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

25. PRIVILEGES

26. ACS ULTRASOUND
EDUCATION PROGRAM
• Structured development within ACS
• Assures proper and safe use of technology
• Model for learning other new skills