Christian España Schmidt MD, FACP

Danbury Hospital

Christian.Espanaschmidt@nuvancehealth.org

Bio

He is an academic hospitalist and the current program director of the Point-of-care ultrasound (POCUS) for Internal Medicine at Danbury Hospital. A program he started in 2017 based on his prior experience in training physicians in procedural medicine and echocardiography electives.
He is an assistant professor at the University of Vermont and the American University of the Caribbean School of Medicine.

Dr. España Schmidt is a graduate of Universidad de San Carlos de Guatemala School of Medicine. As a student, he received many distinctions, including the Cathedra Prima award for being the top student in his class. While in Medical School, he served as the elected representative of the students at the Superior Teaching Committee and the Professors and Dean Council.

After graduation, he finished an Internal Medicine Residency in “Hospital General” in Guatemala City, where he was awarded the “Roemers” award for the top resident for 2000-2003. He was also the recipient of the “Robinson Scholarship” spending four months in Saint Vincent Indianapolis in an elective of echocardiography.

In Guatemala, he was the founder of the East Chapter of the College of Physicians and Surgeons and was President from 2005 to 2009.

He came to New York City in 2009. There he finished a residency in Internal Medicine at Metropolitan Hospital. He received the Gold Foundation Humanism and Excellence in Teaching award at New York Medical College. And served as the Chief Resident. He became a Fellow of the American College of Physicians, nominated by the Vice-president of the College in 2015. In the United States, he worked as an academic hospitalist at The Reading Hospital in Pennsylvania. He has authored and co-authored many articles and posters. He is an international speaker and lecturer in Internal Medicine and POCUS. Today, he has developed the teaching of POCUS and is working on implementing a system-based POCUS certification for his program at Danbury Hospital.

Scholarly Project

Point of Care Ultrasound Curriculum Improvement and Implementation

SCHOLARLY PROJECT
Point of care ultrasound curriculum improvement and implementation

Christian España Schmidt MD, FACP

Patricia A. Tietjen, MD
Teaching Academy, Nuvance Health

PROJECT ABSTRACT

Point of Care Ultrasound Curriculum Improvement and Implementation

Point of care ultrasound (POCUS) is a core skill in many medical disciplines. Now it’s being implemented at the Danbury Hospital for the training of internal medicine residents. Contents of this course, quality, and competencies for graduates have not been yet assessed. Recently it has been reported that 61% of programs in America have some formal training in procedural POCUS and, 35% of internal medicine programs have a curriculum for diagnostic POCUS. It is still not clear what the competencies in training POCUS for internal medicine residents are. The purpose of this “quality-improvement intervention” is to assess the quality of an established POCUS training program in a cohort of Internal medicine residents. The Danbury Hospital POCUS program is a multi-component program offering an initial bootcamp, 14 hours of asynchronous content, lectures in core competencies, rounds with attendings who are proficient in POCUS in the wards and intensive care unit, a one-week elective, point of care ultrasound procedures, “ad-lib scanning program,” simulations, the creation of an image portfolio, and a system-based certification. As part of our quality improvement, this academic year we are assessing the course via completion of asynchronous modules, attendance at lectures, and voluntary learner satisfaction surveys after electives and boot camps. All 22 first-year residents (PGY1s) attended a POCUS bootcamp. None of the residents had any formal POCUS training before the bootcamp. All 22 PGY1s filled out a survey after bootcamp. 100% were satisfied with the Bootcamp, faculty, and time management. All 22 of our PGY1 residents have completed the asynchronous materials. 89% of all our first and second years have attended all lectures. 40 out of 44 first and second years have attended at least 30 hours of POCUS elective. All the 66 residents of all residents had at least one session in the simulation lab for central line placement. Since June 2021 more than 400 studies have been performed and documented by the residents or faculty. (There is no reliable system in place to assess the real number and this is likely an underestimation). 17 out of 22 PGY1 residents have completed satisfaction surveys after the point of care ultrasound elective. 15 strongly agree that POCUS is useful in Internal Medicine, 15 will try to complete a system-based portfolio, 13 feel confident in identifying structures, 15 are confident in image acquisition, 16 are confident in obtaining lung ultrasound, 17 were very satisfied with the elective, 17 were very satisfied with the faculty. The Danbury Hospital POCUS program appears to be well received by residents and faculty involved. Lectures, elective, and simulation sessions have been well attended and POCUS studies are being performed frequently. The overall satisfaction and confidence are high among the residents surveyed.A system for the evaluation of competencies has been outlined, however, remains to be implemented. Presuming that competency development follows course element participation and is often related to reported confidence in skills, we expect that resident POCUS competency will be high.The next steps include assessing residence competency in POCUS performance and expanding the POCUS course more broadly to Nuvance-Health, offering the course to other GME programs, and for medical faculty development.