Developing procedural ultrasound capacity in Malawi through a focused training course.

INTRODUCTION

Ultrasound is an essential tool in resource limited settings. However, significant barriers limit the adoption of ultrasound-guided procedures, including lack of structured training, supervision, and integration into clinical workflows. This study aimed to develop, implement, and evaluate a focused ultrasound-guided procedure training course and early clinical uptake in a tertiary care setting in Malawi.

METHODS

This is an implementation pilot. We conducted an informal needs assessment by way of semi-structured stakeholder interviews to inform course development. Quantitative outcomes for one anchor skill (fascia iliaca block) included knowledge testing, OSCE performance, procedure utilization logs during a 6-week support period, and confidence assessments immediately post-course and after 12 months.

RESULTS

Twenty-eight doctors from multiple specialties completed the ultrasound-guided procedure course, with 27 completing pre- and post-course assessments. Mean knowledge scores for the anchor skill increased from 47.7% pre-course to 74.8% post-course (p <0.01). All participants demonstrated competency in fascia iliaca block on post-course OSCE assessment. Post-course confidence was high across most domains and remained elevated among respondents at 12-month follow-up. During the six-week post-course support period, seven ultrasound-guided procedures were performed with support from the ultrasound team.

CONCLUSION

Implementation of an affordable ultrasound guided procedure course is feasible in resource limited settings within the appropriate setting. Implementation of a new skill utilizing the same is feasible but efficacy cannot be determined from this study.