Learning PoCUS

Khalid Azzam


Kobal SL, Trento L, Baharami S, et al. Comparison of effectiveness of hand-carried ultrasound to bedside cardiovascular physical examination. Am J Cardiol. 2005 Oct 1;96(7):1002-6. PubMed PMID: 16188532.

Is it difficult for a clinician without prior training in ultrasonography to learn point-of-care ultrasound (PoCUS)?

Khalid Azzam: It is not difficult to learn, actually. It is interesting because a lot of studies were done on PoCUS and they looked at very little training, but when they look at very little training, they are looking at one indication only. So there are studies looking at the inferior vena cava (IVC) measurements, which taught residents over about 4 hours of didactic teaching and 20 procedures supervised. In the study that most people quote on teaching, cardiac ultrasound for medical students, they looked at 18 hours of instruction – 4 hours didactic and 14 hours at the bedside – so that is not a lot but that is because it is one focused problem that they are trying to teach. You pick your focus problem, go to proper training, and then you practice, practice, practice, and make sure that there is good quality assurance.

In the future, things will be much better because now we are introducing PoCUS from the medical school level. There are a few schools in the United States and a couple of schools in Canada – McMaster University is going to be one of those schools – that are introducing PoCUS from the undergraduate level, when students are going to learn how to use the machine, how to use it complimentary to your physical examination. Then they move on to their residency, the training gets more intensive, they use PoCUS for specific indications, and then when they come to practice it will just be a second nature. It is like using a stethoscope. You learn in medical school how to use a stethoscope, you practice it through your residency, and when you come into practice, stethoscope is the usual thing that you use every day. What we hope to see is that PoCUS – the handheld or hand-carried ultrasound – will be just another thing that the internist or physician will have and will use for the best benefit of patients.

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