Philip K Angelides, Roger León, Austin Stelmach, Carolina Ortiz-López, Himmer Alfonso Hip Sánchez, Guillermo Bolaños, Michelle Fleshner, Angeline Sawaya, Jakob E Gamboa, Reem M Hanna, Daniel Olson
BACKGROUND: Internal medicine (IM) education in resource-limited hospitals is constrained by heavy workloads and imaging limited to plain radiography. Point-of-care ultrasound (POCUS) supports experiential learning and diagnostic reasoning, yet no rounds-integrated IM curricula have been described in Latin America, and most programs stop short of practice-based bedside assessment.
AIM: To implement and evaluate a rounds-integrated POCUS curriculum in a resource-limited IM setting.
SETTING: Hospital Nacional de Coatepeque (228-bed Guatemalan public hospital).
PARTICIPANTS: Eight final-year medical students without formal ultrasound training.
PROGRAM DESCRIPTION: The curriculum combined flipped-classroom prework, a 2-day course focused on pleural and abdominal fluid detection, and a 2-month longitudinal program embedding POCUS into daily rounds, with Butterfly Cloud portfolio review, WhatsApp-based feedback, and designation of three learners as local "champions" in a train-the-trainer model.
PROGRAM EVALUATION: Knowledge and confidence gains largely persisted at 2 months. Hands-on performance was strongest for pelvic/bladder view acquisition, artifact recognition, and image optimization, and lowest for spine sign recognition and probe orientation and manipulation. Barriers included probe scarcity and limited institutional support; champions emerged as key drivers of peer learning.
DISCUSSION: Rounds-integrated POCUS training is feasible in resource-limited settings and may support early skill development when paired with longitudinal mentorship and local champion development.