Keywords
ultrasonography
learning curve
How to Cite
Abstract
Point of care ultrasound (POCUS) is a widely used clinical tool. This operator-dependent technique requires methods to establish individual benchmarks and to monitor the learning process. This paper demonstrates the usefulness of standard cumulative summation (CUSUM) and learning curve CUSUM (LC-CUSUM) control charts. We present a learning curve example case of a single general practitioner to establish and monitor proficiency in POCUS detection of pulmonary B-lines. A training course for general practitioners was conducted to detect plasma leakage using POCUS. The trainees and an expert radiologist identified the number of lung B lines in the ultrasound records of 53 hospitalized patients. Control charts were used to evaluate a trainee's learning curves compared with the radiologist's results, image quality, and anatomical site.
We found out that it has not been widely adopted as a tool for evaluating POCUS training or for monitoring POCUS performance overtime. Using two different scenarios, we show that the image quality is an important evaluation factor that affects the assessment of the learning curve. The LC-CUSUM and CUSUM control charts are graphical tools to intuitively evaluate learning curves and can be used for real-time monitoring once the trainee reaches a predefined level of competency
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Copyright (c) 2023 Sandra Patricia Usaquén-Perilla, MSc, Deliana Ropero-Rojas, PhD, Jaime Mosquera-Restrepo, PhD, Jonathan D. Kirsch, MD, Zachary P. Kaltenborn, MD; José Isidro García-Melo, PhD; Lyda Elena Osorio-Amaya, PhD