Narrative Review on History of Point-of-Care Ultrasound Training in Critical Care

Point-of-care ultrasound (PoCUS) has evolved from bulky radiology-based machines to a core bedside tool in critical care. Training processes have shifted from informal apprenticeship to structured curricula, yet challenges in standardisation, competence assessment and accreditation persist. This review traces the historical development of PoCUS training and highlights contributions from pioneering educators.

A narrative review of published literature, professional society guidelines and historical accounts was undertaken. Key milestones in PoCUS training, innovations in pedagogy and the perspectives of leading educators were synthesised to provide a comprehensive overview.

Early PoCUS training relied on apprenticeship and short workshops, which improved knowledge but failed to ensure sustained competence. Longitudinal programmes and fellowships offered more robust outcomes but were resource-intensive and inconsistently implemented. Professional societies issued guidelines, though most were consensus-based rather than evidence-driven, leading to variability in curricula and accreditation standards. Recent innovations include Free Open-Access Medical Education, simulation and artificial intelligence-assisted training. Despite these advances, surveys reveal persistent barriers such as lack of trained faculty, inconsistent assessment tools and medicolegal concerns.

The historical trajectory of PoCUS training underscores the tension between rapid clinical adoption and the slower development of robust educational frameworks. While innovations have expanded access, the absence of standardised, validated assessment and accreditation continues to limit training quality and patient safety.

PoCUS training has advanced considerably but remains fragmented. Sustainable progress requires longitudinal, evidence-based curricula, validated assessment tools and global collaboration to ensure safe, high-quality training for future clinicians.