.jpg "Tierra Smith, MD photo")
Tierra Smith, MD
Clinical Assistant Professor
University of Florida
Gainesville, Florida
Disclosure information not submitted.
Lindsay Beamon-Scott, MD
Assistant Professor
University of Rochester, United States
Disclosure information not submitted.
Maxwell Osei-Ampofo, MBChB, MBA, MPH, FGCS
Deputy CEO
Ghana National Ambulance Service, United States
Disclosure information not submitted.
Torben Becker, MD, PhD
Chief, Division of Critical Care Medicine
Shands Hospital - University of Florida
Gainesville, Florida
Disclosure information not submitted.
Title: Advanced Point of Care Ultrasonography Training for Emergency Physicians in Ghana
Introduction: Point of care ultrasound (POCUS) has become an increasingly vital tool for the medical practice in low-resource settings (LRS). POCUS has improved diagnostic accuracy in LRS, and the portability and affordability of this tool have made its widespread implementation more feasible. We report on the outcomes of advanced POCUS training in a low-resource setting.
Methods: The training took place twice over the course of 3 days in two locations in Ghana: Greater Accra Regional Hospital (Accra) and Komfo Anokye Teaching Hospital (Kumasi). Using a pretest, the participants were divided into two groups. The first group completed refresher lectures on Day 1 prior to joining the remaining advanced lectures on Days 2/3. The introductory lectures included the components of the rapid ultrasonography for shock and hypotension (RUSH) exam with an in-depth focus on echocardiography. The advanced lectures included the following: advanced point of care echocardiography, focused assessment with sonography for HIV associated tuberculosis, vascular access, advanced abdomen, ultrasound guided regional anesthesia (USGRA), DVT, and obstetrics. Following each morning of lectures, the groups received 4 hours of clinical practice in the afternoon. Upon completion of the course, the participants completed a survey.
Results: Out of 40 participants, 23 responded to the survey. The level of knowledge was ranked on a scale of 1 to 5 (1-poor, 2-fair, 3-satisfactory, 4-very good, 5-excellent). The rank of knowledge perceived before the course averaged 2.22 and after averaged 3.65. Additionally, 47.8% found advanced echocardiography most useful, followed by 30.4% and 17.4% finding RUSH and USGRA most useful, respectively. In the free text responses with regards to course improvement, the participants requested more sessions, more facilitators, longer courses, more hands-on practice, and more practice ultrasound machines.
Conclusions: The 3-day advanced ultrasound training had a perceived improvement in the ultrasound knowledge of the participants, with many participants requesting further training. This lecture series showed the continued interest and need for additional ultrasound teaching. Future steps include building further infrastructure to allow for a more self-sustainable ultrasound education process for physicians in Ghana.