The 1st ACOUSTIC (Certification of Ultrasound Use in Intensive Care) Course 2023
As the field of medicine progresses, improvement in technology brings upon a new frontier in the management of critically ill patients with the hope of improving their outcomes. Point of care ultrasound is no exception and has been proven to be helpful in offering vital information to decide on therapeutic options in the critically ill who has very limited margin for errors. However, many would argue that high variability in user dependency may be a hindrance towards accurate decision making and thus, training and accreditation is a vital key to ensure everyone is on the same level. Thus, the Malaysian Society of Intensive Care (MSIC) took to task this aspect and started the effort to standardize teaching and formalize ultrasound training in the intensive care. The task was given to Dr Foong Kit Weng, an intensivist practicing in Hospital Raja Permaisuri Bainun with a special interest in ultrasonography. 8 months of work was put into this project as he needed to assemble a team to come up with the course structure and curriculum. The end product is what we finally call ACOUSTIC (Certificate of Ultrasound Use in Intensive Care). The course proposal was submitted and further deliberations, it was approved by the Malaysian Society of Intensive Care for launch.
The course was then introduced on the MSIC website and within 2 weeks, we had about 40 applicants for the course. Because of the limited space we had to ensure a good facilitator to participant ratio, scrutiny had to be observed for this round and eventually 25 participants were shortlisted for the course. The participants had a mix of consultant intensivists, intensive care trainees and anaesthetists from across the nation.
The first course was successfully held in Hospital Raja Permaisuri Bainun Daycare Centre on the 11th and 12th of July 2023. It was a two full day course comprising of didactic lectures and hands on sessions where participants were taught on topics on ultrasonography in a head-to-toe approach with emphasis on hemodynamic management and echodynamics. The facilitators were:
- Dr Foong Kit Weng, Intensivist, Hospital Raja Permaisuri Bainun
- Dr Shanti Ratnam, Intensivist, Thomson Hospital Kota Damansara
- Dr Premela Naidu, Intensivist, Subang Jaya Medical Centre
- Dr Juita Binti Hassan, Intensivist, Pusat Perubatan UiTM
- Dr Gaithridevi, Intensivist, Hospital Pulau Pinang
- Dr Lee Biing Horng, Physician, Hospital Raja Permaisuri Bainun
- Dr Calvin Wong Ke Wen, Physician, Sarawak General Hospital
- Mr Thangervelu Annamalay, Senior Cardiovascular Technician, KPJ Taiping Medical Centre
Participants were very engaging throughout the course with interactive discussions even held during the hands-on sessions. Because this is a certification course, formal assessment will be held at the end of 6 months and during this 6-month period, every candidate would need to fill up a logbook as a prerequisite for the assessment. The logbook will be monitored online by a supervisor assigned by the committee. A 1-week attachment could also be planned to perform on site ultrasonographic examination in Hospital Raja Permaisuri Bainun and Hospital Pulau Pinang during this 6-month period if the candidate is interested to do so, under the purview of Dr Foong Kit Weng and Dr Lee Biing Horng in Perak while Dr Gaithridevi will be covering Penang.
The committee also had a postmortem session with regards to the course’s conduct and we are very thankful for the valuable feedback given. Moving forward, the feedback will enable us to improve on certain aspects of the course to give future candidates an even better learning experience. We also hope that from this course, future supervisors and even facilitators can be elected to further expand the reach of the program with the aim of having each Intensive Care Unit in the nation equipped with an ACOUSTIC on site supervisor.
In conclusion, point of care ultrasound in the intensive care unit is here to stay and with that, proper guidance and accreditation is vital to standardize practice and to minimize errors and user dependency. The committee would like to thank Dr Shanti Rudra Deva for her thoughts and pointers in getting the course rolling for point of care ultrasound in the intensive care fraternity and to the Malaysian Society of Intensive Care for their assistance in the administrative conduct of the course.
