A Novel 'Train the Trainer' Emergency Medicine Resident Point-of-Care Ultrasound Course: A Feasibility Study

A novel multi-site 'train the trainer' point-of-care ultrasound (POCUS) training course was designed to better meet the graduate medical education learning needs of a geographically dispersed consortium of 16 community-based Michigan emergency medicine (EM) residency programs. The specific aim of this study was to explore the feasibility of using volunteer EM physicians who were novices with ultrasound techniques as instructors for a POCUS course. Additionally, the authors evaluated the effectiveness and consistency of a POCUS course delivered over multiple sites to enhance EM residents' ultrasound knowledge and skill acquisition.

For the initial session, the lead instructor conducted a focused two-hour course with the novice instructors. A subsequent four-hour session was then repeated for EM residents whereby the aforementioned novice instructors provided the hands-on instruction. The residents were given 10-item pre- and 20-item post-course knowledge tests to gauge the effectiveness of the instruction model. After the course, a satisfaction survey was administered to the resident participants and a qualitative open-ended survey to the volunteer EM physicians who served as instructors.

Forty-two EM residents from 11 different residency programs attended at one of the three courses that were offered. After adjustments for size differences in the pre- and post-training tests, 35 (87.5%) of total sample resident learners' scores proportionately increased from pre- to post-test scores, with five (11.9%) other residents maintaining their pre-course score levels and only two (4.8%) residents experienced a post-score decline. In addition, resident participants responded favorably to a post-course summary evaluation with an average response of 4.8 (0-5 Likert scale) demonstrating overall satisfaction with the course. In the separate qualitative survey given to instructors, comments consistently conveyed a perceived benefit for the volunteer EM physicians.

The evaluation of this novel model supports the feasibility of the 'train the trainer' program. It provides a proof of principle that train the trainer model can be implemented for POCUS training courses. Despite the small sample size, our results show an increase in the pre- to post-test scores among most participating residents. This model provides an additional option for EM residency program educators to consider when developing their POCUS training courses across multiple GME settings.