Using Standardized Patients to Teach Point-of-Care Ultrasound-Guided Physical Examination Skills to Internal Medicine Residents

BACKGROUND: Point-of-care (POC) ultrasound has been shown to improve procedural outcomes and physical examination accuracy in multiple settings. There are limited data regarding the optimal way to train nonradiologists in POC ultrasound. This is a primary barrier to more widespread use of ultrasound in the physical examination.

OBJECTIVE: We created a workshop to instruct postgraduate year (PGY)-2 and PGY-3 internal medicine residents in POC ultrasound imaging of the abdominal aorta and kidneys.

METHODS: A half-day simulation center workshop was created to review ultrasound operations and teach residents to independently obtain ultrasound images of the abdominal aorta and kidneys on standardized patients with normal anatomy. The workshop incorporated didactic instruction and hands-on ultrasound practice in small groups. Each resident's ability to independently obtain ultrasound images was assessed using a preworkshop and postworkshop skills examination with a standardized patient. Resident knowledge and attitudes toward POC ultrasound were also assessed using a preworkshop and postworkshop test and survey.

RESULTS: A total of 58 residents completed the workshop, and 84% were able to independently obtain high-quality images of the abdominal aorta and kidney after workshop completion, compared with 16% on the preworkshop test. Residents demonstrated a statistically significant increase in their self-reported confidence with ultrasound operation and image acquisition.

CONCLUSIONS: Training using standardized patients can prepare residents to independently obtain POC ultrasound images of the aorta and kidneys. Training resulted in increased resident confidence with POC ultrasound and self-reported likelihood of future use.