Point-of-care ultrasound competency of doctors working in Cape Town emergency departments.

Abstract

Background:  Point-of-care ultrasound (PoCUS) is a core competency in emergency medicine, and its use in other primary healthcare settings is growing. The study investigates the PoCUS competency, training and qualifications of doctors working in public emergency departments.

Methods:  An online survey was distributed to doctors at five public Cape Town emergency departments, followed by a practical assessment of an Extended Focused Assessment with Sonography in Trauma (eFAST) and a basic cardiac ultrasound examination. Descriptive and inferential statistics are presented.

Results:  All participants had attended an in-person PoCUS course before, and 45 (83.3%) were trained by supervisors at work. Eleven participants (20.4%) were credentialled. In the practical assessment, 73.5% were rated as competent in eFAST and 55.9% in basic cardiac ultrasound. The median scores were 80.4% (eFAST) and 76.9% (cardiac ultrasound). Credentialled participants were more likely to achieve a pass mark ( 60%) in eFAST (p  0.001) and cardiac ultrasound (p  0.001).

Conclusion:  All the emergency department doctors who use PoCUS had received formal PoCUS training, and the majority of PoCUS providers had an adequate skill level in the applications tested. The credentialled providers performed better overall. There is a need for further research to investigate the persistently low credentialling rate and potential solutions, not only among practitioners in emergency departments but also generalists and primary care practitioners.Contribution: Our study provides a unique snapshot of the PoCUS skills of junior doctors and trainees in public Cape Town emergency departments.