Background: Point-of-care ultrasound (POCUS) is a powerful bedside tool utilized by hospitalists to care for patients, with wide-ranging applications including aiding clinical diagnosis, monitoring response to therapy, and guiding performance of invasive procedures.1-4 Despite its published benefits, POCUS adoption by hospitalists has lagged behind other specialties, in part due to inconsistent training experiences across internal medicine (IM) residencies and a lack of requirements for proficiency to fulfill IM board certification.1,5 As many hospitalists complete IM residency without achieving competency in POCUS, innovative continuing medical education approaches are needed to meet the demands of this growing field.5 With this in mind, we developed, implemented, and evaluated a “POCUS Olympics” faculty development initiative in an attempt to present foundational POCUS learning objectives to a group of novice hospitalist ultrasonographers in a hands-on and enjoyable learning environment.
Methods: Participating hospitalists were divided into teams comprised of NYU internal medicine faculty from one of four NYU-affiliated hospitals. Teams competed across three events: “Cardiac Charades,” “Blind Taboo,” and “Dyspnea Darts,” which combined performance of a POCUS skill on a standardized patient with a game. POCUS-credentialed faculty scored teams across multiple areas, including their abilities to determine the appropriate views to acquire, the quality of the images they obtained, and their solutions to diagnostic questions posed by the clinical scenario presented. Participants were surveyed before and after training to evaluate their exposures to POCUS and impressions of the curriculum, rated on 5-point Likert scales. We performed paired two-tailed T-tests on retrospective pre-post surveys6 to determine participants’ self-ratings of their ability to perform learning objectives aligned to each event.
Results: Fifteen hospitalists participated. 13/15 (86.7%) and 9/15 (60%) completed the pre- and post-participation surveys, respectively. 62% of respondents classified themselves as “beginners,” 77% had previously taken a POCUS course, and 8% reported regularly using POCUS in their clinical practice. Following training, participants rated improvements in their comfort obtaining basic ultrasonographic views (mean rating 2.44 +/- 0.73 to 3.22 +/- 0.67, p = 0.03) and familiarity with utilizing the BLUE protocol7 to evaluate acute dyspnea (1.89 +/- 1.05 to 3.44 +/- 1.13, p = 0.008) on 5-point Likert scales. There was no statistically significant increase in self-ratings of comfort with obtaining quantitative measurements on cardiac POCUS (2.33 +/- 1.13 to 3.33 +/- 0.87 p = 0.07) and describing technical adjustments to optimize ultrasonographic image acquisition (2.44 +/- 1.13 to 3.33 +/- 0.87, p = 0.07). Participants’ mean ratings of the curriculum ranged from 4.22 to 4.67 across the domains of educational merit, promoting teamwork, and entertainment value, with entertainment value rated the highest.
Conclusions: Among a group of beginning learners, POCUS Olympics improved hospitalists’ self-reported abilities to obtain basic views and familiarity with using the BLUE protocol and was overall rated favorably.