Establishing Point-of-Care Ultrasound General Competencies: A Consensus-Based Delphi Process in Family Medicine

As more family medicine residency programs incorporate point-of-care ultrasound (POCUS), effective ways to teach and assess POCUS competency remain a major challenge. This Delphi study aimed to create expert consensus to define POCUS general competencies for family medicine residents.

We used a traditional Delphi study design to draft and validate a list of POCUS general competencies. We recruited a panel of 25 family medicine POCUS education experts from various backgrounds. Three rounds of voting occurred between February and July of 2025. Drafted survey items were categorized to correspond to the six Accreditation Council for Graduate Medical Education (ACGME) milestones. In each round, panelists rated agreement using a 5-point Likert scale. Items failing to reach consensus after round three were excluded from the final general competency list.

A total of 49 general competencies were drafted prior to round one, and an additional three competencies were added between rounds. After three rounds, 45 general competencies met positive consensus, and seven lacked consensus leading to their exclusion from the final list.

This study used standardized, evidence-based Delphi methodology to establish the first set of POCUS general competencies for teaching and assessing family medicine residents. The general competencies identified represent a broad scope of skills correlating to the six ACGME milestones. The study provides the foundation for future research evaluating how these general competencies can be used to assess POCUS competence for family medicine residents.