In Too Deep: A Point-of-Care Ultrasound (POCUS) Escape Room

Emergency medicine residents and emergency ultrasound fellows.

Point-of-care ultrasound (POCUS) is an essential emergency medicine skill that requires hands-on practice and an understanding of anatomy in three-dimensional space.1 Experientially, some common POCUS challenges are identifying foreign bodies in soft tissue, recognizing nerves, and identifying lower extremity veins in relation to other anatomic landmarks. But finding novel ways to challenge and engage advanced learners who have mastered basic POCUS content can be difficult, and this was the impetus of the current gamified educational activity.

By the end of this session, the participant will be able to:Evaluate and identify the nature of metallic foreign bodies using POCUS.Identify common emergency department fractures on X-Ray and identify relevant sonoanatomy for ultrasound-guided regional anesthesia applications relevant to those fractures.Identify normal lower extremity venous POCUS sonoanatomy and demonstrate understanding of proximal versus distal anatomical location within the lower extremity venous system.

A hands-on, gamified approach was used. This approach builds on previously published escape room models to focus on the application of the three POCUS indications described above.2,3.

After the activity, participants filled out a standardized teaching evaluation including questions about the quality of the material presented, the degree to which they felt actively involved as learners, and free-text qualitative feedback.

Our test group including emergency ultrasound fellows and senior emergency medicine residents successfully completed the escape room. Three of the four participants (75%) completed the evaluation; 3/3 (100%) rated the escape room as exceeded expectations for actively involving learners and qualitatively reported that the activity was "fun," "interactive," "engaging," and "innovative."

We found that using an escape room format for POCUS education was effective and engaging. However, it is important to note that small details in the escape room design may have large impacts on the ability of the learners to complete the activity and meet the educational goals. Overall, we found that this activity was effective and fun for both learners and educators.

Point-of-care ultrasound (POCUS), team building, foreign body identification, ultrasound image review, lower extremity venous, ultrasound-guided regional anesthesia.