Table 4 Comparison of Canadian CCUS recommendations [16] to the current state
Canadian recommendations for critical care ultrasound training and competency | Survey results |
|---|---|
Academic centers Commitment to create and sustain a local CCUS program One machine per unit dedicated to CCUS | Lack of equipment was not a barrier in 91% |
Local experts Support to sustain and/or train local CCUS expert(s) experienced in general CCUS and basic critical care echo Be supported with time and funding Support for faculty development if no local expert exists | 64% feel identifying a local expert as a barrier but 82% has 1–2 per training site Lack of time for educator a barrier in all programs, lack of academic support a barrier in 82% |
Curriculum implementation Didactic and hands-on training in general CCUS and basic echo (10 h each) Core applications that should be taught: basic critical care echo, lung/pleura, guidance of vascular access, identification of free fluid Optional applications include DVT diagnosis, renal ultrasound and abdominal aorta | Hours of dedicated hands-on training: 36% 5–9 h and 27% 10–15 h All programs have formal teaching basic critical care echo 82% have formal teaching in lung/pleural space, 82% vascular access, 64% abdominal free fluid 27% formally teaching DVT, 33% renal |
Portfolio building Supervised studies in core exam types with feedback Performed on patients over simulators Minimum number of studies required in core applications Portfolio kept of completed scans Feedback/supervision should be in real time with local expert at bedside, or through digital storage | Inability to supervise a barrier in 55% 64% of programs do not have a minimum number of studies required 73% are using a training simulator 50% use portfolio review 45% have fully developed feedback mechanisms, 64% receive feedback in real time at the bedside, 36% USB and/or digital archive |
Assessment of competency Each learner should have a final assessment in image acquisition, interpretation, and clinical integration Method for continuing competence: image review sessions, lectures, etc. | 44% have dedicated assessment for trainees 11% formal written exam, 33% OSCE |