Homegrown POCUS education for IM residents demonstrated, deemed successful
Internal medicine researchers have developed a three-year learning track to train select IM residents in all things point-of-care ultrasound, from fundamental principles to advanced workshops, skills assessments and national certification.
The team, from UT Health San Antonio and the South Texas VA health system, describes the undertaking in a study report published online June 17 in the Journal of General Internal Medicine [1].
Since 2018, hospitalist Robert Nathanson, MD, and colleagues have been combining local assets with external educational resources—primarily an established POCUS certificate of completion program—to accept four new POCUS residents per year from a 95-resident program.
As of the authors’ writing of the present report, the team had 12 participants—four residents in one of the three yearly courses—from whom to solicit feedback and gauge progress.
The researchers found the longitudinal POCUS track increased residents’ use and comfort with diagnostic and procedural applications: All 12 residents indicated they were satisfied or very satisfied with the track and would recommend it to prospective applicants (100%).
They also found the most commonly reported barriers to IM residents’ embrace of POCUS were time constraints (83%), lack of available ultrasound equipment (83%) and lack of trained faculty (58%).
Need for Creativity in Securing Institutional Funding
Meanwhile, Nathanson and colleagues suggest the certification process serves as evidence of competence in image acquisition and interpretation. At the same time, they acknowledge uncertainty around long-term knowledge and skills retention as the residents move into IM careers.
Further, the still-new training program “provides limited experience in clinical integration of POCUS findings into bedside decision-making,” Nathanson and co-authors write.
However, “as more faculty become trained, residents will have more frequent supervised clinical integration in the future.”
Looking at inescapable cash layouts, the team notes the above-linked POCUS certificate of completion program—supplied in this case by the Society of Hospital Medicine (SHM) and the American College of Chest Physicians (ACCP)—rang up a bill of around $7,000 per resident, including travel.
“Our IM residency program had to be creative about securing institutional funding for this program,” the authors comment. “At our institution, university funds were reallocated to accept up to four residents per year on the POCUS track. We were fortunate that our Department of Medicine leadership supported the creation of the POCUS track.”
A Model for Other Internal Medicine Residencies to Follow
From Nathanson et al.’s discussion:
Creation of a POCUS track allowed residents with a deep interest in POCUS to receive comprehensive, longitudinal training and complete a certification endorsed by two national specialty organizations [SHM and ACCP]. POCUS track residents’ comfort and frequency of POCUS use increased and overall satisfaction with the program was positive. However, we recognize that our total sample size is relatively small, and future surveys will give us a better understanding of residents’ comfort level with different POCUS applications.”
The UT Health POCUS track, the team concludes, “may serve as a model for IM residencies interested in providing longitudinal training to its residents but [lacking in] the required resources or local expertise to offer such training.”
The journal has posted the report in full for free.
The article’s publication coincides with the posting of of a peer-reviewed IM pilot study whose authors found abbreviated POCUS instruction could enhance IM trainees’ subjective sense of proficiency without building their objective expertise in image interpretation [2].
More Coverage of POCUS Utilization Outside of Radiology:
Shortened POCUS curriculum leaves residents long on confidence, short on skills
Cross-sectional imaging ordered downstream for just 15% of emergency POCUS patients
Ultrasound ‘grand challenge’ launches to promote global POCUS proficiency
Radiologists must ditch ‘illusion’ of handling all POCUS exams, work with clinicians on path forward
Point-of-care ultrasound cuts costs and visit times for patients with developmental hip dysplasia
Focus on POCUS: Hey, Emergency Medicine and Radiology: Who’s in Charge Here?
References:
- Robert Nathanson, Nilam Soni, et al., “Development of a Point-of-Care Ultrasound Track for Internal Medicine Residents.” Journal of General Internal Medicine, June 17, 2022. DOI: https://doi.org/10.1007/s11606-022-07505-5
- Sarbjot Grewal, Arielle Houston, John Bacon, Earvin Balderama, Mohammed Elhassan: “Point-of-Care Ultrasound Curriculum for Internal Medicine Residents During the COVID-19 Era: A Pilot Study.” Cureus, June 14, 2022.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.