50%) completed the survey. Prior training included workshops (16/35; 46%) and selfteaching (11/35; 31%). Eleven percent (4/35) described concerns about potential errors in CCUS performance. The survey helped to refine resources, content, delivery, and assessment. Integration of qualitative and quantitative findings produced a comprehensive curriculum framework. Conclusion Building on published recommendations, our needs assessment identified additional priorities for a CCUS curriculum framework. Specifically, there is a perceived loss of skills following short workshops and insufficient strategies to sustain learning. Addressing these deficits co
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