Abstract 14728: Implementation of a Resident-Led Cardiac Point-of-Care Ultrasound Curriculum for the Internal Medicine Residency Program at UT Southwestern

Abstract

Introduction: The American Society of Echocardiography recommends integration of cardiac point-of-care ultrasound (cPOCUS) into training programs. There is no defined strategy on how to create and implement this on a large scale. Aim: To implement and assess the efficacy of a novel, pilot-tested, resident-led, simulation-based cPOCUS curriculum within the Internal Medicine (IM) internship at UT Southwestern (UTSW). Methods: All 62 categorical interns in the 2022-2023 class in the UTSW IM residency program completed our cPOCUS curriculum during their outpatient weeks over a three-month period. All tests and workshop guides were developed by current IM residents, cardiology fellows and faculty in a fashion that is reproducible annually, even as residents and fellows change. All interns underwent two educational workshops. Workshop 1 focused on acquisition and recognition of basic cardiac anatomy. Workshop 2 focused on abnormal cardiac pathology. Pre-and post-tests assessed their ability to identify cardiac windows, identify abnormal cardiac pathology, and rate their comfortability on a 5-point Likert scale. Results: Analysis was conducted on 39 of 62 responses containing both pre- and post-tests. Of the 39 interns, 6 (15%) scored below 70% on the pre-test. On the post-test, 38 out of 39 (97%) interns scored at least 80%. Furthermore, 4 of the 6 lowest scoring interns on the pre-test scored 100% on the post-test. There was a significant increase in the average pre- and post-test scores by 6% (p=0.02), with greatest improvement in the ability to identify LVEF <40% (12% increase). Post-curriculum, 33 of 39 interns (85%) “agreed” or “strongly agreed” that they felt comfortable interpreting cPOCUS, compared to only 3 of 39 interns prior. Conclusions: Our simulation-based cPOCUS curriculum was successfully implemented within a large intern class at an academic center, with a 100% participation rate. Post-curriculum, there was a significant increase in cPOCUS interpretation scores and increased comfort with acquisition and interpretation. Our curriculum is sustainable, requires minimal cost, and serves as an archetype for the implementation of simulation-based cPOCUS curricula into “inpatient month + clinic week” block-based training programs.