Bootstrapping a pocus curriculum: results in a community hospital-based internal medicine residency program

SESSION TITLE: Education, Research, and Quality Improvement Posters 8 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: To assess the effect on user confidence and objective competence in 12 pre-specified use case modalities of point-of-care ultrasound (POCUS) after the introduction of a pragmatic POCUS curriculum in a community hospital-based internal medicine residency program. METHODS: The POCUS curriculum was started in July 2022 and completed in 6 months. A single faculty member conducted monthly sessions consisting of a 1-hour didactic lecture followed by daily small-group hands-on scanning sessions (4-5 residents per group) for the rest of the week. Scanning was done with both hand-held devices and cart-based machines. We focused on 12 high-yield use cases, including: central venous access, Peripheral IV catheters, DVT evaluation, Pneumothorax, Pleural effusions and consolidations, Pericardial effusions, Right and Left ventricular function, Intra-abdominal free fluid, Hydronephrosis, Fluid status assessment, Intra-abdominal aorta. To assess the effectiveness of our curriculum, residents were asked to rate their confidence level in all 12 of these use cases before and after completing the curriculum on a Likert scale from 1 to 5 (with 1 denoting no confidence at all, and 5 denoting very confident). Residents were also examined for proficiency with a multiple-choice question-based test requiring them to interpret US images of the use cases. (3 questions per use case) The data was subsequently analyzed in SPSS and a paired T-test was used to determine the statistical significance between the changes in mean confidence and proficiency scores seen. RESULTS: For all PGY levels combined, the overall self-reported confidence rating went up from 1.8 to 3.0 (N=30 & 23, respectively, score out of 5) representing a 23.6% increase. (P-value <0.01) This was mirrored in test performance where the average score per use-case (out of 3) went up from 1.01 (N=30) to 1.86 (N=27) showing a 28.4 % increase (P-value <0.01). The highest performance score increase was seen in the PGY-2s with 34.5%, outpacing the reported user confidence which increased by 24%. For the PGY-1s, overall confidence rating and test scores increased by 28.95% and 29.11%. For PGY-3s, who had had the most prior exposure to POCUS training, there was still a sizeable increase in both user confidence and performance score, 18.65% and 26%. All the above findings were statistically significant with p- values <0.05. CONCLUSIONS: Overall, our results showed an across-the-board improvement in user confidence and test performance, seen in all PGY levels and all 12 use cases. Moreover, the percentage increase in self-reported confidence and objectively-tested competence were similar indicating that the confidence was well placed. As our data shows, even with a relatively modest investment of time and resources, an effective POCUS curriculum can be feasibly implemented in internal medicine residency programs. As has been shown in other studies, this improves both the learning experience of the trainees and patient satisfaction. CLINICAL IMPLICATIONS: By demonstrating feasibility and effectiveness, our study furthers the case for adding POCUS training to the educational curricula of Community-based Internal Medicine residency programs. DISCLOSURES: No relevant relationships by Margot Boigon No relevant relationships by John Madara No relevant relationships by Rehan Saeed No disclosure on file for Waqas Ullah