Point-of-care ultrasound (POCUS) has been rapidly adopted by emergency medicine (EM) as a tool for clinical care. There is growing evidence that POCUS may improve care outside of EM, and POCUS has recently seen increased application in other specialties including internal medicine (IM). Nevertheless, no formal training recommendations exist for IM, and there is little data regarding current POCUS use and knowledge among internal medicine residents. Our goal was to assess knowledge and use of POCUS within an IM residency program without a formal POCUS curriculum.
We invited residents in an academic internal medicine residency program to complete an online survey regarding their current use of and confidence in using POCUS. We also invited residents to complete a 24-question knowledge test on POCUS use developed by an expert group of IM and EM POCUS practitioners.
The response rate for the survey was 100/160 (56%). At least 80% of residents supported POCUS use for a variety of applications within cardiovascular, pulmonary, abdominal and vascular systems. Many residents reported using POCUS for these indications in their clinical care (Figure 1). Nevertheless, far fewer residents felt competent to use POCUS without supervision for these indications, and only 28% felt that they had adequate supervision on medicine wards. (Figure 1)
The response rate to the knowledge test was 96/160 (53%). 97% of residents had minimal (fewer than 10 hours) or no prior ultrasound training. The mean score for test respondents was 6.7/24 (28%).
Internal medicine residents in this program reported commonly using POCUS in their clinical practice despite lack of a formal curriculum, poor POCUS knowledge and skills, and minimal supervision. This gap suggests a need to develop competency training and education programs for the use of POCUS in internal medicine.