ArticleBMC medical education2026
Making waves at a community-based program by initiating a diagnostic POCUS curriculum.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPoint-of-care Ultrasound training (POCUS) is becoming standard in Internal Medicine (IM) training programs across the country. However, a 2020 survey conducted by the Association of Program Directors in Internal Medicine reported university-based programs were more likely to implement a POCUS curriculum than other programs (82% vs. 46%, P < 0.001). The aim of this study was to develop, describe, and report out the results of a simple, scalable, and replicable diagnostic POCUS curriculum with definable goals and objectives in a community-based, POCUS Naïve, and limited faculty and resource IM setting.
designThis curriculum was implemented in a 314-bed, community-based hospital system as a component of the IM residency program. Over a 36-month period (July, 2022 – June, 2025), we incorporated three separate iterations of a diagnostic POCUS curriculum. Two Plan, Do, Study, Act (PDSA) cycles were implemented at the end of year one and year two respectively. An online pre and post-test assessed knowledge of POCUS and its applications and a final skills-based image acquisition assessment using live models was performed at the end of each academic year. Residents were separated into cohorts defined as cohort 1 (PGY-1 and PGY-2s during initial curricular implementation), cohort 2 (PGY-1s of the following year), and the advanced cohort (Tier 2 and tier 3 residents during the final iteration). Performance improvement in both knowledge-based assessments and image acquisition were the main outcome measures of this study.
resultsCohort 1 (n = 18/20) had mean knowledge scores that improved from a pretest score of 60.2% (SD 7.8) to a post-test score of 73.3% (SD 9.0), a mean gain of 13.1% (95% CI 8.81–17.42); paired t = 6.43, p < 0.001, Cohen’s dz = 1.51. Post-test data (cohort 1 and 2; n = 11/30) from the following year averaged 83.9% (SD 8.9), a mean difference of 23.3% (95% CI 12.6–34.0) from the year prior. Overall, mean image‑quality scores, using a 0–3 scale, increased across cohorts (cohort 1 = 1.33; cohort 1 and 2 = 1.62; advanced cohort = 2.65), reflecting progressive program maturation and greater engagement among advanced tiers. In the advanced cohort, 10/10 residents were successfully assessed. Proficiency rose to 90.5% (95% CI 80.7%–95.6%) with 74.6% at gold standard quality (95% CI 62.7%–83.7%).
conclusionHaving an advanced POCUS curriculum in place with defined goals and objectives can be achievable and have a positive impact in smaller, community-based IM programs. CLINICAL TRIAL NUMBER: Not applicable.
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