Ultrasonography Performed by Primary Care Residents for Abdominal Aortic Aneurysm Screening

An Innovative Teaching Model

Authors

  • Raymond P. Bailey MD,

    Corresponding author
    1. Received from the Division of General Internal Medicine (RPB, MA), and the Vascular Laboratory (TR, DC), Cedars-Sinai Medical Center; and Zynx Health Incorporated (NLG), Cedars-Sinai Health System, Los Angeles, Calif.
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  • Mark Ault MD,

    1. Received from the Division of General Internal Medicine (RPB, MA), and the Vascular Laboratory (TR, DC), Cedars-Sinai Medical Center; and Zynx Health Incorporated (NLG), Cedars-Sinai Health System, Los Angeles, Calif.
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  • Nancy L. Greengold MD, MBA,

    1. Received from the Division of General Internal Medicine (RPB, MA), and the Vascular Laboratory (TR, DC), Cedars-Sinai Medical Center; and Zynx Health Incorporated (NLG), Cedars-Sinai Health System, Los Angeles, Calif.
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  • Thomas Rosendahl RN, RVT,

    1. Received from the Division of General Internal Medicine (RPB, MA), and the Vascular Laboratory (TR, DC), Cedars-Sinai Medical Center; and Zynx Health Incorporated (NLG), Cedars-Sinai Health System, Los Angeles, Calif.
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  • David Cossman MD, RVT

    1. Received from the Division of General Internal Medicine (RPB, MA), and the Vascular Laboratory (TR, DC), Cedars-Sinai Medical Center; and Zynx Health Incorporated (NLG), Cedars-Sinai Health System, Los Angeles, Calif.
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* Address correspondence and reprint requests to Dr. Bailey: 8723 Alden Dr., Steven Spielberg Bldg., Room 200, Los Angeles, CA 90048 (e-mail: Baileyr@CSHS.org).

Abstract

A prospective pilot study was undertaken to assess a protocol to educate primary care residents in how to personally perform ultrasonography for abdominal aortic aneurysm screening. Resident exams were proctored by a primary care physician trained in ultrasonography and were scored on the level of competence in doing the examination. Patients had ultrasound performed by a resident, followed by repeat examination by the vascular lab. Primary care resident abdominal aortic imaging was achieved in 79 of 80 attempts. Four abdominal aortic aneurysms were identified. There were 75 normal examinations; resident ultrasonography results were consistent with the results of the vascular lab. Ten residents achieved an abdominal aortic ultrasound-independent competence level after an average of 3.4 proctored exams. The main outcome of this study is that a primary care resident, with minimal training in ultrasonography imaging, is able to rapidly learn the technique of ultrasonography imaging of the abdominal aorta.

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