Development of a Point-of-Care Ultrasound Track for Internal Medicine Residents

A shared point of care ultrasound curriculum for graduate medical education

BACKGROUND

Point of care ultrasound (POCUS) education has grown significantly over the past two decades. Like most curricular items, POCUS education is siloed within individual graduate medical education (GME) programs. The purpose of this study was to evaluate the effectiveness of a shared GME POCUS curriculum between five GME programs at a single institution.

METHODS

Post-graduate-year-1 (PGY-1) residents from emergency medicine (EM), family medicine (FM), internal medicine (IM), combined internal medicine-pediatrics (IM-Peds) and combined emergency medicine-pediatrics (EM-Peds) residency programs were enrolled in a core POCUS curriculum. The curriculum included eleven asynchronous online learning modules and ten hands-on training sessions proctored by sonographers and faculty physicians with POCUS expertise. Data was gathered about the curriculum's effectiveness including participation, pre- and post-curricular surveys, pre- and post-knowledge assessments, and an objective skills assessment.

RESULTS

Of the 85 residents enrolled, 61 (72%) participated in the curriculum. Engagement varied between programs, with attendance at hands-on sessions varying the most (EM 100%, EM-Peds 100%, FM 40%, IM 22%, Med-Peds 11%). Pre- and post-knowledge assessment scores improved for all components of the curriculum. Participants felt significantly more confident with image acquisition, anatomy recognition, interpreting images and incorporating POCUS findings into clinical practice (p < 0.001) after completing the curriculum.

CONCLUSION

In this shared GME POCUS curriculum, we found significant improvement in POCUS knowledge, attitudes, and psychomotor skills. This shared approach may be a viable way for other institutions to provide POCUS education broadly to their GME programs.

A Longitudinal Elective Facilitates Point-of-Care Ultrasonography Education for Medical Students: An Observational Study

OBJECTIVE

Determine if a longitudinal point-of-care ultrasonography (POCUS) elective for medical students is effective in improving POCUS knowledge.

METHODS

We share the format of our longitudinal POCUS elective for medical students. To evaluate the efficacy of our longitudinal elective, we compare the difference between pre-elective and post-elective scores on a POCUS test using a paired t-test with threshold of statistical significance of p ≤ .05. We also share the results of a post-elective survey evaluating the effectiveness and quality of the longitudinal POCUS elective.

RESULTS

Pretest mean score was 56.3% (σ = 13.6), while posttest mean score was 73.3% (σ = 9.4), with an average score improvement of 17.0% (95% CI 9.9-24.0%, p < .0001). All students strongly or moderately agreed that they would recommend the elective to future medical students, that they were more confident with their POCUS skills after completing the elective, that the time commitment of the elective was appropriate, and that they felt they had the time to fit the elective into their schedule as a medical school student. Most students (56.7%) strongly or moderately agreed that the knowledge gained from the POCUS elective had helped them in their clinical rotations.

CONCLUSIONS

Our longitudinal POCUS curriculum subjectively and objectively improves medical students' POCUS knowledge while remaining accessible to students. We share our unique longitudinal POCUS elective curriculum, the format of which and its benefits are transferable to other medical schools. Through this, we hope to provide others with ideas on how they may implement a longitudinal POCUS elective.

An in-Depth Examination of the Characteristics of Pre-Hospital Point-of-Care Ultrasound Training Among Emergency Medicine Residents in Laos as Part of an Overseas Elective Rotation

Introduction

Point of Care Ultrasound (POCUS) training has been offering invaluable guidance in the diagnostic process and treatment strategies, particularly in resource-limited settings. The purpose of this study was to determine participant satisfaction with the structure and scope of POCUS training in overseas elective rotation.

Material and Methods

A retrospective observational analytical study was undertaken. The study focused on EM residents from Laos who participated in the international elective rotation at the Khon Kaen University during the academic years 2020-2021 and 2022-2023. The research involved an exploration of training data related to this course, encompassing participant characteristics, the structure and scope of POCUS training, the training assessments, and post completion surveys of participants.

Results

The study involved 24 participants. The course was characterized by its status as an international elective program prehospital POCUS training for post graduate year 3 students. The duration of the rotation ranged from 2 to 4 weeks. Interestingly, in the academic year 2022-2023, the duration of POCUS training was notably extended to 8 hours, accounting for 4.76% of the total time. The training encompassed peer-to-peer didactic lectures, bedside teaching, and observational case studies at the Emergency Department (ED). The results of our survey, boasting a 100% response rate, indicated participants' contentment with the academic performance, the abundance of learning resources, and the knowledge gained from this rotation that would aid their future careers. The overall satisfaction with this course was highly rated, falling into the "satisfy" and "highly satisfy" categories. However, certain challenges were reported, including feelings of isolation due to the distance from relatives, concerns related to interpersonal relationships with colleagues, and a sense of being isolated.

Conclusion

The participants were highly satisfied to the structure and scope of this course. The overseas elective rotation significantly enhanced the knowledge of Laos EM residents' in POCUS and underscored the crucial importance of this course in EM training.

A survey of barriers and facilitators to ultrasound use in low- and middle-income countries

Point-of-care ultrasound has the potential to help inform assessment, diagnosis, and management of illness in low- and middle-income countries (LMIC). To better understand current ultrasound use, barriers and facilitators to use, and perceptions and practices in LMIC, we conducted an anonymous online global survey targeting healthcare providers training and using ultrasound in LMIC. A total of 241 respondents representing 62 countries participated and most were physicians working in publicly-funded urban tertiary hospitals in LMIC. Most had received ultrasound training (78%), reported expertise (65%) and confidence (90%) in ultrasound use, and had access to ultrasound (88%), utilizing ultrasound most commonly for procedures and for evaluations of lungs, heart, and trauma. Access to an ultrasound machine was reported as both the top barrier (17%) and top facilitator (53%); other common barriers included access to education and training, cost, and competition for use and other common facilitators included access to a probe, gel, and electricity, and acceptance by healthcare providers, administrators, and patients. Most (80%) noted ultrasound access was important and 96% agreed that ultrasound improves quality of care and patient outcomes. Improving access to low-cost ultrasound equipment is critical to increasing ultrasound use among those who are trained.