Impact of Longitudinal Pulmonary Ultrasound Curriculum in a Multi-disciplinary Critical Care Fellowship

Point-of-care ultrasound (POCUS) has become a central component in the assessment and management of critically ill patients. Despite its widespread application, there is no standardized curriculum across critical care fellowships. Previous studies have examined the efficacy of ultrasound curricula in enhancing provider comfort and expertise with POCUS. However, these educational interventions are typically limited to specific critical care subspecialties and do not evaluate the longitudinal impact of POCUS training. In this study, we assessed the impact of a longitudinal pulmonary ultrasound curriculum on a multidisciplinary group of critical care fellows. Participants trained in internal medicine, emergency medicine, anesthesia, and neurology first completed a pre-training knowledge assessment. They then attended two one-hour didactic lectures on lung ultrasound (LUS). Hands-on training sessions were provided, with each fellow receiving two-hour scanning sessions under the guidance of critical care ultrasound faculty. Confidence among critical care fellows in acquiring and interpreting images increased from 57% (n = 21) to 79% (n = 19). Similar increases in fellow confidence were noted in using LUS to identify the etiology of respiratory distress and using ultrasound for the diagnostic and therapeutic management of pleural effusions. All study participants were able to accurately complete a comprehensive LUS exam within 10 minutes after training. Quality improvement initiatives and scan reviews provided ongoing feedback over the next year. Upon follow-up with graduates within a year of completing their fellowship, pulmonary ultrasound was routinely used in their practice, with an average frequency of two to three times per week. All respondents reported that pulmonary ultrasound training during fellowship had meaningfully changed how they integrate the tool into their clinical practice.