Evaluation of Internal Medicine Point-of-Care Ultrasound Curricula in Canada Through a Quality Improvement Framework Using Education Indicators.

BACKGROUND: Point-of-care ultrasound (POCUS) is increasingly integrated into residency training; however, POCUS education within Canadian internal medicine (IM) residency programs is not standardized. To support curriculum development and evaluation, the Canadian internal medicine ultrasound (CIMUS) group has previously published consensus-based education indicators (EIs). OBJECTIVE: This study seeks to refine operational working definitions for the published EIs and characterize POCUS education in Canadian IM residency programs. DESIGN: Eleven POCUS experts developed consensus-based working definitions for the previously published EIs. The refined EIs were then used to collect data to evaluate existing POCUS curricula in Canadian IM training programs. KEY RESULTS: The previously 22 published EIs were refined to 17 through expert consensus, with two forms being created to account for programs with POCUS electives. All Canadian IM training programs (n = 17) completed data collection. Significant heterogeneity was noted. Programs have a median of one POCUS faculty (range 0-5), with median annual teaching time of 18 h (ranging from 0 to 204 h). Only one program has assessment processes in place for all POCUS learners. Ten programs (59%) have no POCUS archiving system or feedback mechanism available for independent scans. Only six programs (35%) have program evaluation in place. Seven (41%) have support for equipment or faculty time. Six programs (35%) had a "superuser" augmented POCUS stream, providing a median of 161 additional teaching hours. Within these programs, one-third (n = 2) provide feedback on all learner-acquired images, one-third (n = 2) have no mechanism for feedback on images, while the remaining third (n = 2) give feedback on a subset of studies. CONCLUSIONS: Using an EI-based instrument to capture Canadian IM medicine POCUS curricula implementation efforts revealed significant heterogeneity across all indicators. Use of this instrument may be helpful in supporting the standardization of high-quality POCUS education.