Background? Point-of-care ultrasound is a rapidly evolving component of internal medicine (IM) residency training. The optimal approach for teaching this skill remains unclear.;Objective? We sought to determine whether the addition of a longitudinal ultrasound curriculum to a stand-alone workshop for ultrasound training improved knowledge retention in IM residents.;Methods? We conducted an observational cohort study from July to December 2013. All postgraduate year (PGY)-1 IM residents attended an ultrasound workshop during orientation. Ability to identify static images of ascites, kidney, thyroid, pleural fluid, inferior vena cava, and internal jugular vein was assessed immediately after the workshop. An ultrasound curriculum, including morning report and ultrasound rounds, was initiated during the inpatient medicine rotation. PGY-1 residents were randomly assigned to participate in the longitudinal curriculum. Six months later, we conducted a follow-up survey with all PGY-1 residents.;Results? Forty-eight PGY-1 residents (67%) completed the postworkshop test and the 6-month follow-up test. Of these, 50% (24 of 48) had participated in the ultrasound curriculum. Residents not exposed to the curriculum showed a decline in the identification of ascites, pleural effusion, and internal jugular vein at 6 months (P?.05), whereas those who participated in the curriculum maintained their performance (P?.05).;Conclusions? Six months after exposure to a longitudinal ultrasound curriculum, residents were more likely to correctly identify ultrasound images of ascites, kidney, and pleural effusion. The addition of a longitudinal ultrasound curriculum may result in improved knowledge retention in IM residents.;Introduction Point-of-care ultrasound is gaining popularity among internal medicine (IM) residency programs,1 and is commonly used for invasive bedside procedures resulting in decreased complications and improved patient safety.2,3 It can improve physical examination findings and diagnostic accuracy, and result in potential changes to management.4–6 Prior studies have shown that ultrasound knowledge and skill can be acquired through dedicated training.7,8 Various specialties, such as anesthesia,9 orthopedics,10 and emergency medicine,11 have implemented formal ultrasound training. Additionally, medical schools have added ultrasound as an educational tool in the gross anatomy laboratory with favorable results.12 Most studies on ultrasound education have included a 1-time training workshop. The literature suggests that point-of-care ultrasound knowledge, skills, and self-reported confidence decline over time.8,13,14 Research studies that focus on methods to foster retention of ultrasound knowledge and skills are lacking, so the aim of our study was to evaluate the impact of a longitudinal ultrasound curriculum on the long-term knowledge retention among postgraduate year (PGY)-1 IM residents.;Methods We conducted an observational cohort study with retrospective analysis of all 72 PGY-1 residents (48 categorical and 24 preliminary) at our program. All participated in a half-day, simulation-based ultrasound workshop.7,8 The workshop consists of a 1-hour didactic session on the fundamentals of ultrasound, followed by 3 hours of hands-on education using both cadavers and live human subjects. The PGY-1 residents completed preworkshop and postworkshop examinations in which they reviewed static ultrasound images and were assessed on their ability to identify the following findings or structures: ascites, kidney, thyroid, pleural fluid, inferior vena cava, and internal jugular vein. The test was not multiple choice, and no background information was provided. Examination content was developed with the input of investigators (D.J.K., J.T.R., A.B.) with experience in point-of-care ultrasound, and was adapted from prior research.8 The workshop was previously shown to improve confidence7 and knowledge8 in identifying static ultrasound images. Be
展开▼