Table 3 Outline of POCUS program components at 4 institutions
From: A road map for point-of-care ultrasound training in internal medicine residency
CWRU | UMN | OHSU | BU | |
|---|---|---|---|---|
Timeline of curriculum | PGY-1: 2 half day mixed didactic and hands-on sessions Implemented 2013 PGY-2/3: optional 2-week elective (30 h/week) Implemented 2015 ALL: interspersed hour long didactics throughout the 3 years of training (based on faculty availability) Implemented 2015 | PGY-1: 25 h of training during intern orientation (all interns) Implemented 2012 PGY-2/3: optional 40 h “advanced course” Implemented 2014 Procedural service also available as a 2-week elective Implemented 2016 | PGY-1: 3 half day mixed didactic and hands-on sessions Implemented 2014 PGY-2/3: optional 2 to 3-week elective (30 h/week) Implemented 2014 | PGY 1: ultrasound-guided procedural training during orientation (8 h) plus several sessions throughout the year (6 h) + OSCE Implemented 2012 PGY-2/3: optional 1 week elective (36 h) Implemented 2014 Procedural service which relies heavily on ultrasound also available as elective (40 h/week) Implemented 2007 |
Primary educational methods | Combination of didactics with supervised scanning using task trainers, ultrasound simulators and live ultrasound models For optional advanced elective, direct scanning of hospitalized patients | Intro course: largely web-based video didactics with quizzes, extensively uses of scanning of models, use of ultrasound simulators, and procedural task trainers Advanced course uses similar techniques, with addition of 25 h of scanning patients on wards | Didactic lectures alternating with hands-on scanning practice. Uses ultrasound simulators, and procedural task trainers | Didactic lectures followed by task trainers for procedures. Practice scanning on learners and ultrasound simulator followed by bedside patient scanning |
Equipment | Multiple dedicated laptop and hand-held machines on wards and in simulation center available for resident use (hospital funded) | Multiple dedicated laptop machines on wards (hospital funded) and in simulation center (university funded) | Multiple dedicated laptop machines on wards (some hospital, some university funded) and simulation center (university funded). Have not yet received requested funding for hand-held units | Multiple laptop and larger machines based in ICU with loans to floor, and simulation center (all hospital funded) |
Image management | Images uploaded to a dedicated network drive | Residents may keep portfolios and submit interpretations submitted manually starting with advanced course Process to use PACS and EMR in development | Middleware (see resources paragraph) | Locally stored on machines Residents may keep portfolios and submit manually as part of 1 week ultrasound elective |
Quality assurance | Resident image review occurs from faculty supervision at the time of image acquisition | No formal system specific to residents. Exists in many clinical departments that residents rotate through | Weekly image review sessions for residents on elective, clinical image QA varies by department | No formal system. Confirmatory studies highly encouraged/stressed during didactics |
Primary faculty involved | Hospitalists | Hospitalists, critical care | Hospitalists, emergency medicine, anesthesia | Critical care, cardiology, ER staff (case review during elective), internists at early stages |