I will be coordinating a multi-day point of care ultrasound (POCUS) workshop for providers at Robert Reid Cabral (RRC) Hospital in Santo Domingo, Dominican Republic. Educational initiatives will include didactic lectures, bedside clinical teaching and simulation on models. Curriculum will incorporate a "teach alongside" model where local providers will act in educational roles during the workshop with a focus on sustainability. This workshop is a result of collaboration between physician partners at RRC and Children's Hospital of Philadelphia. Providers will learn and expand upon their current POCUS skills in order to provide faster and more comprehensive care for their patients. This site visit will also include meetings to discuss infrastructure creating, relationship building and sustainability of ongoing POCUS use and education in this setting.
Target learners include pediatric emergency medicine and pediatric critical care providers including attendings, fellows, residents and medical students. These providers provide care to pediatric patients in a large tertiary care children's hospital in Santo Domingo, Dominican Republic which serves as a referral center for children from all over the country and Haiti. They serve an ill and under resourced patient population which has shown incredible benefit from pilot interventions with POCUS education. This provider group was targeted as it had reached out to our hospital to express a specific interest in POCUS education. In addition, the hospital has the resources to be able to therapeutically intervene on abnormal POCUS findings. For example, a patient in respiratory distress was found to have a pericardial effusion using POCUS, which otherwise may not have been discovered. The hospital was able to arrange and perform the appropriate procedure to relieve the effusion the following day. In addition, the provider group has committed to longitudinal POCUS learning goals in bidirectional exchange of education and POCUS cases. It is the perfect setting where educational resources will make a giant impact on patient care.
Providers will gain additional skills in POCUS which will be multifactorial in impact. First, they will gain confidence and skills in performing real time diagnostic imaging that has the potential to change patient diagnosis and management at the bedside. POCUS is especially impactful in this setting, where alternative radiology eg x-ray or CT is often limited in availability. In addition to providing additional information regarding a patient's clinical status, this workshop will also allow providers to gain experience in POCUS education so that they can disseminate skills locally to colleagues to expand impact. Lastly, we will be focusing on a teach alongside and train-the-trainer model to hone skills of local POCUS champions that are emerging. After I return, I will have continued collaboration and communication with our partner group via virtual case discussions and case sharing.
We were excited to provide point of care ultrasound training for dozens for our partners in the Dominican Republic. Highlights of our conference were expansion of interest within the hospital of our training as pediatric fellows from 4 different specialties and their attendings joined- pediatric emergency, intenstive care, pulmonology, surgery and anesthesia all participated enthusiastically. We learned new skills based off of didactic POCUS lectures and hands on practice with 8 ultrasound machines available and multiple simulation models. The training will enabled these physicians to improve the care they provide to their pediatric patients who otherwise might not have access to medical imaging and lead to faster more accurate diagnosis. Ultrasound findings made at the bedside that can be lifesaving and aid with diagnosis and treatment. Our pediatric critical care attending partner from the DR wrote us this note after the conference- "At Robert Reid Cabral Children's Hospital, we are making a difference with the POCUS at the bedside project, becoming the first pediatric intensive care unit with both the training and availability to use such an important and necessary tool. This initiative enhances and optimizes diagnosis and monitoring during critical events that require our intervention, ensuring that decisions are no longer made blindly but are instead based on solid evidence, reducing medical errors and improving timely interventions. Our critical care residents are and will continue to be national multipliers of this essential skill, which is now a global standard in pediatric intensive care. We are beyond grateful for this opportunity- as an institution, as professionals and as individuals."
