Open Access Emergency Medicine (Apr 2020)
Evaluation of Interdisciplinary Emergency Ultrasound Workshop for Primary Care Physicians in Nepal
Abstract
Roshana Shrestha,1 Wolfgang Blank,2 Anmol Purna Shrestha,1 Alok Pradhan1 1Department of General Practice and Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal; 2Medical Clinic I, Klinikum am Steinenberg Reutlingen Teaching Hospital, University Tübingen, Tübingen, GermanyCorrespondence: Roshana ShresthaDepartment of General Practice and Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok 45200, NepalTel +977 9841558332Fax +977 11490707Email [email protected]: Point-of-care ultrasound (POCUS) is a quick bedside tool that has the potential to improve emergency care in resource-limited settings due to its relatively low cost and accessibility. Effort to disseminate the knowledge and skills about POCUS is inadequate in low and middle income countries like Nepal. We conducted a two-day interdisciplinary advanced emergency ultrasound workshop that targeted physicians working in emergency department and primary care, especially in rural Nepal. We explored the effectiveness of this training based on validated Kirkpatrick’s 4 steps of evaluating training outcomes.Materials and Methods: We conducted a prospective quasi-experimental study with mixed research design. Multidisciplinary physicians working in emergency departments participated in the two-day workshop. We assessed and compared the pre- and post-workshop knowledge. We collected on-site and a follow-up feedback to explore pre- and post-workshop confidence level, perceived usefulness and clinical use of ultrasound using a 5-point Likert scale. The barriers to use POCUS were explored.Results: A total of 50 physicians from different parts of Nepal participated in the workshop. The academic level of the participants, duration of their clinical experience and the previous use of POCUS did not have a significant difference in their pre- and posttest knowledge scores. The difference between the median (IQR) pre- and posttest scores [14 (12.75– 17.75) and 24.5 (22.25– 25.5), respectively] was statistically significant (p< 0.001). Perceived confidence level and usefulness of the POCUS increased significantly in all of its domains (p< 0.001). Self-reported increase in its clinical use was significant (p< 0.001) for all fields.Conclusion: The participation in this emergency ultrasound workshop increased the knowledge of participants in POCUS. Their confidence, perceived usefulness and clinical use of POCUS improved significantly. Objective longitudinal follow-up of participants’ skill and demonstration of increased clinical use of POCUS in emergency department influencing the clinical outcome would be the focus of future research.Keywords: emergency department, multidisciplinary, point-of-care ultrasound, primary care, ultrasonography
