POCUS educators investigate ultrasound skills retention

Point-of-care ultrasound (POCUS) has proven to be an important tool for rapid bedside assessments and diagnoses. Basic POCUS image acquisition and interpretation skills have been integrated in the Internal Medicine Residency educational curriculum. The one-hour hands-on and didactic sessions occur every 10 weeks during the residents’ Y-week as it alternates with a longitudinal primary care curriculum. Preceptors and attending physicians in the ICUs and general medicine wards began noticing skill atrophy between sessions.

In a recent publication in the journal Critical Care Medicine, Charles Rappaport, MD; Gregory Schmidt, MD; Boulos Nassar, MD, MPH; Bryan McConomy, MD; Nicholas Arnold, MD; and Aaron Vose, MD, tracked a sample size of 23 first-year medical students and one first-year physician assistant student to analyze the retention of POCUS image acquisition and interpretation skills in novice learners. The study showed that, in general, POCUS skills decayed within 8 weeks after being taught.

The findings from the study also suggested that image identification and image acquisition skills are not equally retained when comparing cardiac and pleural ultrasound, thus the separate skills decay at different rates.

“Cardiac image identification did not decay significantly throughout our study, while cardiac image acquisition did. The exact opposite was seen with pleural ultrasound,” Rappaport said.

From these discoveries, the team hypothesizes that pleural image identification is especially challenging to novice learners because it relies on knowledge of ultrasound physics and artifacts, which are not a part of standard medical school curriculum.

“This is a novel finding as it pertains to ultrasound education, and it will allow us to tailor future renditions of our ultrasound curriculum,” Rappaport said.

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