Original Research

Perioperative Point-of-Care Ultrasound Training: A Survey of Anesthesia Academic Programs in United States and China

Jeffrey Cannon , Daniel C. Sizemore , Yang Zhou , George M. McKelvey , Min Li , Elie J. Chidiac , Xiangyang Guo , Alexandra Reynolds , Hong Wang
School of Medicine, West Virginia University, Department of Anesthesiology, West Virginia University, Department of Anesthesiology, Peking University Third Hospital, Department of Anesthesiology, Detroit Medical Center, Department of Anesthesiology, Wayne State University
J Anesth Perioper Med 2018; 5(2): 61- 69 . Published on Mar 28, 2018 . doi:10.24015/JAPM.2018.0030
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Abstract

Background: Ultrasound plays a large role in daily anesthesia practice and training in the 21st century. From obtaining vascular access to performing a transesophageal echocardiography (TEE), anesthesiologists are expanding their use of ultrasound. Point-of-Care ultrasound (POCUS) is using bedside ultrasound machines to rapidly evaluate, diagnose, and guide patient care, without delay. Multiple residency specialty programs are beginning to implement POCUS training in several clinical situations. However, the current status of POCUS training in Anesthesia residency is unknown.

Methods: A 22-question online survey was sent to US Accreditation Council for Graduate Medical Education (ACGME) Programs and Chinese Programs (Academic hospital setting with an associated residency program in anesthesiology). The survey questions gauged current levels of training and exposure to ultrasound training in several areas such as clinical, didactic, and conferences. Survey enquiries included specialized areas of ultrasound training including regional blocks, TEE, and POCUS. Survey questions also gauged the extent to which POC teaching occurred in institutional curriculums or at regional/national meetings.

Results: There were 130 survey responses from US ACGME anesthesia residency programs and 394 responses from Chinese Anesthesia Residency facilities. US survey responses comprised of 48.5% responses from residents and 51.5% of responses from faculty. Chinese survey responses comprised of 27% responses from residents and 72% responses from either attendings, vice chiefs, or chief physicians. Both countries exhibited a high level of ultrasound-guided regional block training with 96.2% in the US and 94% in China. The extent of TEE training is also universally high in the US with 87.7% of US respondents having received training. TEE training in China was observed to be integrated into cardiac anesthesia rotations. In the US, only 36.2% of survey respondents had received POCUS training, with even fewer (10%) receiving POCUS rotations. In both US and Chinese surveys, less than half of respondents (43.9% in the US vs. 39.9% in China) had attended a POCUS workshop.

Conclusion: A little over one third (36.2%) of US respondents received explicit POCUS training and even fewer (10%) received specific POCUS rotations during their anesthesia residencies. In China, POCUS training only exists in 24.4% of programs, and POCUS rotations are even less available (12.2%). Given the importance of POCUS’s evolving role in anesthesiology, these survey responses show that while there is awareness of POCUS, there is insufficient POCUS training during anesthesia residency in both US and Chinese academic training programs.

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