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A4919 - Results of a Needs Assessment on Internal Medicine Intern Point-of-Care Ultrasound Attitudes and Skills
Author Block: E. Goerlich1, G. Liu2, T. Zhang1, B. T. Garibaldi3; 1Johns Hopkins University School of Medicine, Baltimore, MD, United States, 2Johns Hopkins Hospital, Baltimore, MD, United States, 3John Hopkins University School of Medicine, Baltimore, MD, United States.
Introduction/Rationale
Point-of-care ultrasound (POCUS) is a widely used adjunct to the physical exam, particularly for the critical care and emergency medicine physician. Despite a lack of formal training, many internal medicine physicians are using POCUS to guide medical decision-making. With increased availability of handheld ultrasound devices, there is an opportunity and a need to train internal medicine physicians to utilize this tool as part of bedside diagnosis. We administered a needs assessment to incoming internal medicine interns to evaluate their attitudes, confidence and knowledge in POCUS. This data will be used to design a curriculum for POCUS that will meet the needs of both trainees and residency programs.
Methods A 57-question combined survey and knowledge assessment was administered to incoming interns during their orientation to an internal medicine residency program. The survey portion explored attitudes about using POCUS, level of previous training in POCUS, and confidence in specific POCUS skills. The assessment tested baseline knowledge in the following areas: ultrasound basics, cardiac ultrasound, and lung ultrasound. Reliability of the assessment was tested using Cronbach’s alpha.
Results All 51 interns completed the assessment. One response was discarded due to delayed completion. The majority of interns agreed that POCUS is an important part of the physical exam and medical management, but the majority reported feeling “not confident” using POCUS. No participants felt very or extremely confident. All participants hoped to become at least somewhat competent using POCUS by the end of residency, with most choosing extremely competent. The overall mean on the knowledge assessment was 28.18 out of 49, or 57.5% (SD 7.11). The knowledge assessment was highly reliable with a Cronbach’s alpha of 0.79. Knowledge scores were not significantly associated with attitudes or confidence.
Discussion Internal medicine residents express low levels of confidence, yet desire at least moderate competence, in POCUS skills by the end of residency. A new knowledge assessment on cardiac and pulmonary bedside ultrasound was highly reliable and revealed several areas in which internal medicine residents would benefit from formal training. These findings reinforce the need to develop formal curricula in POCUS for internal medicine residents, and provide a mechanism to tailor such a curriculum to the particular strengths and weaknesses of a given residency program.