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Skill and knowledge retention after training in cardiopulmonary ultrasound in Ghana: an impact assessment of bedside ultrasound training in a resource-limited setting
  1. Maxwell Osei-Ampofo1,
  2. Matthew J Tafoya2,
  3. Chelsea A Tafoya2,
  4. Rockefeller A Oteng3,
  5. Hassan Ali4,
  6. Torben K Becker5
  1. 1 Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
  2. 2 Department of Emergency Medicine, Highland Hospital, Oakland, California, USA
  3. 3 Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
  4. 4 University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA
  5. 5 Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Torben K Becker, Department of Emergency Medicine, University of Florida, Gainesville, FL 32608, USA; tbeckermd{at}


Objective Brief training courses in bedside ultrasound are commonly done by visiting faculty in low-income and middle-income countries, and positive short-term effects have been reported. Long-term outcomes are poorly understood. We held a training course on a cardiopulmonary ultrasound (CPUS) protocol over two separate 10-day periods in 2016. In 2017, 9–11 months after the initial training, we assessed skill and knowledge retention as well as perceived impact on local practice.

Methods A written test using six clinical vignettes and an observed structured clinical examination were used to assess theoretical knowledge and practical skills. Additionally, in-person interviews and a written survey were completed with the physicians who had participated in the initial training.

Results All 20 participants passed the written and clinical examination. The median follow-up test score was 10 out of 12, compared with a median score of 12 on a test completed immediately after the initial training. Physicians identified the ability to narrow their differential diagnosis and to initiate critical interventions earlier than without ultrasound as a key benefit of the CPUS training. They rated the cardiac, abdominal and inferior vena cava components of the CPUS protocol as most relevant to their everyday practice.

Conclusion Long-term ultrasound knowledge and skill retention was high after a brief and intensive training intervention at an academic tertiary hospital in Ghana. Clinicians reported improvements in patient care and local practice patterns.

  • ultrasound
  • training
  • global health

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  • MO-A and MJT contributed equally.

  • Contributors MO-A, MJT and TKB wrote the manuscript and collected the follow-up data. MO-A, MJT, CAT, RAO and TKB performed the ultrasound training. MJT, HA and TKB analysed the data.

  • Funding CAT received grant funding from the University of Michigan International Institute, Ann Arbor, Michigan, USA. CAT and MJT both received reimbursement for travel expenses from the University of Michigan Global Reach program, Ann Arbor, Michigan, USA. Both funders played no other role in this study. General Electric (GE) Company, Connecticut, USA, loaned the VScan devices to Komfo Anokye Teaching Hospital for use in this study. GE had no influence on study design, ultrasound training or data analysis.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional Review Board of the University of Michigan and the Committee on Human Research, Publications and Ethics at Kwame Nkrumah University of Science and Technology, School of Medical Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.