Developing a Roadmap for a Competency-Based Point-of-Care Ultrasound Education Program.

Abstract

Background: The clinical applications of point-of-care ultrasound (POCUS) have proliferated across multiple specialties with technologic advances. POCUS education in residency programs has challenged educators to develop a POCUS- based clinical practice curriculum. The level of exposure needed to achieve POCUS competence is evolving with programs adopting diverse POCUS training initiatives. Our study aims to evaluate our POCUS curriculum and use evaluation results and survey feedback to optimize and improve trainee competence.

Methods: Twenty-one anesthesiology residents participated in a baseline POCUS and a 2-week POCUS exam comprising 65 questions (50 cardiac, 10 lung, and 5 abdominal). Technical competence in lung and cardiac ultrasound was assessed by POCUS supervisors using validated tools. The Rapid Assessment of Competency in Echocardiography (RACE) Scale was used to assess image generation and interpretation domains. The American College of Emergency Physicians - Council of Residency Directors (ACEP-CORD) guidelines measure technical skills for lung ultrasound. Resident perception to POCUS education and training was based on a survey.

Results: Score comparisons between the baseline and 2-week post course multiple-choice exams did not show a statistically significant change in performance. The technical competency assessment demonstrates that Image Generation Scores on the RACE Scale were highest for images in the parasternal long-axis view and lowest for the subcostal view and inferior vena cava view. Results of the resident perception survey showed a strong interest and motivation to learn ultrasound and strong desire for more exposure and training with ultrasound.

Conclusions: Anesthesiology programs have incorporated POCUS training; however, training methods are not uniform. This study aims to provide a road map for residents-in-training to integrate POCUS skills into clinical practice.