Browsing by Author "Wong, Jonathan"

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    An overview of Internal Medicine Point-of-Care Ultrasound rotations in Canada
    (2022-09-02) Gaudreau-Simard, Mathilde; Wiskar, Katie; Kilabuk, Elaine; Walsh, Michael H.; Sattin, Michael; Wong, Jonathan; Burhani, Zain; Arishenkoff, Shane; Yu, Jeffrey; Lam, Ada W.; Ma, Irene W. Y.
    Abstract Background Point-of-care ultrasound (POCUS) is a growing part of internal medicine training programs. Dedicated POCUS rotations are emerging as a particularly effective tool in POCUS training, allowing for longitudinal learning and emphasizing both psychomotor skills and the nuances of clinical integration. In this descriptive paper, we set out to review the state of POCUS rotations in Canadian Internal Medicine training programs. Results We identify five programs currently offering a POCUS rotation. These rotations are offered over two to thirteen blocks each year, run over one to four weeks and support one to four learners. Across all programs, these rotations are set up as a consultative service that offers POCUS consultation to general internal medicine inpatients, with some extension of scope to the hospitalist service or surgical subspecialties. The funding model for the preceptors of these rotations is predominantly fee-for-service using consultation codes, in addition to concomitant clinical work to supplement income. All but one program has access to hospital-based archiving of POCUS exams. Preceptors dedicate ten to fifty hours to the rotation each week and ensure that all trainee exams are reviewed and documented in the patient’s medical records in the form of a consultation note. Two of the five programs also support a POCUS fellowship. Only two out of five programs have established learner policies. All programs rely on In-Training Evaluation Reports to provide trainee feedback on their performance during the rotation. Conclusions We describe the different elements of the POCUS rotations currently offered in Canadian Internal Medicine training programs. We share some lessons learned around the elements necessary for a sustainable rotation that meets high educational standards. We also identify areas for future growth, which include the expansion of learner policies, as well as the evolution of trainee assessment in the era of competency-based medical education. Our results will help educators that are endeavoring setting up POCUS rotations achieve success.
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    Barriers to learning and using point-of-care ultrasound: a survey of practicing internists in six North American institutions
    (2020-04-19) Wong, Jonathan; Montague, Steven; Wallace, Paul; Negishi, Kay; Liteplo, Andrew; Ringrose, Jennifer; Dversdal, Renee; Buchanan, Brian; Desy, Janeve; Ma, Irene W Y
    Abstract Background Point-of-care ultrasound (POCUS) is increasingly used in internal medicine, but a lack of trained faculty continues to limit the spread of POCUS education. Using a framework based on organizational change theories, this study sought to identify barriers and enablers for hospital-based practicing internists to learn and use POCUS in clinical practice. Methods We invited practicing internists at six North American institutions to participate in an electronic survey on their opinions regarding 39 barriers and enablers. Results Of the 342 participants invited, 170 participated (response rate 49.3%). The top barriers were lack of training (79%), lack of handheld ultrasound devices (78%), lack of direct supervision (65%), lack of time to perform POCUS during rounds (65%), and lack of quality assurance processes (53%). The majority of participants (55%) disagreed or strongly disagreed with the statement “My institution provides funding for POCUS training.” In general, participants’ attitudes towards POCUS were favourable, and future career opportunities and the potential for billing were not considered significant factors by our participants in the decision to learn or use POCUS. Conclusions This survey confirms the perceived importance of POCUS to practicing internists. To assist in closing faculty development gap, interventions should address training, supervision, quality assurance processes, availability of handheld devices, as well as dedicated time to perform POCUS during clinical care.
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    Correction: An overview of internal medicine point-of-care ultrasound rotations in Canada
    (2022-09-14) Gaudreau-Simard, Mathilde; Wiskar, Katie; Kilabuk, Elaine; Walsh, Michael H.; Sattin, Michael; Wong, Jonathan; Burhani, Zain; Arishenkof, Shane; Yu, Jefrey; Lam, Ada W.; Ma, Irene W. Y.