Point-of-care ultrasound (POCUS) has arguably revolutionized the healthcare industry, and many believe its impact has only begun. With many in the field predicting that this modality will become as commonplace as the stethoscope, healthcare workers are actively looking for paths to learn and expand their POCUS capabilities. It’s incorporated into educational programs, volunteer opportunities, and medical professionals’ day-to-day practices.
As the use of this modality has reached worldwide usage, organizations like The Point-of-Care Ultrasound Certification Academy provide a collaborative community for physicians and other medical workers to advance the mission of improving global health by allowing them to “demonstrate their knowledge, test their proficiency and promote best practices in POCUS.”
While awareness surrounding POCUS has grown exponentially in recent years, there are still barriers for the healthcare industry to overcome to ensure the implementation of its fullest potential. According to a 2020 study published in The Ultrasound Journal, the five top challenges to learning and using POCUS as identified by participants were:
Lack of training
Lack of handheld ultrasound devices
Lack of direct supervision
Lack of time to perform POCUS during rounds
Lack of quality assurance processes
An additional study published in 2019 highlighted how although many emergency medicine residency programs have strenuous POCUS curricula, “this training does not always readily translate to routine use in clinical decision-making.”
To help elevate the skill set of POCUS users, discussions and research surrounding the current standards of training and education experiences are taking place throughout the medical community.
One healthcare professional dedicated to researching POCUS for patient care and guiding future accreditation, Dr. Andre Kumar, MEd, joined us on a recent FOCUS on POCUS™ podcast episode to talk about POCUS training and competency. Dr. Kumar is a clinical assistant professor of internal medicine at Stanford University, and the director for the Stanford Medicine Procedure Service, President of the Society of Hospital Medicine Bay Area, and an instructor for the Society of Hospital Medicine POCUS Certification Program.
Along with being the lead investigator for a multi-institutional study surrounding the use of POCUS for COVID-19, he recently published two randomized trials that explored how to train resident physicians with POCUS optimally.
In the episode, he spoke to how while there’s been an increasing presence of POCUS across the clinical training spectrum, extending beyond just internal medicine, developing competency in POCUS requires more than solely providing access to the modality. Dr. Kumar compared it to a stethoscope in that “just because you have it available to you; you may not know how to use it or use it well.”
This statement addresses the aforementioned studies’ concerns that while trainees need access to the modality, further guidance and training beyond lecture settings benefit their ability to thoroughly grow their POCUS skill sets.
The trials Dr. Kumar conducted suggest that access to POCUS alone is not the biggest barrier to gaining competency. His research also addressed a plateau effect connected to the standard teaching method of POCUS and other capabilities. When trainees and healthcare workers first experience the modality, there’s an initial increase in their competency, but there’s a plateau effect after a while. For medical professionals looking to develop mastery, it takes substantially more time and effort.
“We realized that just giving someone a device and not allowing them personalized feedback in real-time as they’re scanning real patients is not going to be sufficient to get them to that next level,” said Dr. Kumar. While the current system will help trainees develop their initial POCUS skill set, Dr. Kumar says we should be striving for more.
“What we are really trying to get at with POCUS is developing a mastery of this, in the same level of mastery we would expect our physicians to use the stethoscope for the physical exam.”
Healthcare providers and patients alike stand to benefit from using the findings from studies such as Dr. Kumar’s to help enhance current POCUS curricula. To better provide opportunities and training programs that allow those in medicine to develop POCUS mastery, listen to his podcast episode.
Given the impact that POCUS has already had on the medical community and the level of care patients receive, if healthcare professionals come together to break through these barriers, the outcome will be astronomical.