Not All Residents Are Assessed the Same

Bedside ultrasound competency assessment of emergency medicine residents varies considerably throughout the U.S.

Assessment for emergency medicine (EM) residency competency in bedside ultrasound (US) varies significantly between facilities, according to an article published in the journal Academic Emergency Medicine.

Researchers from the University of Arizona Medical Center in Tucson performed a cross-sectional survey study to assess current methods used by EM residency training programs to evaluate bedside ultrasound competency.

One-hundred-sixty-one questionnaires were sent to all EM residency program directors and emergency ultrasound directors. The researchers received 124 responses (77 percent response rate). The questionnaires asked about:

• Ultrasound rotation
• Structure of ultrasound curriculum

• Presence of ultrasound fellowship

• Image archiving

• Quality assurance methods

• Feedback

• Competency assessment tools

• Frequency of assessment

The results varied widely between facilities in all fields, including how often and when competency was assessed:

Competency assessed at end of US rotation
26 percent
Competency assessed every six months
8 percent
Competency assessed annually
13 percent
Competency assessed during final year of training
8 percent
Competency assessed with combination of intervals
3o percent
Competency not assessed
16 percent

Objective structured clinical exams (OSCEs) were used by 14 percent of facilities, and standardized direct observation tools (SDOTs) were used by 21 percent. Approximately 33 percent assessed ultrasound competency with multiple-choice questions and 30 percent used practical examinations.

“Currently, a majority of EM residency programs assess resident competency in bedside US. However, there is significant variation in the methods of competency assessment,” the researchers concluded.

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