The State of Point-of-Care Ultrasonography Training in Pediatric Hospital Medicine Fellowship

Point-of-care ultrasonography (POCUS) provides rapid diagnostic and procedural support in conditions commonly encountered by pediatric hospitalists. It has been increasingly incorporated into undergraduate and graduate medical education, yet the extent of POCUS training in pediatric hospital medicine (PHM) fellowship is unknown. This study aims to describe the current state of POCUS education in PHM fellowships, perspectives on its value, and barriers to implementation.

A survey was developed by PHM and POCUS experts and distributed electronically to PHM fellows and fellowship program directors (PDs) and associate PDs (APDs) between August and October 2022. Comparative analyses were conducted based on respondent and program characteristics.

The response rate was 72% (183/253). Forty-two percent of PDs/APDs reported that their program provides POCUS training. The most common applications taught were lung, soft-tissue, and cardiac examinations and procedural guidance. Compared with PDs/APDs, fellows agreed more strongly that POCUS should be included in fellowship training (P < .001) and reported a greater desire for advanced hands-on skills (P < .001) than PDs/APDs' expectations. Barriers to training included a lack of qualified instructors, limited access to needed technology, and the absence of a standard PHM-specific curriculum.

More than one-third of PHM fellowship programs offer some POCUS training; however, significant barriers remain. Trainees are increasingly entering fellowship with POCUS experience, perhaps influencing their perspectives on its value and desire for higher-level skills. Expanding POCUS education in PHM fellowship offers a unique opportunity for trainees to develop clinical skills that can distinguish them as fellowship graduates and improve patient care.