Background: Point-of-care-ultrasound (POCUS) is increasingly recognized as a fundamental skill in internal medicine for diagnostic and therapeutic interventions. Many internal medicine programs lack structured POCUS training leading to variable resident exposure and confidence. An internal needs assessment indicated that our residents most desired training in cardiac POCUS. Therefore, we implemented a focused curriculum to improve resident confidence and clinical utilization in cardiac POCUS skills.
Methods: Categorical internal medicine residents at the University of Maryland were enrolled from March to September 2025. Sessions took place during outpatient rotations, typically one session every other month. Each session was composed of a 20-minute didactic followed by 1 hour of small group hands-on instruction led by a medicine chief resident or pulmonary/critical care fellow. Pre- and post-intervention surveys utilized Likert-type scales to measure perception of value of POCUS training, frequency of clinical utilization of POCUS and confidence in specific cardiac skills such as estimating left and right ventricular ejection fraction and inferior vena cava diameter. Pre and post data were compared using paired t-tests.
Results: Sixty-five categorical residents participated in the curriculum and thirty-three completed both pre and post surveys. This group completed an average of 1.5 sessions over the study period (range 1-3). 97% agreed or strongly agreed that they desired competency in POCUS and 84.6% believed it would be valuable in their future careers. Of the eight assessed skills, residents reported statistically significant (p< 0.05) improved confidence in four, including selecting the correct ultrasound probe, assessing pericardial effusion, measurement of inferior vena cava diameter and identifying cardiac tamponade. Measuring left ventricular and right ventricular function, obtaining basic cardiac views and adjusting knobs on POCUS machine suggested modestly improved mean Likert scores but did not meet statistical significance. Residents also indicated increased clinical utilization of POCUS in the prior 4 months from 1-2 patients scanned to 4-7 patients pre and post curriculum.
Conclusions: Internal medicine residents agree that competence in POCUS is valuable for clinical care and useful in their future careers. A structured POCUS curriculum proved feasible though change in confidence in specific skills varied after our intervention.