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AN EVALUATION OF THE
   ACS ULTRASOUND
 EDUCATION PROGRAM




M. Margaret Knudson, MD, FACS
     San Francisco, CA
BACKGROUND
•   Ultrasound: wide applications in surgery
•   Little formal training: residency
•   Need for education/training
•   Didactic and Practical
            -interpretation
            -performance
PURPOSE OF STUDY
• EVALUATE:
  -effectiveness of courses:knowledge
  -impact: surgical practice
HYPOTHESIS
Reasons why surgeons would enroll:
  -gain new knowledge/skills
  -credentialing
METHODOLOGY
Survey: ACS students: 1998-2002
    1. Use: Ultrasound before course
    2. Hours: Ultrasound training
    3. Courses: ACS and other
    4. Use: Ultrasound after course
    5. Exams: Type and number/month
RESULTS
• 1,791 surveys mailed
• 873 completed (50% response)
• All states/12 foreign countries
NH 3
            WA 23                                                                                                  VT 9
                                      MT 2                                                                                               ME 3
                                                          ND 1
                                                                          MD 11
                                                                                                                                           MA 10
         OR 13
                                                                                      WI 16                              NY 61
                            ID 4
                                                           SD 1                                   MI 16
                                                                                                                                               RI 5
                                         WY 1
                                                                                                                     PA 24              CT 12
                                                                            IA 6
                                                            NE 10                      IL 37            OH 23
                     NV 3                                                                                                              NJ 14
    CA 57                                                                                        IN 6
                              UT 6            CO 10                                                           WV 2                       DE 2
                                                                              MO 10                                       VA 24
                                                                  KS 12                           KY 8
                                                                                                                        NC 21              MD 32
                                                                                                 TN 16
                                                                    OK 12                                          SC 2
                                                                                   AR 14
                             AZ 10            NM 1                                                    AL 12

                                                                                               MS 5
                                                                                                                GA 13
Argentina        1                   Australia        1           TX 42
                                                                                    LA 14
Canada           11                  Greece           1
                                                                                                                     FL 17
Guam             1                   Hong Kong        1
Japan            1                   London           1
Puerto Rico 5                        New Zealand 1
Philippines      1                   Saudi Arabia 1
Unknown 190
ULTRASOUND USE: BEFORE
    AND AFTER COURSES
             100
              90
              80
              70
    %         60
                            65%
Performing    50   58%
Ultrasound    40
              30
              20
              10
               0
                   N= 370   N= 565
                   Before    After
TOTAL NUMBER OF COURSE
                  HOURS IN ULTRASOUND
                     250                     Average: 10 Hours
Number of surgeons




                                 247
                     200
                                       207
                                                                 <4
                     150
                                                                 5-8
                                                    128          9-16
                     100
                                                                 17-24
                     50                      80                  >24


                       0    12

                           Total number of course hours
HOURS OF DIDACTIC
                             INSTRUCTION
                     300
Number of surgeons




                     250            283          Average: 5-8 Hours
                     200                                              <4
                                                                      5-8
                     150
                              156                                     9-16
                     100                                              17-24
                                           112                        >24
                      50                                 80

                       0                           24
                           Total number of didactic instruction
HOURS OF HANDS-ON TRAINING
                     250
                             248
Number of surgeons




                     200           210
                                              Average: 4-8 Hours
                                                                   <4
                     150
                                                                   5-8
                                                                   9-16
                     100
                                                                   17-24
                                                       88          >24
                      50                 81


                       0                         17
                           Total number of hands-on hours
ENROLLMENT:ACS
                           ULTRASOUND COURSES
                                                    (1998-2002)
                     600
Number of surgeons




                     500   547                                    Breast
                                                                  Basic
                     400                                          Vascular
                     300                                          Acute
                                 312                              Abdominal
                     200                                          Intraop/Laparoscopic
                                                                  Head/Neck
                     100                    158
                                                  128
                                       49               76   46
                       0
                           Type of ACS course taken
ENROLLEMENT: NON-ACS
                       ULTRASOUND COURSES
                                              (1998-2002)
                     180
Number of surgeons




                     160    170
                     140                                         Breast
                     120          135                            Basic
                     100                                         Vascular
                      80                                         Acute
                                             84
                      60                                         Abdominal
                                                  50             Intraop/Laparoscopic
                      40                56
                                                       40        Head/Neck
                      20
                                                            19
                       0
                           Type of non-ACS course taken
TYPES OF ULTRASOUND
                        EXAMS PERFORMED
                                                     (1998-2002)
                     400
Number of surgeons




