Impact of Point-of-Care Ultrasound on Clinical Decision-Making During Common Critical Care Scenarios: Linking...

As point-of-care ultrasound (POCUS) becomes mainstream, educational efforts to teach image acquisition, interpretation, and incorporation of findings into clinical decision-making become more relevant to ensure quality and competency. Despite expanding POCUS use, limited data exist on how novice learners translate newly acquired POCUS skills into diagnostic and management decisions. In this educational study, we investigated the impact of incorporating POCUS into patient assessment on diagnostic and management decisions of novice POCUS learners.

Learners participated in a one-day POCUS course, consisting of high-yield lectures, case discussions, and hands-on training. Diagnostic and management skills and confidence in those skills were assessed by administering clinical vignettes prior to the course without the use of POCUS, prior to the course with access to POCUS images, and at the conclusion of the course with access to POCUS images.

A one-day POCUS course improved learners' overall diagnostic accuracy, management decisions, and confidence level in their clinical decision-making across clinical scenarios where POCUS is indicated. Despite overall improvement, access to POCUS images had varied effects on changes in diagnostic accuracy and management decisions.

With training, access to POCUS images can augment diagnostic accuracy and enhance management where POCUS is indicated. Furthermore, learners display greater confidence in their decisions when they have access to POCUS images. These findings should be interpreted considering important methodological limitations, including the absence of a control group and potential testing effects from repeated case exposure. Clinical evaluation of this phenomenon in real patient encounters is required.