The design, performance and organizational impact of a point-of-care ultrasound (POCUS) elective for internal medicine residents.

Background: An educational gap for point-of-care-ultrasound (POCUS) training exists within Internal Medicine (IM) residency programs in that there is currently no standardized training paradigm. To address this need, we designed and implemented a five-day (one work week) elective for POCUS training intending to target IM resident POCUS knowledge and skills. This course integrates self-directed learning and supervised hands-on practice to deliver effective resident education in POCUS.

Methods: IM residents completed the five-day POCUS elective. Residents who took the elective were given an elective evaluation survey, written POCUS knowledge exams at a pre-course and post-course timepoint, as well as a post-course skills assessment exam.

Results: 45 IM residents completed the elective in total. 47% (N = 21) of all participating residents completed the evaluation survey. 94% of those who responded to the evaluation survey reported above average or outstanding satisfaction with all aspects of the elective, including hands-on teaching and materials provided. Written knowledge exams results showed a significant increase in POCUS knowledge scores, with pre-test and post-test scores increasing from 39 to 66%, respectively (N = 30, p < 0.001). Overall, on a skills evaluation of tested residents (N = 20), 45% were deemed to acquire images independently while 40% could interpret independently, with all learners deemed able to do both with some level of supervision. Overall use of POCUS by IM residents as measured by saved ultrasound studies increased after the implementation of the elective, suggesting institutional impact.

Discussion: POCUS training is a recognized need for IM residency programs. While existing POCUS training programs vary in both length of course and depth of material to suit different educational objectives, we have presented a well-received and effective POCUS training paradigm aimed at achieving knowledge acquisition for clinical practice. This POCUS elective rotation, which is integrated into trainee's patient care experiences, circumvents several known barriers to POCUS education including work-hour limitations and limited trainee hands-on experience opportunities. We propose that our elective serves as a model for IM residencies which have similar needs with respect to POCUS education.