Training in Diagnostic Ultrasound: Essentials, Principles and Standards : Report of a WHO Study Group, Issues 875-880
Addresses the urgent need to improve the training and clinical performance of physicians and allied health professionals who use ultrasound for diagnostic applications. Noting that the clinical benefits of this safe, effective, and highly flexible diagnostic tool depend on the training and skills of the user, the report responds to the problems created by the absence, in all but a few affluent countries, of properly developed programmes for training in ultrasonography. These problems, which include the expense of unnecessary examinations as well as the risk of misdiagnosis, are further compounded by the lack of regulation of equipment, its low cost, and recent technical innovations that have increased the difficulties of performing examinations and interpreting their results.
With these problems in mind, the report sets out international guidelines, including recommended curriculum content, for training users to perform and interpret clinical examinations commonly required in different health care settings. While noting that nurses, physicians' assistants, and other health workers often perform examinations, the report recognizes that the interpretation of ultrasound images and diagnostic decision-making are everywhere the responsibility of physicians. Recommended minimum standards for training reflect the consensus reached by an international group of 15 experts. Several professional societies, including the World Federation for Ultrasound in Medicine and Biology, also contributed their considerable experience and advice.
The report has six main sections. The first traces the rapid development of diagnostic ultrasound and explains why standards for ultrasonography training must be regarded as a prerequisite for the provision of high-quality diagnostic ultrasound services. Section two reviews recent trends in the utilization of diagnostic ultrasound in clinical practice, and examines the variety of practices, in a range of different countries, that govern the training of users.
Against this background, section three presents recommended ultrasonography curricula judged appropriate for medical students, and for the general, advanced, and specialized training of physicians. General ultrasonography training for sonographers and other allied health professionals is covered in section four.
The recommended content of curricula is expanded in section five, which describes the aspects of basic sciences and instrumentation that should be included in general and advanced training for physicians and allied health professionals. Section six discusses the level of competence that should be reached during training, and presents recommended standards for training programmes and the training process, including requirements for instructors and training centres. The report concludes with a summary of recommendations and conclusions, followed by a list, organized according to clinical specialty, of common applications of diagnostic ultrasound.
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