dc.contributor.author | Muriuki, Daniel M | |
dc.date.accessioned | 2024-05-29T08:07:52Z | |
dc.date.available | 2024-05-29T08:07:52Z | |
dc.date.issued | 2023 | |
dc.identifier.uri | http://erepository.uonbi.ac.ke/handle/11295/164888 | |
dc.description.abstract | Background: Differentiating cardiovascular causes of dyspnea in resource-limited healthcare
settings can be challenging. The use of accessible, rapid point-of-care Focused Cardiac Ultrasound
(FoCUS) protocols may potentially alleviate these challenges. The Cardiac Ultrasound for
Resource-limited Settings (CURLS) protocol is a non-validated, context specific, easy to train,
easy to use Sub-Xiphoid Single Window FoCUS tool. We sought to assess trainee competence in
evaluating cardiovascular causes of dyspnea using CURLS after a brief training.
Methods: This was a quasi-experimental study conducted at the Kenyatta National Hospital over
3 weeks. We enrolled 45 graduate medical pre-interns, novices in echocardiography. Trainees
received simulated didactic and hands-on FoCUS skills training using the CURLS protocol and
2018 EACVI FoCUS training and competence assessment recommendations. Competency was
assessed in three domains: image interpretation, image acquisition, and image quality. Image
interpretation was assessed using a multiple-choice test. Image acquisition skills were assessed
using an OSCE checklist that measured their ability to obtain a Sub-xiphoid image on two healthy
living models. Image quality grading was graded by two FoCUS experts using the 2018 ACEP 5-
point image quality assurance grading scale. Data analysis involved computing trainee scores using
ranges, medians and 95% confidence intervals. Proportions of trainees who attained competence
were expressed in percentages.
Results: Aggregate image interpretation competency was attained by n=38 (84 %) of trainees with
a median score of 80%. The proportion of trainees attaining category-specific image interpretation
competency was as follows: pericardial effusion n=44 (98%), left atrial enlargement n= 40 (89%),
cardiomyopathy n=38 (84%), left ventricular hypertrophy n=37 (82%), and right ventricular
enlargement n=29 (64%). Image acquisition skills competency was attained by n=36 (80%) of
trainees with a median image acquisition skills test performance score of 82 %. Three-quarters of
trainee-obtained images were of good quality.
Conclusion: The majority of trainees in our study attained competency in FoCUS skills after
training with the CURLS protocol. The training conditions and participant selection bias limit
results generalizability | en_US |
dc.language.iso | en | en_US |
dc.publisher | university of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.title | Focused Cardiac Ultrasound - Competency Among Pre-internship Medical Officers in Diagnosing Cardiac Causes of Dyspnoea | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |