The PEARLS Program: Point-of-Care Ultrasound for Emergency and Acute Care in Resource-Limited Settings

Area of Science:

• Medical Education
• Point-of-Care Ultrasound (POCUS)
• Global Health

Background:

• Limited access to radiology services in low-resource settings necessitates innovative diagnostic solutions.
• Point-of-care ultrasound (POCUS) offers a valuable tool for emergency and acute care in resource-limited environments.
• The PEARLS program was developed to address the need for scalable POCUS training in low- and middle-income countries (LMICs).

Purpose of the Study:

• To evaluate the effectiveness and scalability of the PEARLS (POCUS in Emergency and Acute care in Resource-Limited Settings) program.
• To assess clinician engagement and POCUS skill acquisition through a longitudinal training model with remote mentorship.
• To identify challenges and facilitators for sustained POCUS competency in LMICs.

Main Methods:

• A review of participant data from Vanuatu, Tonga, and Papua New Guinea was conducted.
• The PEARLS program involves a three-day in-person course, provision of portable ultrasound devices, secure online image storage, and remote coaching.
• A train-the-trainer model was implemented, with participants transitioning to faculty roles after one year.

Main Results:

• Forty participants uploaded a total of 576 scans, primarily utilizing the extended FAST exam, critical care echocardiography, and first-trimester pregnancy assessments.
• Remote mentoring facilitated high participant engagement throughout the training period.
• Only one participant achieved the benchmark of 25 uploaded scans, indicating challenges in reaching full competency.

Conclusions:

• The PEARLS program demonstrates a viable, scalable framework for POCUS education in resource-limited settings.
• Longitudinal training with remote mentorship can enhance POCUS proficiency, but requires addressing infrastructure challenges.
• The program fosters local expertise and improves acute care diagnostics in LMICs.