Teaching point-of-care ultrasound in Ethiopia
When Anne Aspler, MD, FRCPC, worked in the developing world in the early 2000s, she noticed that cell phones were more prevalent than in the developed world. The infrastructure for landlines was often cumbersome for resource-limited areas, so people found another solution.
Fast forward to the 2020s and Dr. Aspler sees a strong parallel with imaging infrastructure. Instead of introducing costly and cumbersome imaging solutions, resource-limited countries are turning to more affordable, portable technologies such as handheld point-of-care ultrasound (POCUS).
“POCUS imaging is poised to become the primary imaging modality in many emergency departments across the globe,” says Dr. Aspler.
As POCUS becomes more common, it needs practitioners to use it. Radiologists are in short supply at the 20 public hospitals in Addis Ababa, Ethiopia, where Dr. Aspler is using International Development, Aid and Collaboration funding to help build a POCUS fellowship. For example, at Tikur Anbessa Specialized Hospital, the city’s foremost teaching hospital, radiology is not available after 5:00 p.m. “If a patient comes in after an accident at night, they have to travel to another location and pay out of pocket for radiology service,” says Dr. Aspler.
No formal POCUS fellowship program exists at present in sub-Saharan Africa, so Dr. Aspler and her team see a golden opportunity to build the East African Emergency Point of Care Ultrasound Fellowship in Addis Ababa in partnership with Addis Ababa University, the University of Toronto and others. She and her co-lead Claire Acton, MD, FRCPC, are developing a sustainable fellowship that will increase the area’s capacity to administer emergency POCUS as handheld ultrasound becomes more common.
Working with identified candidates to improve skills
Addis Ababa University currently has four junior Emergency Medicine faculty members with core foundational competency in POCUS who need additional expertise to administer a high-quality POCUS education program and fellowship. “These excellent faculty are poised to become leaders in the field pending further mentorship and training,” says Dr. Aspler. In addition to training the four identified Emergency physicians as teachers, Dr. Aspler’s project will recruit two to three other trainees to learn skills in key areas:
- Ultrasound scanning expertise, from beginner to advanced applications
- Expertise as a teacher, including curriculum development and leadership skills
- Scholarship and research experience in POCUS
- Understanding how to develop and implement a quality assurance process for POCUS
- Administrative experience to set up and run a POCUS program
“The ultimate goal is to enable local staff to be experts in teaching POCUS and save lives,” says Dr. Aspler.
In addition to the training program, Dr. Aspler’s two-year project will create a POCUS faculty mentorship program, which will enable the four identified university faculty to run the program indefinitely with support from the University of Toronto.