Deliberate Practice in Point-of-care Ultrasound Interpretation of Hydronephrosis

Point-of-care ultrasound (POCUS) has become increasingly utilized as an important tool in acute care settings. Deliberate practice as part of POCUS training has previously been shown to enhance learner performance in image interpretation, though its efficacy in residents' identification of hydronephrosis with renal POCUS has not been well-studied. In our study, we aimed to evaluate the learning curve for internal medicine residents using deliberate practice for the identification of hydronephrosis on renal POCUS interpretation.

We recruited internal medicine residents from Mount Sinai Beth Israel and Mount Sinai Morningside/West, and asked them to complete a 30-case educational instrument on the interpretation of hydronephrosis. The study was conducted as a series of two separate hour-long sessions and included residents with varying baseline POCUS experience. We mapped cumulative accuracy as learning curves to assess resident performance.

A total of 47 participants completed the survey and deliberate practice instrument and demonstrated significant improvement in confidence level and image interpretation skills. All learners demonstrated improvement in accuracy with repetitive practice. We mapped the learning curve and found a plateau in accuracy at 20-25 cases. Statistical analysis of the results was performed with Microsoft Excel Version 16.85, and R version 4.3.2.

Deliberate practice in the identification of hydronephrosis on renal POCUS using a novel case-based instrument improves residents' accuracy. This approach is easily reproducible, can impact learners at different stages of experience, and can be integrated into a more comprehensive curriculum on POCUS.