                     350     369
                     300                                              Breast
                     250                                              Vascular
                                                                      Acute
                     200
                                                                      Abdominal
                     150                 183
                                               157         156        Intraop/Laparoscopic
                     100           105               115              Head/Neck
                     50                                               Endoluminal
                                                                 38
                       0
                           Type of ultrasound performed
BREAST ULTRASOUND EXAMS
       PER MONTH
                                        (1998-2002)
                     140
Number of surgeons




                     120
                                                      131
                     100                                          1-2
                                               99                 3-5
                     80                                           6-10
                                        85
                     60                                           >10
                     40          54
                     20
                      0
                           Number of Breast U/S exams per month
VASCULAR ULTRASOUND EXAMS
        PER MONTH
                                         (1998-2002)
                     45
                     40
Number of surgeons




                                                        42
                     35
                     30
                                                                   1-2
                     25        28
                                                                   3-5
                     20                                            6-10
                     15                         20
                                        15                         >10
                     10
                      5
                      0
                          Number of vascular U/S exams per month
ACUTE/TRAUMA ULTRASOUND
    EXAMS PER MONTH
                                    (1998-2002)
                      70
 Number of surgeons



                      60
                                                  64
                      50
                      40       46   49                 1-2
                      30                               3-5
                      20                               6-10
                                          24
                      10                               >10

                       0
                           Number of acute U/S exams
                                 per month
INTRAOP/LAPAROSCOPIC
ULTRASOUND EXAMS PER MONTH
                                      (1998-2002)
                       50
                                50
  Number of surgeons



                       45
                       40
                       35
                                       37
                       30                                    1-2
                       25
                                                             3-5
                       20
                       15                                    6-10
                                                    16       >10
                       10                    12
                        5
                        0
                            Number of intraop/laparoscopic
                               U/S exams per month
HEAD/NECK ULTRASOUND
         EXAMS PER MONTH
                                        (1998-2002)
               80
Number of surgeons




               70               74
               60
               50                                                  1-2
                                        49                         3-5
               40
               30                                                  6-10
                                                                   >10
               20                             21
               10
                                                      12
                     0
                         Number of head/neck U/S exams per month
ENDOLUMINAL ULTRASOUND
   EXAMS PER MONTH
                                      (1998-2002)
                      18
                      16        18
 Number of surgeons




                      14
                      12
                      10                                     1-2
                       8                                     3-5
                       6                            8        6-10
                                            7
                       4                                     >10
                                      5
                       2
                       0
                           Number of endoluminal U/S exams
                                      per month
EVALUATION BY STUDENTS
•   Course relevance to needs
•   Knowledge and skills gained
•   Direct application to practice
•   Stimulate additional education
•   Overall rating
STUDENT EVALUATIONS
• 60-70%: skills applied to practice
• Majority: would seek additional training
• 91%: rated courses as good-excellent
CONCLUSIONS
• ACS Education in US: successful
• Popularity increased by support:
     -ASBS
     -SAGES
     -AAST
     -Endocrine surgeons
CONCLUSIONS
REASONS TO ENROLL IN COURSES:
     -formalize ultrasound training
      -expand to new uses of ultrasound
      -credentials and privileges
PRIVILEGES
ACS ULTRASOUND
   EDUCATION PROGRAM
• Structured development within ACS
• Assures proper and safe use of technology
• Model for learning other new skills

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An Evaluation Of The Acs Ultrasound Education Program

