Training, experience and perceptions of point of care ultrasound amongst internal medicine trainees: implications for training, curriculum development and service delivery.

Abstract

Point of care ultrasound (POCUS) has revolutionised modern day medicine and has widespread utilisation throughout healthcare settings. Despite the availability of ultrasounds, there are no requirements for internal medicine trainees (IMTs) to undergo any form of POCUS training. This study aimed to explore the perceptions and experience of IMTs of POCUS. A multicentre survey was distributed via mass email to all internal medicine trainees (IMT1-ST8) across two deaneries in Southwest England. A total of 42% (213/509) IMTs completed the survey. Of these 97% (207/213) contributed to the acute medical or general medical rota and 95% (202/213) of trainees reported performing invasive procedures on call. Training in ultrasound site selection was reported by 30% (63/213) of IMTs and 11% (23/213) worked in a trust with accessible POCUS training. Formal POCUS accreditation was reported by 16.0% (34/213) of trainees. Identifying sonographic findings of common medical conditions was considered useful by 86.9% of trainees. Identifying pleural effusions being the most useful (99%, 211/213), whilst identifying a deep vein thrombosis was the least (87%,185/213). Higher confidence scores were reported for ultrasound assisted as opposed to ultrasound guided ascitic or pleural procedures, although this was not significant. On a 10-point Likert scale most trainees highly rated POCUS training (Median = 10, interquartile range 8-10). Free text responses supported POCUS training in the IMT curriculum. We found IMTs perceive POCUS training as highly valuable. However, few IMT trainees are obtaining sufficient experience or training of POCUS. Opportunities for enhanced POCUS training should be embedded in training programmes.