Motivations, barriers, and professional engagement: a multisite qualitative study of internal medicine faculty’s experiences learning and teaching point-of-care ultrasound

Abstract

Background Point-of-care ultrasound (POCUS) graduate medical education is expanding across many specialties, but a lack of trained faculty is a common barrier. Even well-designed faculty development programs struggle with retention, yet little is known about the experiences of practicing physicians learning POCUS. Our objective is to explore the experiences of clinician-educators as they integrate POCUS into their clinical and teaching practices to help inform curriculum design. Methods Qualitative study using instrumental case study design to analyze interview data from 18 internal medicine clinician-educators at 3 academic health centers. Interviewees were recruited by program directors at each site to include participants with a range of POCUS use patterns. Interviews took place from July–August 2019. Results Analysis yielded 6 themes: teaching performance, patient care, curriculum needs, workflow and access, administrative support, and professional engagement. Participants felt POCUS enhanced their teaching skills, clinical decision making, and engagement with patients. The themes highlighted the importance of longitudinal supervision and feedback, streamlined integration of POCUS into clinical workflow, and administrative support of time and resources. Interviewees reported learning and teaching POCUS helped combat burn-out and enhance their sense of professional engagement. Conclusions Learning POCUS as a practicing clinician-educator is a complicated endeavor that must take into account mastery of psychomotor skills, existing practice habits, and local institutional concerns. Based upon the themes generated from this study, we make recommendations to help guide POCUS faculty development curriculum design. Although this study focused on internists, the findings are likely generalizable to other specialties with growing interest in POCUS education.

Development of a hybrid point-of-care ultrasound curriculum for first year medical students in a rural medical education program: a pilot study

“…In line with these findings, our students reported feeling connected and refreshed by their participation in the elective, particularly the hands-on scanning component. Overall, the results from our students’ experiences and perceptions of POCUS mirror trends reported in the literature [ 3 , 15 , 54 , 67 , 71 ].…”

“…While participant enjoyment of educational experiences, including satisfaction with the course content, resources, and instructors, is not essential for learning to occur, it is linked with higher quality learning outcomes and improved psychological well-being [ 53 , 69 , 70 ]. Moreover, training in POCUS has been shown to promote engagement, and combat burnout in students and practitioners [ 68 , 70 , 71 ]. In line with these findings, our students reported feeling connected and refreshed by their participation in the elective, particularly the hands-on scanning component.…”

“…However, medical students and health care professionals in practice and academics face high rates of depression, burnout, and moral distress [ 76 – 80 ]. Therefore, curating engaging, enjoyable, and valued educational experiences may carry benefits beyond the traditionally measured academic outcomes [ 69 , 71 ]. Finally, promoting students’ confidence in clinical settings may set them up for continued success [ 68 , 69 ].…”

A Clinician’s Guide to the Implementation of Point-of-Care Ultrasound (POCUS) in the Outpatient Practice

“…Clinicians report the use of POCUS gives them more time in direct contact with patients, is interesting to learn and conduct, and garners positive feedback from trainees, all of which were suggested to reduce concerns for burnout. 33 …”

Implementing a Sports Ultrasound Curriculum in Undergraduate Medical Education

“…As the utilization of US expands, there has been an impetus to incorporate an US curriculum at the undergraduate medical education level (6)(7)(8)(9) in order to improve comprehension of anatomy, as well as accuracy of the physical examination (2,(10)(11)(12)(13). Previous studies have demonstrated a better understanding of musculoskeletal (MSK) and cardiac anatomy/physiology when US was used as a teaching tool (14)(15)(16)(17)(18)(19)(20)(21).…”