SHM Converge Scientific Abstract ePoster Gallery-Assessing Clinical Integration of Point-of-Care-Ultrasound via Objective Structured Clinical Examination

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This study evaluated whether an OSCE could assess not only point-of-care ultrasound (POCUS) image acquisition, but also clinical reasoning and integration of ultrasound findings into patient care. The authors created a case-based OSCE for second-year internal medicine residents after a two-day diagnostic POCUS course covering lung, DVT, cardiac, and abdominal scanning.<br /><br />Thirty-seven PGY-2 residents participated 9–12 months after training. In the OSCE, residents were given a clinical scenario involving a lupus patient on immunosuppressants who initially presented with shortness of breath and later developed shock. They were asked to scan a human model, while faculty revealed actual patient ultrasound clips corresponding to the views the learner obtained. The key findings were bilateral pleural effusions with B-lines and cardiac tamponade.<br /><br />Results showed wide variation in image acquisition. Only 38% of residents completed a full exam. Although most chose the correct exam based on the case (89% for lung, 100% for heart), many did not obtain all necessary lung views to rule out important pathology. However, residents generally did well interpreting the clips and integrating them into the case: all generated reasonable differentials, and most correctly identified tamponade and appropriate next management steps, such as cardiology consultation and/or pericardiocentesis.<br /><br />The main conclusion was that residents were much stronger at contextualizing ultrasound findings and making management decisions than at acquiring complete images. The authors suggest that future POCUS curriculum should focus heavily on improving image acquisition, while recognizing that even residents who do not become proficient sonographers may still learn to use and interpret POCUS effectively in clinical reasoning.

Asset Subtitle

Nalinee C. Srisarajivakul-Klein

Meta Tag

Author List Deborah Cooke, Isaac Holmes, Jennifer L. Dong, Michael Janjigian, Nalinee C. Srisarajivakul-Klein

Category Innovations

Concept Point-of-Care Ultrasound

Concept Differential Diagnosis

Concept POCUS Finding

Concept Management Decision

Concept Ultrasound Examination

Distinguished Non-Finalist

Presenter Organization NYU Grossman School of Medicine, NYC H&H | Bellevue

Presenting Author Nalinee C. Srisarajivakul-Klein

Track Education

Keywords

point-of-care ultrasound

POCUS

OSCE

clinical reasoning

image acquisition

internal medicine residents

ultrasound interpretation

cardiac tamponade

pleural effusions

diagnostic ultrasound

Point-of-Care Ultrasound

Differential Diagnosis

POCUS Finding

Management Decision

Ultrasound Examination