Fostering Collaboration in Global Emergency Ultrasound Training Programs

David A. Martin, MD
Director, Emergency Ultrasound Fellowship
Department of Emergency Medicine
Alameda Health System - Highland Hospital
Volunteer Clinical Professor
UCSF School of Medicine

The newly established joint meeting between the American College of Emergency Physicians (ACEP) Emergency Ultrasound Global Ultrasound Subcommittee and the Society for Academic Emergency Medicine (SAEM) Global Emergency Medicine Academy POCUS Committee aims to enhance global collaboration and knowledge-sharing in emergency ultrasound. This initiative kicked off with two engaging sessions featuring expert panel discussions on key challenges and innovations in global ultrasound training.

The first meeting focused on remote quality assurance (QA) in ultrasound education, a crucial component for ensuring competency in global ultrasound training. A panel of experts with extensive experience in global health ultrasound initiatives shared insights into successfully implementing remote QA within their international training programs.

Panelists discussed various platforms that facilitate remote image review, with SonoClipShare emerging as a widely used, free option for global programs. This platform allows educators to review images asynchronously, provide structured feedback, and track learner progress across different sites. Some programs have also incorporated proprietary cloud-based storage systems, such as the Butterfly Cloud, to manage images and interpretations.

A significant barrier to effective remote QA is the ability to upload and store ultrasound images, particularly in regions with limited internet connectivity. Panelists shared strategies to overcome these challenges, such as offline image storage with batch uploading when reliable connections are available.

While some remote QA solutions are free, others require institutional investment. The discussion highlighted the importance of securing funding for software, data storage, and faculty time to ensure long-term sustainability. Some programs have secured donations or grants to support these costs, while others rely on the volunteer efforts of dedicated ultrasound educators.

The conversation underscored the need for a structured, scalable approach to remote QA. By integrating QA into regular workflows and providing ongoing mentorship, global ultrasound programs can ensure continuous skill development and program sustainability.

The second meeting focused on tele-ultrasound and its role in enhancing POCUS education and patient care. With advances in portable ultrasound technology and internet connectivity, tele-ultrasound has become a powerful tool for remote instruction, especially in areas where in-person mentorship is not feasible.

Panelists included experts from the U.S. and abroad who are actively integrating tele-ultrasound into their training programs. They highlighted how tele-ultrasound can be used for both real-time procedural guidance and remote learning in global health settings.

Panelists described various approaches to incorporating tele-ultrasound into medical education. Some programs employ a hybrid model, combining asynchronous training (such as pre-recorded didactic sessions) with scheduled tele-guidance for live scanning practice. Others utilize on-demand tele-guidance, allowing trainees to contact an expert for real-time assistance during patient care.

Several tele-ultrasound platforms were reviewed, including Butterfly’s TeleGuidance, Philips Lumify’s Reacts, and Zoom-based solutions. Key features that enhance tele-ultrasound training include live video streaming of both the ultrasound screen and the operator’s hand positioning, real-time image annotation, and bidirectional communication between instructors and learners.

Despite its advantages, tele-ultrasound faces barriers similar to remote QA, such as internet connectivity issues, cost, and institutional acceptance. Panelists shared experiences of overcoming resistance from radiology departments and securing buy-in from hospital administrators. In some cases, tele-ultrasound has proven instrumental in demonstrating the value of POCUS through real-time improvements in patient care.

Affordability remains a concern, particularly for low-resource settings. While some programs have received donated handheld ultrasound devices, others have had to fundraise or find creative solutions to minimize costs. The discussion also emphasized the importance of training local champions who can continue the program beyond its initial implementation.

These initial sessions set the stage for ongoing collaboration between ACEP and SAEM’s global ultrasound subcommittees. As global POCUS education continues to expand, initiatives like remote QA and tele-ultrasound will play a crucial role in ensuring high-quality, sustainable training programs.

Future meetings will continue exploring topics relevant to global emergency ultrasound. By fostering open discussions and sharing best practices, this joint venture aims to improve collaboration and elevate global emergency ultrasound training programs.

Save the Date

Meetings occur via Zoom on the second Wednesday of odd months (January, March, May, etc.) at 10:00 AM PST / 12:00 PM CST / 1:00 PM EST.

For more information or to get involved, please join our subcommittee Google Group, search for ACEP EUS Global Health Subcommittee.