Characteristics of Simulation-Based Point-of-Care Ultrasound Education: A Systematic Review of MedEdPORTAL Curricula.

Jaskaran Singh,Lukas H Matern,Marvin G Chang,Edward A Bittner

doi:10.7759/cureus.22249

Abstract

Point-of-care ultrasonography (POCUS) is increasingly recognized as a safe, efficacious, and cost-effective diagnostic and procedural tool used by many medical disciplines. Although standardized POCUS curricula are lacking, simulation represents an effective modality to teach the fundamentals of POCUS in medical education. We sought to characterize POCUS simulation cases available within MedEdPORTAL, the primary repository of learning resources for health professions, to highlight areas for future curricular development and study.This systematic review was performed based on a comprehensive search of MedEdPORTAL. Identified simulations were categorized and contrasted with respect to their target audiences, settings, pathologies, required materials and equipment, and POCUS techniques tested.A total of eight curricula were identified. The majority (6/8) were targeted at trainees in acute care specialties. Pathologies included in most simulations involved cardiac or pericardial disease, although obstetric and medical diseases were also tested in isolated cases. While half (4/8) of the identified simulation curricula incorporated diagnostic POCUS interpretation, only a few (2/8) allowed for high-fidelity ultrasound simulation. While self-reported learner satisfaction appeared to be generally high, most (7/8) identified curricula did not include objective assessments of learning outcomes.A small number of simulation-based POCUS curricula have been published within MedEdPORTAL. The widespread use of simulation for POCUS may be limited by the financial costs of high-fidelity training equipment. While simulation provides a highly promising solution to the need for greater instruction in POCUS, there is a need for comprehensive, standardized, and cost-effective curricula that can be adapted to varied educational environments.

Highlights

The Accreditation Council for Graduate Medical Education (ACGME) requires both anesthesiology residents and critical care medicine fellows from various subspecialty backgrounds to participate in at least one simulated intraoperative clinical experience per year of training, while other residency programs including general surgery and emergency medicine have widely incorporated simulation into their training programs [3]
We review the available ultrasound simulation cases and associated learning materials contained in the MedEdPORTAL® database, a peer-reviewed repository of instructional materials and medical education literature maintained by the Association of American Medical Colleges (AAMC)
After reviewing 47 reports returned during an initial search, we identified a total of eight eligible simulation curricula targeted toward teaching Point-of-care ultrasonography (POCUS)

Summary

Introduction

BackgroundPoint-of-care ultrasound (POCUS) has assumed an increasingly prominent role in the delivery of medical care with the introduction of more affordable, portable, and versatile ultrasound devices. While demand for and applications of POCUS have grown, ultrasound education has not been consistently provided or standardized across medical training programs. This lack of a unified curriculum presents a significant barrier to the widespread adoption of ultrasound as a diagnostic modality, as it has been repeatedly demonstrated that operator experience is the primary limiting factor in the diagnostic and procedural utility of the technology [2]. The Accreditation Council for Graduate Medical Education (ACGME) requires both anesthesiology residents and critical care medicine fellows from various subspecialty backgrounds to participate in at least one simulated intraoperative clinical experience per year of training, while other residency programs including general surgery and emergency medicine have widely incorporated simulation into their training programs [3]. Simulation lends itself well to acute care training, as it provides opportunities to develop the reflexes and decision-making necessary to handle critical scenarios that may not otherwise be encountered during a formalized training period

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