Background: Limited diagnostic capacity in resource-constrained hospitals leads to delayed diagnoses and inequitable outcomes. At Hospital Nacional Juan José Ortega de Coatepeque in Guatemala, internists frequently manage conditions such as decompensated cirrhosis and pleural effusions with only plain radiography available and no access to a radiologist. A needs assessment of 36 providers showed limited prior ultrasound exposure, with 72% reporting no formal training. Despite this, 72% expressed willingness and capacity to dedicate 1–2 hours weekly, with pulmonary and abdominal training as high priorities. Context-adapted point-of-care ultrasound (POCUS) can strengthen bedside decision-making, improve procedural safety, and build sustainable diagnostic capacity. Similar global initiatives demonstrate that focused training—reinforced by mentorship and local champions—is feasible and effective in resource-constrained settings.
Purpose: To evaluate the feasibility and impact of implementing a targeted POCUS curriculum for medical students and internists in a rural Guatemalan hospital.
Description: We developed a standardized two‑day workshop using a flipped classroom approach, with pre‑workshop videos to maximize scanning time. The workshop focused on foundational ultrasound principles, thoracic and abdominal anatomy, pleural effusion and ascites detection, image interpretation, and case integration, with structured pre-/post- knowledge and confidence assessments. All participants have access to a Butterfly probe for educational scanning, with image review and support by University of Colorado POCUS-trained hospitalists. Learning is reinforced through longitudinal activities, including:• In-person mentored scanning sessions with University of Colorado faculty, supplemented by remote teleguidance• Targeted “teach the teachers” sessions to empower local champions to sustain training independently• Image review rounds to provide structured feedback• Portfolio development in Butterfly Cloud, aligned with WHO recommendations for competency-based training and ongoing evaluation• Online modules to reinforce key conceptsImplementation occurs in two phases:Phase 1 – Pilot Study with Sixth-Year Medical Students (Completed Nov 2025)Eight sixth-year medical students completed the workshop, including supervised scanning and guided image interpretation. They continued scanning with a Butterfly probe under in-person and remote supervision, supplemented by online modules and motivated by identified champions.Phase 2 – Internist Training Program (Feb–Mar 2026)Nine internists will participate in the same standardized workshop, including targeted lectures and progressive independence scanning sessions. Following the workshop, internists will continue educational scanning with a Butterfly probe under in-person and remote supervision, supplemented by longitudinal online modules and motivated by identified champions to support skill development and prepare them to teach other physicians and medical students.
Conclusions: This project demonstrates the feasibility of strengthening diagnostic capacity in a resource-constrained rural hospital through standardized POCUS training, with benefits for health equity. A standardized curriculum paired with ongoing mentorship provides a scalable and sustainable model for ultrasound education, with potential expansion to additional POCUS applications across similar global settings.