Point-of-care ultrasound in palliative medicine residency programs: report of a national survey and local workshop

Abstract

Purpose: Point-of-care ultrasound (POCUS) is used in various clinical specialties to improve diagnostic and procedural accuracy and has many potential applications in palliative care. However, it is unclear what is the current state of training and use of POCUS in palliative care in Canada. Our objectives were to understand the current state of training and use of POCUS in Canadian Palliative Medicine subspecialty residency programs and to develop and implement a local training workshop for POCUS in palliative care.

Methods: We surveyed residency program leaders regarding formal training and clinical applications of POCUS for faculty and residents in their programs. The results from the national survey informed the design of a workshop for POCUS at our institution. Faculty and resident participants completed pre- and post-workshop surveys evaluating their comfort with using and teaching POCUS.

Results: Most residency programs provided between one to ten hours of POCUS teaching to residents. Clinical application was generally limited to assessing ascites and performing paracentesis. Lack of POCUS-trained faculty was identified as the most common barrier to more widespread use of POCUS. On a limited budget, we successfully implemented a POCUS training workshop at our institution that improved participant confidence and comfort in using and teaching POCUS.

Conclusions: Although POCUS is viewed as a beneficial skill for enhancing patient care and is a competency in palliative medicine residency programs, there are gaps in both training and utilization. A POCUS workshop is an effective and low-cost "first-step" intervention that can be easily replicated in other programs.

Keywords: Ascites; POCUS; Palliative care; Paracentesis; Point-of-care ultrasound; Symptoms.