Physician Assistant Student Point-of-Care Ultrasound Examinations: Rates of Pathology and Accuracy of Interpretation

Point-of-care ultrasound (POCUS) is becoming an increasingly important skillset for practicing clinicians. Various methods of successful incorporation of POCUS into physician assistant (PA) program curricula have been described, but little is known about the accuracy of PA students' interpretation of POCUS examinations.

Retrospective, observational quantitative research was conducted on previously collected POCUS data from one PA program. Physician assistant students were required to complete a minimum of 25 POCUS examinations for each of the aorta, bladder, heart, lungs, and kidney. Examinations were completed on nonpatients and patients. All examinations included an interpretation by the PA student and were reviewed by faculty for quality and accuracy. Descriptive statistics were completed, and accuracies were calculated.

A total of 8936 POCUS examinations were included in the study obtained by 70 students; 6600 (73.86%) on nonpatients and 2336 (26.14%) on patients. Pathologic findings were noted on 5.75% of all examinations. Most examinations with pathologic findings were completed on patients, but pathologic findings were noted on a small amount of nonpatient examinations. Physician assistant students had a sensitivity of 92.02%, specificity of 99.88%, positive likelihood ratio of 766.83, and negative likelihood ratio of 0.08 on all POCUS examinations.

Physician assistant students are highly accurate at interpreting POCUS images of the aorta, bladder, heart, lungs, and kidneys. Physician assistant students were more accurate on patient examinations than nonpatient examinations, likely related to curricular sequencing. This study demonstrates that identification of pathology does occur on nonpatient models but overall is very uncommon.