General practitioners' scanning competence following tailored ultrasound training: a hybrid effectiveness-implementation study

BACKGROUND: As an imaging modality, ultrasound relies on user skill and demands the integration of anatomical understanding, image acquisition techniques, and clinical knowledge. Proficiency in performing Point-of-Care Ultrasound (POCUS) examinations is a gradual process necessitating ongoing practice and exposure. Office-based general practitioners (GPs) encounter distinctive educational challenges when striving to acquire and sustain scanning competences. Therefore, traditional short workshops and training programs are not well suited for GPs. This hybrid effectiveness-implementation study aimed to explore whether a novel educational program, specifically tailored to meet the learning needs of office-based GPs, could lead to scanning competence by the program's conclusion and if this competence can be sustained post-course.

METHODS: GPs working in office-based general practice in Denmark were invited to participate in a three-months ultrasound educational program. To assess its effectiveness, participants underwent scanning competence evaluation by external experts at the end of the training program and again three months later. The experts assessed the participants twice using the objective structured assessment of ultrasounds skills (OSAUS) standardized evaluation tool. This evaluation covered seven items: 'indication for the examination', 'applied knowledge of ultrasound equipment', 'image optimization', 'systematic examination', 'interpretation of images', 'documentation of the examination', and 'medical decision-making'. To evaluate implementation of the educational program, data were collected on the participants' completion of the program's educational elements and their use of POCUS following the program.

RESULTS: The 18 participating GPs were found to have scanning competence scores after completing the educational program, ranging from 68.9% to 82.3% of the maximum score, depending on the POCUS application. At follow-up, their scores had significantly increased for all POCUS applications, ranging from 80.9% to 92.6% of the maximum score. While completion of the educational elements varied between participants, all implemented POCUS in their daily practice during the educational program.

CONCLUSION: This study emphasizes that a customized training program, considering the learning challenges faced by office-based GPs, can result in scanning proficiency that continues to develop in the months following the training.

TRIAL REGISTRATION: Clinical trials registration ID NCT05274581.