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Demonstration of a Longitudinal Action Medical Mission (LAMM) Model to Teach Point-of-Care Ultrasound in Resource-Limited Settings

Yao, Michael and Uhr, Lauren and Daghlian, George and Amrute, Junedh M. and Deshpande, Ramya and Mathews, Benji and Patel, Sanjay A. and Henri, Ricardo and Liu, Gigi and Reierson, Kreegan and Johnson, Gordon (2020) Demonstration of a Longitudinal Action Medical Mission (LAMM) Model to Teach Point-of-Care Ultrasound in Resource-Limited Settings. . (Unpublished)

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BACKGROUND: Short-term medical missions prevail as the most common form of international medical volunteerism, but they are ill-suited for medical education and training local providers in resource-limited settings. OBJECTIVE: The purpose of this study is to evaluate the effectiveness of a longitudinal educational program in training clinicians how to perform point-of-care ultrasound (POCUS) in resource-limited clinics. DESIGN: A retrospective study of such a four-month POCUS training program was conducted with clinicians from a rural hospital in Haiti. The model included one-on-one, in-person POCUS teaching sessions by volunteer instructors from the United States and Europe. The Haitian trainees were assessed at the start of the program and at its conclusion by a direct objective structured clinical examination (OSCE), administered by the visiting instructors, with similar pre- and post- program ultrasound competency assessments. RESULTS: Post-intervention, a significant improvement was observed (p < 0.0001), and each trainee showed significant overall improvement in POCUS competency independent of the initial competency pre-training (p < 0.005). There was a statistically significant improvement in POCUS application for five of the six medically relevant assessment categories tested. CONCLUSION: Our results provide a proof-of-concept for the longitudinal education-centered healthcare delivery framework in a resource-limited setting. Our longitudinal model provides local healthcare providers the skills to detect and diagnose significant pathologies, thereby reducing avoidable morbidity and mortality at little or no addition cost or risk to the patient. Furthermore, training local physicians obviates the need for frequent volunteering trips, saving costs in healthcare training and delivery.

Item Type:Report or Paper (Discussion Paper)
Related URLs:
URLURL TypeDescription Paper
Yao, Michael0000-0002-7008-6028
Daghlian, George0000-0002-4921-0442
Additional Information:The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license. This version posted May 13, 2020. No external funding was received in explicit support of the work presented. Data Availability: The data that support the findings of this study are available from the first author upon reasonable request. The authors have declared no competing interest. Author Declarations: All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes. I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes. I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes.
Subject Keywords:POCUS, Resource-limited, Longitudinal, Haiti, POCUS Training
Record Number:CaltechAUTHORS:20201120-065932095
Persistent URL:
Official Citation:Demonstration of a Longitudinal Action Medical Mission (LAMM) Model to Teach Point-of-Care Ultrasound in Resource-Limited Settings. Michael Steven Yao, Lauren Uhr, George Daghlian, Junedh M Amrute, Ramya Deshpande, Benji Mathews, Sanjay A Patel, Ricardo Henri, Gigi Liu, Kreegan Reierson, Gordon Johnson. medRxiv 2020.05.08.20095760; doi:
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:106748
Deposited By: Tony Diaz
Deposited On:20 Nov 2020 17:49
Last Modified:16 Nov 2021 18:56

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