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Point of care Ultrasound (POCUS) has been adopted into clinical practice across many fields of medicine. Undergraduate medical education programs have recognized the need to incorporate POCUS training into their curricula, traditionally done in small groups with in-person sessions. This method is resource intensive and requires sufficient equipment and expertise. These requirements are often cited as barriers for implementation. During the Coronavirus Disease 2019 (COVID-19) pandemic, POCUS education was required to adapt to physical distancing regulations, giving rise to novel teaching methods for POCUS. This article outlines the implementation of a POCUS teaching session before and during the pandemic. It describes how these innovations can scale POCUS teaching and overcome barriers moving forward. A flipped classroom model was implemented for all learners. Learners were given an introductory POCUS module before the scheduled in-person or virtual teaching session. Sixty-nine learners participated in conventional in-person teaching, while twenty-two learners participated in virtual teaching following the pandemic-related restrictions. Learners completed a written test before and following the teaching. In-person learners were assessed using an objective structured assessment of ultrasound skills (OSAUS) pre- and post-learning sessions. A follow-up survey was conducted three years after the teaching sessions were completed. Both in-person and virtual groups demonstrated statistically significant improvement in knowledge scores (p <0.0001). Both groups had similar post-test learning scores (74.2 ± 13.6% vs. 71.8 ± 14.5 %, respectively). On follow-up questionnaires, respondents indicate that they found our online and in-person modes of teaching helpful during their residency. POCUS education continues to face a variety of barriers, including limitations in infrastructure and expertise. This study describes an adapted POCUS teaching model that is scalable, uses minimal infrastructure and retains the interactivity of conventional small-group POCUS teaching. This program can serve as a blueprint for other institutions offering POCUS teaching, especially when conventional teaching methods are limited.
RESUMO
Introduction Evidence suggests that newly licensed physicians are not adequately prepared to prescribe safely. There is currently no national pre-licensure prescribing competency assessment required in North America. This study's purpose was to survey Canadian medical school leaders for their interest in and perceived need for a nationwide prescribing assessment for final year medical students. Method In spring of 2015, surveys were disseminated online to medical education leaders in all 17 Canadian medical schools. The survey included questions on perceived prescribing competency in medical schools, and interest in integration of a national assessment into medical school curricula and licensing. Results 372 (34.6 %) faculty from all 17 Canadian medical schools responded. 277 (74.5%) respondents were residency directors, 33 (8.9%) vice deans of medical education or equivalent, and 62 (16.7%) clerkship coordinators. Faculty judged 23.4% (SD 22.9%) of their own graduates' prescribing knowledge to be unsatisfactory and 131 (44.8%) felt obligated to provide close supervision to more than a third of their new residents due to prescribing concerns. 239 (73.0%) believed that an assessment process would improve their graduates' quality, 262 (80.4%) thought it should be incorporated into their medical school curricula and 248 (76.0%) into the national licensing process. Except in regards to close supervision due to concerns, there were no significant differences between schools' responses. Conclusions Amongst Canadian medical school leadership, there is a perceived inadequacy in medical student prescribing competency as well as support for a standardized prescribing competency assessment in curricula and licensing processes.