Background
As portable ultrasound (US) devices are becoming lighter, smaller, cheaper and more durable, the feasibility of US use in wilderness medicine (WM) applications is being explored. A barrier to US use is the training of providers. Studies have already examined the WM provider’s ability to create appropriate images in wilderness settings. Few studies have looked at training providers to appropriately use US images to independently make decisions about treatment and evacuation.
Objective
This study will evaluate novice participant’s abilities to interpret ultrasound images in a wilderness setting after a brief, on-line tutorial. It is hoped that this will help refine US training for WM providers.
Methods
Participants registering for an established WM simulation were asked to watch an on-line tutorial before the event. All participants received unique log-in capability, allowing tracking of who actually participated in the tutorial. During the event, one of the medical challenges was an US interpretation segment in which each subject was presented with a series of US videos requiring interpretation. The accuracy of participants’ readings was assessed and compared to their level of training and whether they accessed the on-line video.
Results
There were 72 participants in the study; 43 watched all 3 training videos. Physicians (attending and residents) were significantly more likely to identify intraperitoneal fluid (89%) than nonphysicians (64%), but physician performance was not improved by watching the videos (89% vs 90%). Among the nonphysicians, watching the videos was significantly associated with identifying intraperitoneal fluid (76% vs 47%). Results for pneumothorax trended similarly but did not reach significance.
Conclusions
For novice providers, an on-line training program followed by simulation testing provides a reasonable format for learning interpretation of US images. Further curricular refinement will be necessary to be able to train to full competency.