Community-Based Tele-Mentored Ultrasound for Urological Screening in Rural Primary Care

Authors

  • Afdal Universitas Riau, Indonesia https://orcid.org/0009-0000-0112-7853
  • Indra Jaya Universitas Riau, Indonesia
  • Muhammad Teguh Hardiansyah Universitas Riau, Indonesia
  • Muhammad Adan Yashar Universitas Riau, Indonesia https://orcid.org/0009-0007-3319-5560
  • Gatot Aji Prihartomo Universitas Riau, Indonesia
  • Romy Deviandri Universitas Riau, Indonesia
  • Sinta Chaira Maulanisa Universitas Riau, Indonesia

DOI:

https://doi.org/10.33394/jpu.v7i2.20028

Keywords:

Tele-Mentored Ultrasound, Online Consultation, Urological Screening, Rural Primary Care

Abstract

This community service activity aims to assess the feasibility and impact of the community-based HHUS tele-mentoring program for urological screening in rural primary healthcare centers in Indonesia. A prospective quasi-experimental study was conducted from August to October 2025 at Pangkalan Baru Primary Health Center, Riau, Indonesia. Four general practitioners (GPs) underwent a one-day HHUS training session, followed by one month of tele-mentoring using the UroSono Mentor app, a telemedicine platform that supports both real-time video consultation and asynchronous image review, and one additional month of independent practice. Confidence, usability, feasibility, mentor responsiveness, patient satisfaction, and behavioral intention were assessed using structured questionnaires. Data were analyzed using the Friedman test (p < 0.05). Confidence scores improved significantly across all phases (p = 0.018), increasing from 2.06 (pre-training) to 4.37 (tele-mentoring) and 3.81 (independent practice). Training satisfaction was high (3.81 ± 0.19), with positive ratings for mentor responsiveness (4.44 ± 0.24) and usability (4.13 ± 0.14). Patient satisfaction averaged 4.49 ± 0.54. Of the 26 patients examined, 69.2% had normal findings, while 30.8% required referral. Community-based tele-mentored HHUS effectively enhanced GPs’ competence and confidence, achieving strong acceptance among both healthcare providers and patients. The UroSono Mentor model shows promise for scalable integration into rural urological screening programs.

References

Aakjær Andersen, C., Brodersen, J., Davidsen, A. S., Graumann, O., & Jensen, M. B. B. (2020). Use and impact of point-of-care ultrasonography in general practice: A prospective observational study. BMJ Open, 10(9), 1–9. doi:https://doi.org/10.1136/bmjopen-2020-037664

Akanuwe, J. N. A., Siriwardena, A. N., Bidaut, L., Mitchell, P., Bird, P., Lasserson, D., … Lilford, R. (2023). Practitioners’ views on community implementation of point-of-care ultrasound (POCUS) in the UK: a qualitative interview study. BMC Health Services Research, 23(1), 1–10. doi:https://doi.org/10.1186/s12913-023-09069-4

Baribeau, Y., Sharkey, A., Chaudhary, O., Krumm, S., Fatima, H., Mahmood, F., & Matyal, R. (2020). Handheld Point-of-Care Ultrasound Probes: The New Generation of POCUS. Journal of Cardiothoracic and Vascular Anesthesia, 34(11), 3139–3145. doi:https://doi.org/10.1053/j.jvca.2020.07.004

Bidner, A., Bezak, E., & Parange, N. (2022). Evaluation of antenatal point-of-care ultrasound training workshops for rural/remote healthcare clinicians: a prospective single cohort study. BMC Medical Education, 22(1), 1–16. doi:https://doi.org/10.1186/s12909-022-03888-5

Bisset, B., Shriram, T., Davuluri, M., Azar, H., Beilan, J., Amin, R., & Houman, J. (2025). Applications and Outcomes of Telehealth and Integrated Care in Men’s Health Urology. Journal of Medical Internet Research, 27, 1–10. doi:https://doi.org/10.2196/69095

Britton, N., Miller, M. A., Safadi, S., Siegel, A., Levine, A. R., & McCurdy, M. T. (2019). Tele-ultrasound in resource-limited settings: A systematic review. Frontiers in Public Health, 7(SEP). doi:https://doi.org/10.3389/fpubh.2019.00244

Bui, C., Parange, N., Bezak, E., & Bidner, A. (2024). The Role of Telehealth in Ultrasound Training for Remote Learners: A Systematic Review. Telemedicine and E-Health, 30(4), 963–975. doi:https://doi.org/10.1089/tmj.2023.0396

Duarte, M. L., Dos Santos, L. R., Iared, W., & Peccin, M. S. (2022). Telementored ultrasonography: A narrative review. Sao Paulo Medical Journal, 140(2), 310–319. doi:https://doi.org/10.1590/1516-3180.2020.0607.R2.15092021

Eadie, L., Mulhern, J., Regan, L., Mort, A., Shannon, H., Macaden, A., & Wilson, P. (2018). Remotely supported prehospital ultrasound: A feasibility study of real-time image transmission and expert guidance to aid diagnosis in remote and rural communities. Journal of Telemedicine and Telecare, 24(9), 616–622. doi:https://doi.org/10.1177/1357633X17731444

Elshehry, A., Ghafri, S. Al, & Jufaili, M. Al. (2025). Longitudinal point-of-care ultrasound training program for emergency medicine faculty in Oman: a Kirkpatrick model approach. BMC Medical Education, 25(1). doi:https://doi.org/10.1186/s12909-025-07954-6

