Implementation of a Sustainable Point-of-Care Ultrasound Education in Anesthesia in a Resource-Limited Setting (SPEARS) training program in India.
Academic Article
Overview
abstract
PURPOSE: The Hospital for Special Surgery (New York, NY, USA) partnered with Osmania General Hospital (OGH) in Telangana, India, to pilot a novel point-of-care ultrasound (POCUS) training program called Sustainable Point-of-Care Ultrasound Education in Anesthesia in a Resource-Limited Setting (SPEARS). In this study, we sought to teach essential POCUS skills that could be integrated into daily practice, evaluate the program's impact, and establish a reproducible framework for anesthesia providers in resource-limited settings. METHODS: We conducted a mixed-methods local needs assessment at OGH through direct observations, surveys, and interviews. On the basis of these data, we designed the SPEARS intervention, incorporating online didactics, and training modules followed by a 1-week in-person course. SPEARS was implemented at two time points: in February 2023 (time point 1) and December 2023 (time point 2). Participants were anesthesiology attending physicians and postgraduate residents (N = 26). Data collected at each time point included pre- and post-training knowledge tests, clinical skills assessments, and post-training satisfaction surveys. Participants also maintained logbooks to examine changes in POCUS use over time. The impact of the intervention was analyzed using the Kirkpatrick evaluation model. RESULTS: Repeated measures analysis of variance showed a significant positive within-participant effect on knowledge and clinical skills scores across time points. The mean (standard deviation) 5-point Likert scale satisfaction score was 4.4 (0.8). Logbooks indicated a notable increase in the number of POCUS examinations performed after training. CONCLUSIONS: The SPEARS intervention was associated with improved POCUS knowledge, clinical skills, and use among anesthesia providers in a resource-limited setting. These findings suggest that similar blended-learning training initiatives could be adapted and implemented in other resource-limited contexts to build sustainable POCUS capacity.
