Education and training models for point-of-care ultrasound in perioperative medicine: a narrative review

Point-of-care ultrasound (POCUS) has become an increasingly important component of perioperative medicine, supporting real-time assessment of cardiovascular function, pulmonary pathology, gastric content, airway anatomy, vascular access, regional anesthesia, and perioperative complications. Perioperative POCUS is relevant to anesthesiologists and to the broader perioperative team, including critical care clinicians, pain physicians, emergency clinicians, surgeons, and ultrasound educators who participate in perioperative diagnosis, procedures, resuscitation, and postoperative care. Despite its growing clinical relevance, POCUS education in anesthesiology and perioperative medicine remains heterogeneous, with variable curricular scope, inconsistent assessment strategies, and persistent barriers related to faculty expertise, protected training time, equipment access, and competency verification. This narrative review used a transparent, targeted search strategy across biomedical and education databases, with adapted PRISMA reporting elements used to describe sources, search concepts, and selection boundaries while preserving the interpretive purpose of a narrative synthesis. Simulation-based education offers a practical and ethically sound approach for teaching POCUS before learners perform examinations in high-stakes perioperative environments. This review synthesizes educational theory, perioperative POCUS competency frameworks, empirical ultrasound simulation evidence, cross-disciplinary procedural simulation literature, and assessment scholarship to propose an integrated training model for perioperative POCUS. We organize simulation-based POCUS education into six complementary models: low-fidelity task training, standardized-patient and peer scanning, high-fidelity physiologic simulation, hybrid operating-room crisis simulation, virtual and augmented reality platforms, and longitudinal simulation-based mastery learning. Effective perioperative POCUS education should progress from cognitive preparation and deliberate image acquisition practice to interpretation, clinical integration, documentation, and team-based decision-making. Assessment should combine image-quality rubrics, interpretation tests, entrustable professional activities, objective structured clinical examinations, image portfolios, and longitudinal workplace-based feedback. Because the evidence base differs across simulation modalities and assessment tools, programs should distinguish empirically tested instruments from locally adapted or theoretical tools and should validate competency thresholds before using them for high-stakes credentialing. Key research priorities include multicenter validation of competency thresholds, comparative effectiveness studies of simulation modalities, cost-effectiveness analyses, faculty development models, responsible integration of artificial intelligence, and studies linking simulation-based training to clinical performance and patient outcomes. Simulation is not a substitute for supervised clinical scanning; rather, it is a bridge between theoretical knowledge and safe, competent bedside practice.