POINT-OF-CARE ULTRASOUND CURRICULUM FOR INTERNAL MEDICINE RESIDENTS: A SINGLE-CENTER EXPERIENCE

Abstract

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: Point-of-care ultrasound (POCUS) has been used widely by pulmonary and critical care physicians/trainees for years with the recent trend of integrating similar curriculums in internal medicine resident training. It is known to supplement the physical exam, aide to accurate diagnosis and improved patient care. Here, we demonstrate that a curriculum including didactics combined with single hands on session not only increases the knowledge of ultrasound basics among the internal medicine trainees but also enhance their skill level, accuracy and confidence to image acquisition and interpretation. METHODS: Internal medicine residents and internal medicine-pediatric residents were invited to participate in this internal medicine ultrasound curriculum. As a part of curriculum all residents first attended two detailed POCUS didactic sessions and completed online ultrasound modules followed by hands on sessions which started with an hour of quick review of previously held didactics and three hours of performing ultrasound image acquisition and interpretation on standardized patients on three stations. Each station had a specific task assigned including lung ultrasound, limited cardiac views, abdominal ultrasound as well as basics of ultrasound including knobology and artifacts. Residents took a pretest with 20 questions on the subject of POCUS basics and organ system findings then same questions were posed in posttest after conclusion of the session. Standardized feedback was then obtained from residents. Each station was supervised by a critical care physician or an internal medicine physician with formal training in basic ultrasound. Session also included a computerized ultrasound manikin to familiarize residents with pathological ultrasonographic findings. RESULTS: 54 residents of all post graduate years participated in our pilot POCUS curriculum. For the pre-test the mean score is 15.87(81%) (Minimum 11 and maximum 20) whereas for post-test the mean score is 17.47 (88.95%) (Minimum 14 and maximum 20). This difference was statistically significant with p < 0.001 (Mann Whitney U test). Standardized feedback obtained from the trainees revealed that 99% felt the session stimulated their interest and thinking and they would like more hands on session to enhance their skills. 98% of the trainees said the session motivated them to continue learning ultrasound, found it practical and relevant to their field of practice and improved their ability to manage patients. All appreciated practicing ultrasound on a standardized patient to learn normal anatomy. CONCLUSIONS: This pilot confirmed that the didactics combined with single hands on session did improve knowledge, skills and confidence to use ultrasound in the internal medicine residents. CLINICAL IMPLICATIONS: We plan to make this curriculum a yearly activity with integration of new ultrasound elective for two weeks along with continued bedside teaching. DISCLOSURES: No relevant relationships by Harmeen Goraya, source=Web Response No relevant relationships by Gayathri Krishnan, source=Web Response No relevant relationships by Keyur Vyas, source=Web Response No relevant relationships by Cody Webster, source=Web Response