Chest
Original ResearchPulmonary ProceduresA New Instrument to Assess Physician Skill at Thoracic Ultrasound, Including Pleural Effusion Markup
Section snippets
Test Development
The UGSTAT tests skill level up to the point of skin markup at the best site for pleural needle insertion but does not include real-time imaging, such as is used for small, complex effusions. It consists of 11 assessment domains that cover knowledge of ultrasound knobology, recognition of ultrasound images that illustrate common pleural effusion appearances, the ability to perform a thoracic ultrasound and mark an appropriate site for drainage of a pleural effusion, and a global rating scale
Results
Twenty-two participants were tested, including eight in the novice group, seven in the intermediate group, and seven in the advanced group. In the advanced group, the median number of ultrasound cases on real patients prior to assessment was 200 (range, 30-200). For the intermediate group, the median time from having the instructional course to first assessment was 3 weeks (range, 2-26 weeks). The time taken to administer the test was between 6 and 14 min. Preliminary testing demonstrated good
Discussion
This study has introduced and validated a new tool for the assessment of physician-performed thoracic ultrasound, including markup for pleural effusions. The test gives results that are reliable and accurately reflect the skill level of those being assessed. In a time when ultrasound is becoming integral to the practice of the pulmonologist, this tool could be used to determine the adequacy of physician thoracic ultrasound training prior to clinical practice or to provide a way to document
Conclusions
Procedural training on mannequins prior to unsupervised performance on patients is rapidly becoming the standard in medical education. This study validates the UGSTAT, which can now be used to determine the adequacy of thoracic ultrasound training prior to clinical practice. It is likely that its role could be extended to live patients, providing a way to document ongoing procedural competence.
Acknowledgments
Author contributions: Dr Salamonsen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Salamonsen: contributed to the study formulation, data collection, and writing of the manuscript.
Mr McGrath: contributed to the scoring of ultrasound performances with the UGSTAT and review of the manuscript.
Dr Steiler: contributed to the scoring of ultrasound performances with the UGSTAT and review of the manuscript.
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Funding/Support: Dr Salamonsen received research scholarships from The University of Queensland and the Royal Brisbane and Women's Hospital Foundation.
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