Grubic, N., Nihal, S., Herr, J. E., Jelic, T., Montague, S. J., Aleksova, N., … Johri, A. M. (2025). Training Nonexpert Users in Cardiopulmonary Point-of-Care Ultrasound Using a Virtual Curriculum and a Teleconsultation Model: A Multicentre Study. CJC Open. doi:https://doi.org/10.1016/j.cjco.2025.06.009

Jemal, K., Ayana, D., Tadesse, F., Adefris, M., Awol, M., Tesema, M., … Mendez, I. (2024). Implementation and evaluation of a pilot antenatal ultrasound imaging programme using tele-ultrasound in Ethiopia. Journal of Telemedicine and Telecare, 30(6), 1005–1016. doi:https://doi.org/10.1177/1357633X221115746

Kirkpatrick, A. W., McKee, J. L., Ball, C. G., Ma, I. W. Y., & Melniker, L. A. (2022). Empowering the willing: the feasibility of tele-mentored self-performed pleural ultrasound assessment for the surveillance of lung health. Ultrasound Journal, 14(1). doi:https://doi.org/10.1186/s13089-021-00250-6

Kirshenbaum, E., Rhee, E. Y., Gettman, M., & Spitz, A. (2021). Telemedicine in Urology: The Socioeconomic Impact. Urologic Clinics of North America, 48(2), 215–222. doi:https://doi.org/10.1016/j.ucl.2021.01.006

Moore, C. L., & Copel, J. A. (2011). Point-of-care ultrasonography. New England Journal of Medicine, 364(8), 749–757. doi:https://doi.org/10.1056/NEJMra0909487

Naik, N., Hameed, B. M. Z., Nayak, S. G., Gera, A., Nandyal, S. R., Shetty, D. K., … Somani, B. K. (2022). Telemedicine and Telehealth in Urology—What Do the ‘Patients’’ Think About It?’ Frontiers in Surgery, 9(April), 1–11. doi:https://doi.org/10.3389/fsurg.2022.863576

Neves, A. L., van Dael, J., O’Brien, N., Flott, K., Ghafur, S., Darzi, A., & Mayer, E. (2024). Use and impact of virtual primary care on quality and safety: The public’s perspectives during the COVID-19 pandemic. Journal of Telemedicine and Telecare, 30(2), 393–401. doi:https://doi.org/10.1177/1357633X211066235

Novara, G., Checcucci, E., Crestani, A., Abrate, A., Esperto, F., Pavan, N., … Ficarra, V. (2020). Telehealth in Urology: A Systematic Review of the Literature. How Much Can Telemedicine Be Useful During and After the COVID-19 Pandemic? European Urology, 78(6), 786–811. doi:https://doi.org/10.1016/j.eururo.2020.06.025

Robertson, T. E., Levine, A. R., Verceles, A. C., Buchner, J. A., Lantry, J. H., Papali, A., … McCurdy, M. T. (2017). Remote tele-mentored ultrasound for non-physician learners using FaceTime: A feasibility study in a low-income country. Journal of Critical Care, 40, 145–148. doi:https://doi.org/10.1016/j.jcrc.2017.03.028

Smith, A., Addison, R., Rogers, P., McLean, J. S., Boyd, S., Hoover, K., … Parsons, M. (2018). Remote mentoring of point-of-care ultrasound skills to inexperienced operators using multiple telemedicine platforms: Is a cell phone good enough? Journal of Ultrasound in Medicine, 37(11), 2517–2525. doi:https://doi.org/10.1002/jum.14609

Swanson, J. O., Nathan, R. O., Swanson, D. L., Perez, K. M., Bresnahan, B. W., Mirza, W., & Goldenberg, R. L. (2019). Use of ultrasound and mHealth to improve perinatal outcomes in low and middle income countries. Seminars in Perinatology, 43(5), 267–272. doi:https://doi.org/10.1053/j.semperi.2019.03.016

Vatsvåg, V., Todnem, K., Næsheim, T., Cathcart, J., Kerr, D., & Oveland, N. P. (2020). Offshore telementored ultrasound: a quality assessment study. Ultrasound Journal, 12(1). doi:https://doi.org/10.1186/s13089-020-00180-9

Wherton, J., Greenhalgh, T., Hughes, G., & Shaw, S. E. (2022). The Role of Information Infrastructures in Scaling up Video Consultations During COVID-19: Mixed Methods Case Study Into Opportunity, Disruption, and Exposure. Journal of Medical Internet Research, 24(11), 1–16. doi:https://doi.org/10.2196/42431

Zhou, Y. J., Guo, L. H., Bo, X. W., Sun, L. P., Zhang, Y. F., Chai, H. H., … Xu, H. X. (2023). Tele-Mentored Handheld Ultrasound System for General Practitioners: A Prospective, Descriptive Study in Remote and Rural Communities. Diagnostics, 13(18), 1–12. doi:https://doi.org/10.3390/diagnostics13182932

Downloads

Published

2026-05-08

How to Cite

Afdal, Jaya, I., Hardiansyah, M. T., Yashar, M. A., Prihartomo, G. A., Deviandri, R., & Maulanisa, S. C. (2026). Community-Based Tele-Mentored Ultrasound for Urological Screening in Rural Primary Care. Jurnal Pengabdian UNDIKMA, 7(2), 444–457. https://doi.org/10.33394/jpu.v7i2.20028

Citation Check