A core curriculum of point-of-care ultrasound examinations for frontline physicians in primary care: results from a European Delphi study

Abstract

Point-of-care ultrasound (PoCUS) has found its way into primary care in some, but not all, European countries. A prerequisite for achieving Europe-wide comparable diagnostic reliability of PoCUS performed by primary care physicians is high-quality training that is limited to relevant, frequently encountered PoCUS applications that are easy to learn and master. A European Federation of Societies for Ultrasound in Medicine (EFSUMB) task force performed a brainstorming exercise to identify all possible ultrasound examinations that could be performed in primary care. A 3-stage Delphi process was launched. The Delphi panelists were 95 primary care physicians from 28 European countries with more than 2 years of experience using and teaching ultrasound. Solely focusing on the complexity of performing PoCUS, the panelists reduced the brainstorming list in a stepwise manner to a basic core curriculum intended for primary care frontline physicians including 40 diagnostic PoCUS examinations within 13 different anatomical areas and no ultrasound-guided procedures. A 75% cut-off was used for agreement. Despite the great heterogeneity of the Delphi panel representing different views and contexts from across Europe, kappa statistics showed substantial or moderate agreement across Delphi rounds 2 and 3 for 85% of the 40 diagnostic PoCUS applications. The results of this study offer guidance for EFSUMB to establish training recommendations for a basic core curriculum that can be adapted to the needs of different regions of Europe and thus create a basis for PoCUS to become a reliable diagnostic tool in primary care across Europe, based on common quality standards.

Zusammenfassung

Point-of-Care-Ultraschall (PoCUS) hat in einigen, aber nicht allen europäischen Ländern Einzug in die Primärversorgung gehalten. Voraussetzung für eine europaweit vergleichbare diagnostische Zuverlässigkeit des PoCUS, wenn er von Ärzten in der Primärversorgung durchgeführt wird, ist eine hochwertige Ausbildung, die sich auf relevante, häufige PoCUS-Anwendungen beschränkt, die leicht zu erlernen und zu beherrschen sind. Eine Arbeitsgruppe der European Federation of Societies for Ultrasound in Medicine (EFSUMB) führte ein Brainstorming durch, um alle möglichen Ultraschall-Untersuchungen zu ermitteln, die in der Primärversorgung durchgeführt werden könnten. Es wurde ein 3-stufiges Delphi-Verfahren gestartet. Die Delphi-Panel-Teilnehmer waren 95 Hausärzte aus 28 europäischen Ländern mit mehr als 2 Jahren Erfahrung in der Anwendung und in der Lehrtätigkeit im Bereich des Ultraschalls. Die Panel-Teilnehmer konzentrierten sich ausschließlich auf die Komplexität der Durchführung des PoCUS und reduzierten die Brainstorming-Liste schrittweise auf ein Basis-Curriculum für Ärzte in der Primärversorgung, das 40 diagnostische PoCUS-Untersuchungen in 13 verschiedenen anatomischen Bereichen, ohne ultraschallgeführte Verfahren, umfasst. Als Schwellenwert für die Zustimmung wurde eine Quote von 75% festgelegt. Trotz der großen Heterogenität des Delphi-Gremiums, das unterschiedliche Ansichten und Kontexte aus ganz Europa repräsentierte, zeigte die Kappa-Statistik in den Delphi-Runden II und III für 85% der 40 diagnostischen PoCUS-Anwendungen eine erhebliche oder mittlere Übereinstimmung. Die Ergebnisse dieser Studie bieten der EFSUMB eine Orientierungshilfe für die Erstellung von Ausbildungsempfehlungen für ein Basis-Curriculum, das an die Bedürfnisse der verschiedenen Regionen Europas angepasst werden kann. Somit wird die Grundlage dafür geschaffen, dass PoCUS auf der Basis gemeinsamer Qualitätsstandards zu einem zuverlässigen Diagnose-Werkzeug in der Primärversorgung in ganz Europa wird.

Keywords

Point-of-care Ultrasound - General Practice - Family Medicine - Primary Healthcare - Curriculum

Publication History

Received: 10 November 2024

Accepted after revision: 16 April 2025

Accepted Manuscript online:
16 April 2025

Article published online:
04 June 2025

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