A Blueprint for Initiating a Standardized Preliminary Point of Care Ultrasonography Training Curriculum

Emergency medicine, ICU, Cardiology and etc. is another solution. This method also helps build interprofessional collaboration and exposes trainees to a wider range of pathology that can be taught and seen. We overcame this barrier by first appointing a POCUS faculty leader, who led development, recruitment, and maintenance of the program. Assigning a POCUS faculty leader has shown to have improved outcomes when building a POCUS curriculum. We then compiled faculty that were a mix between all avenues aforementioned. In conjunction with our POCUS faculty leader, all our POCUS recruited faculty closely participated in developing our POCUS curriculum, so standardization of teaching methods and quality analysis were honored.

EQUIPMENT ACQUISITION

Finances are often a limitation to acquisition of ultrasound devices which can be a large barrier to POCUS curriculum development. Without the appropriate number of devices, the implementation of POCUS training is essentially moot. While multi-probe ultrasound machines are extremely sensitive and diagnostic, they can often be extremely expensive to procure in bulk. However, with the development of technology, lower portable hand-held units are becoming more affordable and are sensitive enough for IM training. Our program provided each IM department with one hand-held ultrasound device to be used on IM teaching service rounds. It was expected that our residents would be able to utilize the large ultrasound machines that were stationed in the emergency department and ICU while on those rotations respectively. Funding for the hand-held POCUS devices was requested through a split of education, grant funding, and non-profit and hospital device funding to make it more affordable.

QUALITY ANALYSIS

Our quality assessment of resident image procurement is assessed only by our POCUS elected and trained faculty. Our residents are expected to review their images with our POCUS faculty at the end of each academic day and receive feedback. If this is unable to be done, then our residents are expected to upload de-identified HIPPA compliant images to a free image sharing domain that is utilized. Images were then pulled from the domain and reviewed weekly by our POCUS faculty and feedback was given in person to the respective resident. Quality assessment can pose a large barrier to implementing a POCUS curriculum. If there is not a large enough faculty to review images in real time at the end of each day, the implementation of a HIPPA compliant image sharing domain public or private remains a good option.

Conclusion

To help promote multidisciplinary collaboration in medicine, calls for a need for standardized training in advancements in medical technologies. POCUS training has shown to be revolutionary in bedside assessments of patients in real time. POCUS has shown to decrease time to diagnosis and reduce overall costs by decreasing the need for formal imaging modalities. With these well-established benefits, the need for standardized mandatory POCUS curriculum needs to be established for IM residency training programs. POCUS training is no longer just an emergency medicine or ICU specific skillset. While the American College of Physicians has formally made a statement for their support of POCUS, the barrier to its use by internal medicine physicians remains to be inadequate training.

Overall, this manuscript outlines a preliminary blueprint that can be utilized for the successful implementation of POCUS curriculum in IM residences nationwide. A further novel aspect of our POCUS program is the establishment of POCUS trained faculty that are a mix of both allopathic and osteopathic trained. This allows for a larger clinical interpretation that can be established from the acquisition of POCUS images. Not only can our residents make clinical decisions to treat with medications based off the image procurement but can also utilize osteopathic manipulative techniques when appropriate.