New consensus-based recommendations on point-of-care ultrasound (POCUS) skills, instructional methods, and assessment strategies could help improve education and training nationwide, as detailed in a recent study published in Annals of Internal Medicine.
POCUS serves as a valuable diagnostic and therapeutic tool, allowing healthcare providers to make rapid clinical decisions while increasing diagnostic accuracy, shortening hospital length of stay, and improving bedside medicine.
Despite a growing adoption of POCUS education across the U.S. internal medicine residency programs, instruction on the technology has remained highly variable and inconsistent, said Leela Chockalingam, MD, assistant professor of Medicine in the Division of Hospital Medicine and first author of the study.
“My co-authors and I realized that POCUS was not taught uniformly to all internal medicine residents nationally, and many residents don’t get any POCUS education at all. We realized that there was no national consensus on which POCUS skills should be taught in internal medicine residencies and how they should be taught,” Chockalingam said.
To address this issue, Chockalingam and her team conducted a modified 3-round Delphi panel consisting of online surveys, taken from December 2023 to May 2024, asking POCUS experts to rank the importance of POCUS skills, teaching methods and evaluation strategies on a 5-point Likert scale.
Experts included individuals holding POCUS leadership positions at U.S.-based national internal medicine societies, who teach at national or regional POCUS courses, or who have a publication record in POCUS education.
After three rounds of surveys, 53 of 103 POCUS skills, 14 of 35 teaching methods, and 5 of 9 evaluation strategies met consensus for inclusion. The included skills spanned lung, abdominal, procedural, cardiac, musculoskeletal, and vascular domains. Teaching and evaluation methods focused on direct image acquisition practice, portfolio development, and clinical reasoning.
“Our study focused more on discrete skills than applications, leading to a larger number of included skills than previously published lists. Our study is also one of the first to publish consensus-based teaching and evaluation methods,” Chockalingam said.
Overall, the findings inform standardized curriculum development across internal medicine residency programs, according to Chockalingam.
“We hope our paper can help guide national organizations in future standard-setting efforts and provide a framework for residency programs hoping to expand their curricula,” Chockalingam said.