<p>A Longitudinal Curriculum In Point-Of-Care Ultrasonography Improves Medical Knowledge And Psychomotor Skills Among Internal Medicine Residents</p>

Abstract

PurposeDespite its growing popularity and clinical utility among hospital-based physicians, there are no formal competency requirements nor training standards for United States based Internal Medicine Residencies for learning point-of-care ultrasonography (POCUS). The purpose of this investigation was to study the impact and effectiveness of a novel POCUS curriculum for an Internal Medicine (IM) residency program.Patients and methodsThis was a Single-Group Educational Quasi-Experiment involving Categorical and Preliminary Internal Medicine Residents in Post-Graduate Years 1 through 3 at a single United States academic tertiary center. The study period was from January 1, 2017, through June 30, 2017, during which time the residents participated in monthly modules including didactics and hands-on ultrasound scanning skills with live models. Participants completed a comprehensive knowledge examination at the beginning and end of the six-month period. Participants were also tested regarding hands-on image acquisition and interpretation immediately before and after the hands-on skills labs. The primary outcome measure was performance improvement in a comprehensive medical knowledge assessment.ResultsIn total, 42 residents consented for participation. The residents’ monthly rotations were adjusted in order to accommodate the new educational process. Among 29 participants with complete data sets for analysis, the mean (SD) comprehensive knowledge examination score improved from 60.9% before curriculum to 70.2% after curriculum completion (P<0.001). Subgroup analysis determined that improvement in medical knowledge required attending at least 2 out of the 6 (33%) educational sessions. Attendance at hands-on skills labs correlated significantly with improvement; didactics alone did not.ConclusionA longitudinal POCUS curriculum consisting of both didactic sessions and hands-on skills labs improves knowledge, image acquisition, and interpretation skills of residents. Having this curriculum span at least 6 months provides learners the opportunity to attend multiple classes which strengthens learning through repetition while also providing learners flexibility in schedule.

Evaluating a longitudinal point-of-care-ultrasound (POCUS) curriculum for pediatric residents

“…Point-of-care ultrasound (POCUS) is an ideal imaging modality for many reasons including portability, allowing for immediate bedside access, assistance in real time decision making, and procedural accuracy. Many medical specialties use ultrasound in some manner, including anesthesia [1], neonatology [2], internal medicine [3][4][5], family medicine [6,7], critical care medicine [8][9][10], and emergency medicine [11,12].…”

Skill retention with ultrasound curricula

“…The utility of an ultrasound workshop combined with a designated curriculum has proven beneficial in minimizing attrition rate, but did not address the practical acquisition and interpretation of images [ 3 , 4 ]. Longitudinal ultrasound curricula has been shown to increase knowledge retention and improve skill acquisition in internal medicine (IM) residents, but skill acquisition retention has not been fully quantified [ 5 ]. IM physicians were able to accurately assess left systolic function using focused cardiac ultrasound with a rigorous training program in one study [ 6 ].…”

Can ultrasound novices develop image acquisition skills after reviewing online ultrasound modules?

“…These skills are used by the operator to move and manipulate the transducer in response to sensory information such as the image on the screen or the feel of a chest wall rib. However, the traditional model of ultrasound training is in-person, hands-on practice either with live models or costly simulators [ 1 , 4 , 7 , 14 ]. These in-person training sessions are resource-intensive, requiring expensive equipment and highly trained instructors.…”