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Assessing Internist Competency in Point-of-Care Ultrasound Using the Entrustable Professional Activity Framework.

Joseph H Donroe1, André N Sofair2, Kevin M Piro3

  • 1Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. joseph.donroe@yale.edu.

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|March 17, 2026
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Summary
This summary is machine-generated.

A new framework and instrument were developed to assess competency in point-of-care ultrasound (POCUS) for internal medicine (IM) learners. This tool provides reliable and feasible workplace-based assessments for POCUS skills.

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Area of Science:

  • Medical Education
  • Point-of-Care Ultrasound (POCUS)
  • Competency Assessment

Background:

  • Point-of-care ultrasound (POCUS) is a critical skill in internal medicine (IM).
  • Robust methods are needed to effectively assess POCUS competency in IM learners.
  • Current assessment strategies may not fully capture the nuances of POCUS proficiency.

Purpose of the Study:

  • To develop an Entrustable Professional Activity (EPA) framework for POCUS competency.
  • To create a validated instrument for assessing POCUS skills in IM residents.
  • To establish a reliable and feasible method for workplace-based POCUS evaluation.

Main Methods:

  • An expert panel of IM POCUS educators developed the EPA framework and assessment instrument.
  • Validity, reliability, and feasibility were evaluated through bedside assessments of IM learners.
  • Data from 604 assessments on 48 learners across three academic sites were analyzed using G-study and D-study statistics.

Main Results:

  • An EPA titled "Assessing the acutely ill patient using POCUS" was developed.
  • Learner variance ranged from 27.7% to 31.4%, indicating significant individual differences in POCUS skills.
  • Reliability indices of 0.8 required 9-11 observations, and assessment completion time averaged 4.65 minutes.

Conclusions:

  • An EPA-based instrument for workplace POCUS assessment in IM was successfully developed.
  • Evidence of validity, reliability, and feasibility supports bedside POCUS competency assessment for IM learners.
  • This tool is expected to be highly valuable for IM programs assessing POCUS competence.