Building a Bigger Tent in Point-of-Care Ultrasound Education: A Mixed-Methods Evaluation of Interprofessional, Near-Peer Teaching of Internal Medicine Residents by Sonography Students

BACKGROUND: Point-of-care-ultrasound (POCUS) training is expanding in undergraduate and graduate medical education, but lack of trained faculty is a major barrier. Two strategies that may help mitigate this obstacle are interprofessional education (IPE) and near-peer teaching. The objective of this study was to evaluate a POCUS course in which diagnostic medical sonography (DMS) students served as near-peer teachers for internal medicine residents (IMR) learning to perform abdominal sonography. METHODS: Prior to the IPE workshop, DMS students participated in a train-the-trainer session to practice teaching and communication skills via case-based simulation. DMS students then coached first-year IMR to perform POCUS examinations of the kidney, bladder, and gallbladder on live models. A mixed-methods evaluation of the interprofessional workshop included an objective structured clinical exam (OSCE), course evaluation, and qualitative analysis of focus group interviews. RESULTS: Twenty-four of 24 (100%) IMR completed the OSCE, averaging 97.7/107 points (91.3%) (SD 5.2). Course evaluations from IMR and DMS students were globally positive. Twenty three of 24 residents (96%) and 6/6 DMS students (100%) participated in focus group interviews. Qualitative analysis identified themes related to the learning environment, scanning technique, and suggestions for improvement. IMR felt the interprofessional training fostered a positive learning environment and that the experience complimented traditional faculty-led workshops. Both groups noted the importance of establishing mutual understanding of expectations and suggested future workshops have more dedicated time for DMS student demonstration of scanning technique. CONCLUSION: An interprofessional, near-peer workshop was an effective strategy for teaching POCUS to IMR. This approach may allow broader adoption of POCUS in medical education, especially when faculty expertise is limited

Prospective evaluation of cardiac ultrasound performance by general internal medicine physicians during a 6-month faculty development curriculum

Abstract Background Point-of-care (POCUS) education is rapidly expanding within medical schools and internal medicine residency programs, but lack of trained faculty is a major barrier. While POCUS training can improve short-term outcomes, knowledge and skills rapidly decay without deliberate practice and feedback. The purpose of this study was to evaluate the performance of focused cardiac ultrasound (FCU) by volunteer general internal medicine (GIM) faculty participating in a longitudinal POCUS curriculum. Methods Participants: Nine GIM clinician-educators participated in a 6-month POCUS curriculum. Faculty performance was compared to three cardiology fellows. Three diagnostic cardiac sonographers (DCS) were also evaluated and served as the gold standard. Evaluation: the primary outcome was a FCU efficiency score, calculated by dividing image quality score by exam duration. FCU exams were conducted on three standardized patients after completion of an introductory workshop, at 3 months, and at 6 months. Two blinded cardiologists scored the exams. Analysis: mean efficiency scores were compared using a linear mixed effects model, followed by pairwise comparisons using Tukey’s test. Results GIM faculty’s FCU efficiency scores were maintained over the 6-month period (2.2, SE 1.0 vs. 3.8, SE 1.0, p = 0.076). Their scores at each session were similar to cardiology fellows (p > 0.69), but inferior to DCSs (p < 0.0001). Conclusion GIM faculty participating in a POCUS curriculum maintained their FCU performance over 6 months with efficiency scores comparable to experienced cardiology fellows

MOESM1 of Prospective evaluation of cardiac ultrasound performance by general internal medicine physicians during a 6-month faculty development curriculum

Additional file 1. Instructions for study participants, facilitators, and standardized patients

Building a bigger tent in point-of-care ultrasound education: a mixed-methods evaluation of interprofessional, near-peer teaching of internal medicine residents by sonography students

Abstract Background Point-of-care-ultrasound (POCUS) training is expanding in undergraduate and graduate medical education, but lack of trained faculty is a major barrier. Two strategies that may help mitigate this obstacle are interprofessional education (IPE) and near-peer teaching. The objective of this study was to evaluate a POCUS course in which diagnostic medical sonography (DMS) students served as near-peer teachers for internal medicine residents (IMR) learning to perform abdominal sonography. Methods Prior to the IPE workshop, DMS students participated in a train-the-trainer session to practice teaching and communication skills via case-based simulation. DMS students then coached first-year IMR to perform POCUS examinations of the kidney, bladder, and gallbladder on live models. A mixed-methods evaluation of the interprofessional workshop included an objective structured clinical exam (OSCE), course evaluation, and qualitative analysis of focus group interviews. Results Twenty-four of 24 (100%) IMR completed the OSCE, averaging 97.7/107 points (91.3%) (SD 5.2). Course evaluations from IMR and DMS students were globally positive. Twenty three of 24 residents (96%) and 6/6 DMS students (100%) participated in focus group interviews. Qualitative analysis identified themes related to the learning environment, scanning technique, and suggestions for improvement. IMR felt the interprofessional training fostered a positive learning environment and that the experience complimented traditional faculty-led workshops. Both groups noted the importance of establishing mutual understanding of expectations and suggested future workshops have more dedicated time for DMS student demonstration of scanning technique. Conclusion An interprofessional, near-peer workshop was an effective strategy for teaching POCUS to IMR. This approach may allow broader adoption of POCUS in medical education, especially when faculty expertise is limited