  • 1. AN EVALUATION OF THE ACS ULTRASOUND EDUCATION PROGRAM M. Margaret Knudson, MD, FACS San Francisco, CA
  • 2. BACKGROUND • Ultrasound: wide applications in surgery • Little formal training: residency • Need for education/training • Didactic and Practical -interpretation -performance
  • 3. PURPOSE OF STUDY • EVALUATE: -effectiveness of courses:knowledge -impact: surgical practice
  • 4. HYPOTHESIS Reasons why surgeons would enroll: -gain new knowledge/skills -credentialing
  • 5. METHODOLOGY Survey: ACS students: 1998-2002 1. Use: Ultrasound before course 2. Hours: Ultrasound training 3. Courses: ACS and other 4. Use: Ultrasound after course 5. Exams: Type and number/month
  • 6. RESULTS • 1,791 surveys mailed • 873 completed (50% response) • All states/12 foreign countries
  • 7. NH 3 WA 23 VT 9 MT 2 ME 3 ND 1 MD 11 MA 10 OR 13 WI 16 NY 61 ID 4 SD 1 MI 16 RI 5 WY 1 PA 24 CT 12 IA 6 NE 10 IL 37 OH 23 NV 3 NJ 14 CA 57 IN 6 UT 6 CO 10 WV 2 DE 2 MO 10 VA 24 KS 12 KY 8 NC 21 MD 32 TN 16 OK 12 SC 2 AR 14 AZ 10 NM 1 AL 12 MS 5 GA 13 Argentina 1 Australia 1 TX 42 LA 14 Canada 11 Greece 1 FL 17 Guam 1 Hong Kong 1 Japan 1 London 1 Puerto Rico 5 New Zealand 1 Philippines 1 Saudi Arabia 1 Unknown 190
  • 8. ULTRASOUND USE: BEFORE AND AFTER COURSES 100 90 80 70 % 60 65% Performing 50 58% Ultrasound 40 30 20 10 0 N= 370 N= 565 Before After
  • 9. TOTAL NUMBER OF COURSE HOURS IN ULTRASOUND 250 Average: 10 Hours Number of surgeons 247 200 207 <4 150 5-8 128 9-16 100 17-24 50 80 >24 0 12 Total number of course hours
  • 10. HOURS OF DIDACTIC INSTRUCTION 300 Number of surgeons 250 283 Average: 5-8 Hours 200 <4 5-8 150 156 9-16 100 17-24 112 >24 50 80 0 24 Total number of didactic instruction
  • 11. HOURS OF HANDS-ON TRAINING 250 248 Number of surgeons 200 210 Average: 4-8 Hours <4 150 5-8 9-16 100 17-24 88 >24 50 81 0 17 Total number of hands-on hours
  • 12. ENROLLMENT:ACS ULTRASOUND COURSES (1998-2002) 600 Number of surgeons 500 547 Breast Basic 400 Vascular 300 Acute 312 Abdominal 200 Intraop/Laparoscopic Head/Neck 100 158 128 49 76 46 0 Type of ACS course taken
  • 13. ENROLLEMENT: NON-ACS ULTRASOUND COURSES (1998-2002) 180 Number of surgeons 160 170 140 Breast 120 135 Basic 100 Vascular 80 Acute 84 60 Abdominal 50 Intraop/Laparoscopic 40 56 40 Head/Neck 20 19 0 Type of non-ACS course taken
  • 14. TYPES OF ULTRASOUND EXAMS PERFORMED (1998-2002) 400 Number of surgeons 350 369 300 Breast 250 Vascular Acute 200 Abdominal 150 183 157 156 Intraop/Laparoscopic 100 105 115 Head/Neck 50 Endoluminal 38 0 Type of ultrasound performed
  • 15. BREAST ULTRASOUND EXAMS PER MONTH (1998-2002) 140 Number of surgeons 120 131 100 1-2 99 3-5 80 6-10 85 60 >10 40 54 20 0 Number of Breast U/S exams per month
  • 16. VASCULAR ULTRASOUND EXAMS PER MONTH (1998-2002) 45 40 Number of surgeons 42 35 30 1-2 25 28 3-5 20 6-10 15 20 15 >10 10 5 0 Number of vascular U/S exams per month
  • 17. ACUTE/TRAUMA ULTRASOUND EXAMS PER MONTH (1998-2002) 70 Number of surgeons 60 64 50 40 46 49 1-2 30 3-5 20 6-10 24 10 >10 0 Number of acute U/S exams per month
  • 18. INTRAOP/LAPAROSCOPIC ULTRASOUND EXAMS PER MONTH (1998-2002) 50 50 Number of surgeons 45 40 35 37 30 1-2 25 3-5 20 15 6-10 16 >10 10 12 5 0 Number of intraop/laparoscopic U/S exams per month
  • 19. HEAD/NECK ULTRASOUND EXAMS PER MONTH (1998-2002) 80 Number of surgeons 70 74 60 50 1-2 49 3-5 40 30 6-10 >10 20 21 10 12 0 Number of head/neck U/S exams per month
  • 20. ENDOLUMINAL ULTRASOUND EXAMS PER MONTH (1998-2002) 18 16 18 Number of surgeons 14 12 10 1-2 8 3-5 6 8 6-10 7 4 >10 5 2 0 Number of endoluminal U/S exams per month
  • 21. EVALUATION BY STUDENTS • Course relevance to needs • Knowledge and skills gained • Direct application to practice • Stimulate additional education • Overall rating
  • 22. STUDENT EVALUATIONS • 60-70%: skills applied to practice • Majority: would seek additional training • 91%: rated courses as good-excellent
  • 23. CONCLUSIONS • ACS Education in US: successful • Popularity increased by support: -ASBS -SAGES -AAST -Endocrine surgeons
  • 24. CONCLUSIONS REASONS TO ENROLL IN COURSES: -formalize ultrasound training -expand to new uses of ultrasound -credentials and privileges
  • 26. ACS ULTRASOUND EDUCATION PROGRAM • Structured development within ACS • Assures proper and safe use of technology • Model for learning other new skills