Skill and knowledge retention after training in cardiopulmonary ultrasound in Ghana: an impact assessment of bedside ultrasound training in a resource-limited setting.

Objective: Brief training courses in bedside ultrasound are commonly done by visiting faculty in low-income and middle-income countries, and positive short-term effects have been reported. Long-term outcomes are poorly understood. We held a training course on a cardiopulmonary ultrasound (CPUS) protocol over two separate 10-day periods in 2016. In 2017, 9-11 months after the initial training, we assessed skill and knowledge retention as well as perceived impact on local practice.

Methods: A written test using six clinical vignettes and an observed structured clinical examination were used to assess theoretical knowledge and practical skills. Additionally, in-person interviews and a written survey were completed with the physicians who had participated in the initial training.

Results: All 20 participants passed the written and clinical examination. The median follow-up test score was 10 out of 12, compared with a median score of 12 on a test completed immediately after the initial training. Physicians identified the ability to narrow their differential diagnosis and to initiate critical interventions earlier than without ultrasound as a key benefit of the CPUS training. They rated the cardiac, abdominal and inferior vena cava components of the CPUS protocol as most relevant to their everyday practice.

Conclusion: Long-term ultrasound knowledge and skill retention was high after a brief and intensive training intervention at an academic tertiary hospital in Ghana. Clinicians reported improvements in patient care and local practice patterns.