Outcomes of a quasiexperimental study of a hands-on POCUS curriculum in undergraduate medical education

Abstract Background Point-of-care ultrasonography (POCUS) education is increasingly provided in medical schools. However, there is a lack of understanding regarding how to teach POCUS to undergraduate students. The aim of this study was to implement and evaluate a teaching strategy within the Internal Medicine clerkship. The Kirkpatrick framework is used to evaluate an educational program on four levels (reaction, learning, behavior, and results). We evaluated our program on the first three levels. Methods We enrolled 159 medical students in a single-center, prospective, quasiexperimental study between 2023 and 2024. The intervention comprised a 2-h hands-on session. The participants completed three time-point assessments to test their image interpretation skills (precourse, postcourse, and a 6-month follow-up). Friedman and Dunn's tests were used to compare results. Twenty-six participants were assessed on their ability to acquire images from patients. Satisfaction and behaviors were surveyed. A linear mixed model was applied to identify variables that influence improvements in image interpretation. Results Among the 140 respondents at the end of the clerkship, 136 (97%) were satisfied with the intervention. Among the 78 respondents who completed the follow-up survey at 6 months, 73 (93%) reported that the intervention contributed to their ability to perform POCUS again. There was a significant increase in the interpretation of images assessed at the three time points (9/20 vs. 14.5/20 vs. 14/20, chi-squared = 76.6, p < 0.001), and no significant decline was observed at 6 months (Z = -0.1, p > 0.99). Image acquisition skills (N = 26) suggested high proficiency for non-cardiac views, but substantial challenges in cardiac windows. POCUS application in real patients was reported by 110/140 participants (78.6%) and 42/78 participants (53.9%) during the clerkship and at the 6-month follow-up, respectively. Conclusions This teaching strategy was associated with high student satisfaction and significant learning and retention of interpretation skills. Given the non-controlled design and reliance on self-reported behavioral data, these findings suggest a positive impact on undergraduate education rather than establishing definitive effectiveness.