Early, Supervised Point-of-Care Ultrasound Training for Internal Medicine Interns: A Quality Improvement Initiative

Background and objective Point-of-care ultrasound (POCUS) is increasingly being integrated into inpatient internal medicine; however, early residency training remains inconsistent. Objective evaluations of structured early-intern POCUS curricula that assess both knowledge and technical competency are limited. This study aimed to address this shortcoming through a quality improvement initiative. Methods We conducted a six-month quality improvement initiative within an internal medicine residency program (July-December 2023). Twenty interns participated in an early, structured POCUS curriculum consisting of didactics, supervised bedside training, and longitudinal reinforcement. Knowledge was assessed using a 15-question multiple-choice examination administered pre- and post-intervention. Practical competency was evaluated post-intervention using a standardized 30-point skills rubric. Paired knowledge outcomes were compared using the exact McNemar's test. Results At baseline, 10% (2/20) of participants met the passing threshold on the knowledge examination. Post-intervention, 95% (19/20) achieved a passing score (p < 0.001). Notably, 90% (18/20) passed the composite practical skills assessment. While 87% demonstrated proficiency in landmark identification and 65% achieved adequate overall image acquisition, performance was lower in advanced applications, including inferior vena cava measurement (35%) and aortic valve visualization (45%). Conclusions An early, supervised POCUS curriculum was associated with significant improvements in intern knowledge and high rates of technical competency. Descriptive analysis identified predictable limitations in advanced cardiac and inferior vena cava assessments, which informed targeted curricular refinement. Further research is required to evaluate long-term retention and clinical impact.