<p>Internal medicine residents’ point-of-care ultrasound skills and need assessment and the role of medical school training</p>

Abstract

Introduction: Point-of-care-ultrasound (POCUS) as a useful bedside tool is growing. Few studies have examined residents’ attitude towards POCUS or compared POCUS image interpretation skills between residents with and without POCUS training in medical school. Material and Methods: We distributed an anonymous survey and image interpretation test to assess residents’ attitude towards POCUS, confidence, and skills in interpreting POCUS images and videos. Using independent samples t-tests, we compared mean confidence levels and test scores between residents with and without prior POCUS training. Results: Fifty-two residents responded to survey (response rate 68%) and 59 took the image interpretation test (77%). Most residents (90%) reported being interested in POCUS. Residents with prior POCUS training (n=13) were either PGY-1 (9) or PGY-2 (4). No PGY-3 resident had prior training. Most residents (83%) thought POCUS could be extremely useful in the inpatient setting compared to 29% for outpatient setting. PGY-1 residents with prior training had a higher mean confidence level than PGY-1 residents without prior training, but the difference was not statistically significant (3.26 vs 2.64; p =0.08). PGY-1 with prior training had a mean confidence level that was close to that of PGY-3 residents. PGY-1 residents with prior training scored significantly higher than PGY-1 residents without prior training in image interpretation test (10.25 vs 7; p =0.01). Residents felt most confident in interpreting inferior vena cava images (mean 3.7; max. 5), which also had the highest score in image interpretation test (correct response rate of 88%). Conclusion: Our residents seem very interested in POCUS. PGY-1 residents with prior POCUS training in medical school seem to have higher confidence in their POCUS skills than PGY-1 residents without prior training and outperformed them in image interpretation test. The study is very instructive in building our future POCUS curriculum for residents.

Introduction of an academic medical center’s point-of-care ultrasound curriculum to internal medicine residents at a community-based teaching hospital

“…However, they rated lower levels of confidence in their own ability to use POCUS at the bedside. High levels of interest in POCUS training were observed, consistent with the report by Elhassan et al [ 15 ]. Vascular access applications such as US-PIV and US-CVC were ranked highest, suggesting that IM residents value procedural POCUS applications more than diagnostic POCUS applications.…”

Confidence Level and Ability of Medical Students to Identify Abdominal Structures After Integrated Ultrasound Sessions

“…Anatomy, physical examination skills, and confidence in sonography can all be addressed through additional didactic and hand-on ultrasound sessions. Additionally, increasing student confidence in ultrasound has been shown to have a positive impact during residency, where residents with prior point-of-care ultrasound exposure outperformed those without when both groups took image interpretation tests [26].…”

The Conundrum of Volume Status Assessment: Revisiting Current and Future Tools Available for Physicians at the Bedside

“…This examination appears to be relatively easy to acquire and interpret at the bedside by novice learners. In one survey, medical residents reported that they feel more confident performing IVC POCUS examination than any other POCUS skills, and during an image interpretation test it ranked first [ 57 ].…”

“…POCUS is now suggested or endorsed by many internal medicine societies (e.g., the Society of Hospital Medicine, the Association of European Society of Cardiology, and, recently, the American College of Physicians) to assist physicians with diagnosing and treating many common pathologies [54][55][56]. Several studies showed that medical residents are interested in POCUS and therefore many medical schools have started POCUS curricula [57,58]. Although ultrasound is operator-dependent and clinical utility is expected to improve with more practice, POCUS is accessible to students at all training levels and can be performed by non-physicians and physicians-in-training with sensitivity and specificity exceeding that of CXR for pathologies such as pulmonary edema and pleural effusion [51,59].…”