INSIGHT Training Program

What you need to know

Thank you for supporting the INSIGHT training program. This page describes the training requirements to become competent in providing the INSIGHT training scan and translating this to train others and provide useful clinical information

Overview

Ultrasound is different from imaging such as a chest X-ray or CT scan, because you are viewing the patient anatomy and pathophysiology in real time rather than reviewing a static picture of clinical information from a moment in time.

INSIGHT is a whole-body or multi-system critical care ultrasound scanning protocol. This differs from standard diagnostic ultrasound which tends to look at one specific structure (e.g. the liver) to identify suspected abnormalities. INSIGHT training includes face-to-face and distant supported training in a rapid scheduled assessment of critically ill patients. Although nurse led, INSIGHT is open to any healthcare professional In critical care ultrasound, the ability to assess and re-assess, and/or provide the ultrasound at any time (day or night) could be invaluable especially when departmental imaging may not be immediately available.

Training

Making the training work

The training is free and the team are aware how busy you are likely to be. The format of training consists of a training day followed by supervised and unsupervised scans with ICU patients. We will tailor your supervised scans to suit your work and home commitments. We will try to find ways of making the course as stress-free as possible for you.

Some trainees choose to complete their first 5 directly supervised scans on a day off which can help maintain momentum. Others choose to scan patients they are looking after during their shifts which helps to create a more comprehensive picture of their clinical condition.

To be effective in a critical care setting, the ultrasound images have to be provided by and available to the whole inter-professional team with the minimum number of clicks. This is because the tempo of critical illness (septic shock; lung injury/ARDS; traumatic brain injury) is much higher than standard disease. We will be exploring ways of optimising storage and accessibility of images during the research project.

Training day

The initial 1-day face-to-face training session includes didactic lectures, case studies, hands-on sessions to develop practical skills, and useful online resources. Lectures will be taught by intensivists who are experienced PoCUS supervisors and accredited in sonography.

Trainees will complete a written multiple choice knowledge questionnaire (MCQ) before and after the training day to assess knowledge learnt.

Main Training Programme (6-month limit to achieve competency)

The training programme consists of:

- Five initial INSIGHT scans directly supervised by at least a FUSIC accredited clinician.

- Trainees will then alternate unsupervised and supervised scans until they achieve a consistently high score across all competency domains.

- We are assessing competence in image acquisition, image quality, reporting, and overall proficiency.

After completion of training

A key part of INSIGHT is trying to build systems in place to ensure that INSIGHT is applied clinically in day-to-day practice and that skills are maintained. Trainees are free to continue performing scans with 3 monthly reviews to ensure they are to INSIGHT standard. All scans performed post INSIGHT training are reviewed by an appropriately trained clinician. We are developing a 'train the trainer' pathway for all INSIGHT-competent clinicians.

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Who can do INSIGHT

ICU Nurses, ACCPs, physiotherapists or doctors that can commit to a 6-month training programme.

Is INSIGHT supported by patients and their relatives

INSIGHT is supported by multiple patients and public and the INSIGHT program is designed to help all of our patients irrespective of their background or diagnosis. The study was designed with the input of ICU survivors, ICU patient family members and the public. Because of this, the INSIGHT scan is performed only when it is convenient to the patient, without repositioning them, and ensuring they are comfortable during the scan. We co-designed our study outcomes to make them patient-centred and relevant to the ICU patient.

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Training

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