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Emergency point-of-care ultrasound training, credentialing and accreditation
Emergency point-of-care ultrasound (EPCUS), performed by doctors, has recently become a popular skill that is used to enhance the accuracy of physical examination of patients. EPCUS provides additional, real-time, patient data which would not have been otherwise available. The effect is improved diagnostic accuracy and reduction in procedural error rates. Ultrasound technology is rapidly evolving. Machines are now more compact, portable, durable, and simpler to use, and provide improved image quality.
Unfortunately training, credentialing and accreditation of EPCUS skills in South Africa have not kept up with the technology. Many poor-quality courses currently exist, with no follow-up formal training, which does not provide the clinician with any form of accreditation.
Current evidence shows that best outcomes are achieved when doctors complete a formal ultrasound course (quality assured by a recognised accreditation body), immediately followed by a formal EPCUS training programme (supervised by experienced trainers) and finally pass a formal skills assessment test.
During the formal training programme, the candidate needs to perform a minimum number of trainer-reviewed ultrasound scans to become competent. Accredited trainers should review all scans as candidates progress in logging their minimum required scans, and provide formal feedback to each candidate. This can be done in real time during practical training sessions with patients, by discussion of previously saved scans (print-outs or saved images) or with the aid of interactive website formats (www.physiciansonographers.org).
Upon completion of the training programme the candidates need to be formally tested and formally accredited when showing minimum requirement competence.
Only one such a national EPCUS training programme (Fig. 1) currently exists, which is accredited and hosted within the Emergency Medicine Society of South Africa (EMSSA) and recommended by the College of Emergency Medicine of South Africa (CEMSA). Once the candidates achieve competency their new EPCUS provider status is registered on-line (www.emssa.org.za/ultrasound-professionals/) for transparency reasons. The demand for formal EPCUS training currently far exceeds both trainer and facility capacity.
The current EMSSA EPCUS training programme is shown in Fig. 1.
The EPCUS training programme is accessible to all doctors including general practitioners, hospital-based doctors and specialists. For more information, please contact: emssa.org.za OR www.eci-sa.org/epcus OR www.physiciansonographers.org
Further reading
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