Introduction: Resident education in ICUs includes not only traditional teaching on bedside rounds and didactic lectures but also education and exposure in skills such as Point of Care Ultrasound (POCUS) and ICU procedures (central line, arterial line placement, endotracheal intubations, ultrasound guided peripheral iv insertion etc). Methods: We created a voluntary two part ‘Hands-on-Critical Care Curriculum’ for Internal Medicine (IM) Residents which included POCUS workshop and Procedural simulation workshop. Our faculty was POCUS trained and certified. The workshops were conducted on multiple days and included interested PGY-2 and PGY-3 IM residents. Residents received workshops’ reading materials including goals and objectives, relevant articles, instructional videos etc prior to the workshop. Participants completed a pre-test consisting of 20 multiple-choice and open-ended questions to assess baseline knowledge. POCUS workshop on standardized patients included four stations—cardiac, lung, abdominal, and integrative (“putting it all together”). Faculty to learner ratio was 1:3 to 1:4. Procedural workshop included central line, arterial line, endotracheal intubation and ultrasound guided peripheral iv simulation on manikins. A post-test was administered two weeks later to assess knowledge acquisition following the workshops and a follow-up survey 4 months later. Results: A total of 29 residents (15 PGY-2 and 14 PGY-3) participated in the POCUS workshop and 20 residents (12 PGY-2 and 8 PGY-3) in the procedural workshop. The overall mean scores for POCUS improved from 47% to 76% (PGY-2: 42% to 71%, PGY-3: 52.5% to 81.3%, p < 0.0001). For procedural workshop, the overall mean scores improved from 56.5% to 69.4% (PGY-2: 56.5% to 67.8%, PGY-3: 56.5% to 66.6%, p< 0.001). A follow-up survey 4 months later showed behavioral shift with increase in focused POCUS exams and ICU procedures (central lines, arterial lines and US guided peripheral iv) performed by residents in the ICU. Conclusions: Formal POCUS and procedural simulation education should be integrated into ICU teaching curriculum. Our results showed improvement in knowledge scores for POCUS and procedural simulation among IM residents and behavioral shift in residents’ POCUS and procedural activities in the ICUs.
Lee et al. (Sun,) studied this question.