Christan Santos, MSN, FNP-BC
Nurse Practitioner
Mayo Clinic Hospital in Florida
Jacksonville, Florida
Disclosure information not submitted.
Sarah Peacock, DNP, ACNP
Nurse Practitioner
Mayo Clinic Hospital in Florida
Jacksonville, Florida, United States
Disclosure information not submitted.
Nikki Matos, DNP, FNP-BC
Nurse Practitioner
Mayo Clinic, United States
Disclosure information not submitted.
Ami Grek, DNP, ACNP
Nurse Practitioner
Mayo Clinic, United States
Disclosure information not submitted.
Title: Advanced Practice Provider Onboarding: Implementation of a Simulation-Based Ultrasound Curriculum
Introduction: Point-of care ultrasound (POCUS) is a commonly used clinical tool in the intensive care unit (ICU) as it provides rapid and reliable bedside diagnostics. Unlike medical programs, the integration of ultrasound training in advanced practice provider (APP) curricula is limited and inconsistent. To meet this gap in knowledge, we developed and implemented a simulation-based POCUS curriculum as part of the onboarding process for all APPs within the Department of Critical Care Medicine.
Methods: Competency objectives were created targeting ultrasound orientation and knobology, bedside echocardiography, lung exam, focused assessment with sonography in trauma (FAST), optic nerve sheath, and procedural needle guidance. Each preceptor was provided this competency worksheet to assess the onboarding APP’s baseline skills and progress throughout orientation, detailing the APP at a competency level of 1 (novice), 2 (needs minimal assistance), or 3 (independent). Within the first month of hire, the onboarding APP was provided a didactic lesson on ultrasound knobology, probe manipulation, and basic ultrasound views followed by a four-hour, one-on-one simulation course on a standardized patient model in our simulation center. The instructor was an expert APP who was previously trained and deemed competent in POCUS. Upon completion of simulation training, the new APPs performed POCUS on ICU patients under the direct supervision of an expert APP to gain further experience.
Results: Over the past 4 years, 7 onboarding APPs have completed this training with 100% advancing at least one level of ultrasound competency after the simulation training. Each APP was able to navigate the ultrasound machine, correctly identify the appropriate transducer for the associated exams, as well as independently obtain parasternal, apical, and subxiphoid cardiac windows, identify pleural sliding, and perform a FAST exam by the end of the simulation.
Conclusion: After review of both formal and informal evaluations, this course demonstrated to be a successful method to provide APPs with basic ultrasound training during onboarding. In evaluations, 100% of attendees stated they would recommend this course to colleagues. Each of the APPs who underwent this simulation utilize POCUS either independently or with minimal assistance in their practice.