Effectiveness of a primary care clinical ultrasound classroom for family physicians as a formative intervention system, a quasi-experimental trial: Study protocol

Fernando Diego-Domínguez, Miguel Torrecilla-García, Jesús Casado-Huerga, Maria Ángeles Paule-Sánchez, Clara Isabel Soria-López, José Manuel Iglesias-Clemente, José María de Dios-Hernández, Natalia Diego-Mangas, María Cubillo-Jiménez, Fernando Pérez-Escanilla, Fernando Diego-Domínguez, Miguel Torrecilla-García, Jesús Casado-Huerga, Maria Ángeles Paule-Sánchez, Clara Isabel Soria-López, José Manuel Iglesias-Clemente, José María de Dios-Hernández, Natalia Diego-Mangas, María Cubillo-Jiménez, Fernando Pérez-Escanilla

Abstract

Introduction: Clinical ultrasound is a technique that increases diagnostic capacity and facilitates clinical decision making. The objective is to develop and validate an ultrasound training methodology oriented to the clinical practice of the family physician.

Methods: Quasi-experimental study, with a before/after design, a control group, and 1 year of follow-up. Twenty family physicians working in primary care health centers with a list of over 800 patients will be included, as well as a control group of family physicians with similar characteristics in terms of age, sex, and patient list. A structured training process oriented to the clinical practice of the family physician, primary care clinical ultrasound classroom (AECAP), will be carried out, and the improvement of knowledge and skills of the participants will be evaluated, as well as the improvement of the quality of care based on clinical indicators.

Discussion: The family physician is in a privileged situation allows increasing the performance of ultrasound in frequent clinical situations and reducing care hours. We hope that the results obtained in this study demonstrate the effectiveness of the structured training method (AECAP) and support the generalization of ultrasound in primary health care.

Ethics and dissemination: The study was approved by the Medical Research Ethics Committee of Salamanca on December 17, 2018 (cod 2018 11 134). The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number: NCT04283383.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Clinical ultrasound training in the primary care clinical ultrasound classroom (AECAP).

References

    1. Conde-Olasagasti JL, Campillo-Artero C, Hernández Torres A. Ultrasound in Primary Care Madrid: Evaluation Agency of Health Technologies (AETS) Ministry of Health and Consumption - Carlos III Health Institute. 1998.
    1. Sanchez Barrancos IM, Tranche Iparraguirre S. [Reasons for the relevance of ultrasound performed by doctors family]. Aten Primaria 2015;47:261–3.
    1. Hahn RG, Roi LD, Ornstein SM, et al. Obstetric ultrasound training for family physicians. Results from a multi-site study. J Fam Pract 1988;26:553–8.
    1. Parker L, Nazarian LN, Carrino JA, et al. Musculoskeletal imaging: medicare use, costs, and potential for cost substitution. J Am Coll Radiol 2008;5:182–8.
    1. Smith-Bindman R, Aubin C, Bailitz J, et al. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med 2014;371:1100–10.
    1. Sánchez-Barrancos IM. SemFYC ultrasound working group Clinical scenarios of ultrasound in family medicine. Barcelona: semFYC Editions; 2016.
    1. Woo MY, Taylor M, Loubani O, et al. My patient has got abdominal pain: identifying biliary problems. Ultrasound 2014;22:223–8.
    1. Bhagra A, Tierney DM, Sekiguchi H, et al. Point-of-care ultrasonography for primary care physicians and general internists. Mayo Clin Proc 2016;91:1811–27.
    1. Bornemann P, Barreto T. Point-of-care ultrasonography in family medicine. Am Fam Physician 2018;98:200–2.
    1. Soni MJ, Arntfield R, Kory P. Ecografía a pie de cama. Fundamentals of clinical ultrasound. Spanish edition of the first English edition of the work point-of-care ultrasound. Barcelona: Elservier España S.L.U.; 2016.
    1. Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med 2011;364:749–57.
    1. Grantcharov TP, Rasti Z, Rossen B, et al. Interobserver agreement in ultrasound examination of the biliary tract. Acta Radiol 2002;43:77–9.
    1. Esquerra M, Roura Poch P, Masat Tico T, et al. [Abdominal ultrasound: a diagnostic tool within the reach of general practitioners]. Aten Primaria 2012;44:576–83.
    1. Gaspari RJ, Dickman E, Blehar D. Learning curve of bedside ultrasound of the gallbladder. J Emerg Med 2009;37:51–6.
    1. Alonso R, Sanchez IM, Vegas T, et al. Abdominal ultrasound in primary care. FMC 2015;22:5–36.
    1. Blanquer J. SVMFYC primary care ultrasound working group. Relevance of Clinical Ultrasound in Primary Care 2017; Available at: .
    1. Wordsworth S, Scott A. Ultrasound scanning by general practitioners: is it worthwhile? J Public Health Med 2002;24:88–94.
    1. Speets AM, Hoes AW, van der Graaf Y, et al. Upper abdominal ultrasound in general practice: indications, diagnostic yield and consequences for patient management. Fam Pract 2006;23:507–11.
    1. Filopei J, Siedenburg H, Rattner P, et al. Impact of pocket ultrasound use by internal medicine housestaff in the diagnosis of dyspnea. J Hosp Med 2014;9:594–7.
    1. Vicente-Molinero A, Aznar S, Yáñez F. Ultrasound in Primary Care: state of the question. SEMERGEN 2009;35:58–61.
    1. Andersen CA, Davidsen AS, Brodersen J, et al. Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study. BMC Fam Pract 2019;20:89.
    1. General Directorate of Planning and Health Care Regional Health Management of Castilla y León. PORTFOLIO OF SERVICES OF PRIMARY CARE Valladolid: Junta de Castilla y León 2019.
    1. Marwick TH. The future of echocardiography. Eur J Echocardiogr 2009;10:594–601.
    1. Liebo MJ, Israel RL, Lillie EO, et al. Is pocket mobile echocardiography the next-generation stethoscope? A cross-sectional comparison of rapidly acquired images with standard transthoracic echocardiography. Ann Intern Med 2011;155:33–8.

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