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

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 south-west 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% (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), while 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 that IMTs perceive POCUS training as highly valuable. However, few IMTs are obtaining sufficient experience or training of POCUS. Opportunities for enhanced POCUS training should be embedded in training programmes.