Juliette Begin*; Elodie Petrecca; Robert Hovey

McGill University, Montreal, QC, Canada

*Corresponding Author: Juliette Begin (email: juliette.begin@mail.mcgill.ca)

Download article PDF – POCUS Journal 2026;11(1):12-13

DOI: https://doi.org/10.24908/pocusj.v11i01.20481

Conference Abstract – Séguin Canadian POCUS Education Conference 2025

While national recommendations for point of care ultrasound (POCUS) integration in undergraduate medical education (UGME) are outlined by Canadian POCUS leaders, a critical barrier remains: the absence of standardized national objectives for POCUS teaching and evaluation [1].

To address this gap, we propose an outcome-driven approach to learning—the entrustable professional activity (EPA). This tool evaluates a student’s competency and progression in performing clinical tasks [2–7]. In Canada, EPAs are used to document key clerkship competencies, making it readily accessible.

We suggest a series of POCUS-specific EPAs spanning the UGME curriculum. Establishing EPAs across the program’s entirety reinforces a longitudinal educational framework, enhancing skill retention[8–11]. Our proposed EPAs include a 10-domain checklist assessing common POCUS competencies. Each EPA builds on skills developed in completed ones, creating a coherent progression that mirrors learners’ evolving clinical responsibilities.

To align with national standards, EPAs will be derived from the Canadian POCUS Acute Care Core curriculum [12]. Due to its high scalability, the ultrasound applications within this EPA-based program can be updated without modifying the assessment framework, allowing the curriculum to remain current with medical advancements. Pre-clerkship EPAs will emphasize foundational physics, knobology, anatomical landmark recognition, and supervised image acquisition. Clerkship EPAs will focus on independent image acquisition and their integration in clinical contexts.

To test this method, an initial phase will be conducted in entering cohorts in Quebec’s four medical schools. Evaluation will be based on learner performance, measured through completion rates, entrustment scores, and student and faculty feedback on usability and educational value. EPAs will occur during existing practical sessions or clinical rotations, thus requiring no additional equipment nor instructor. Costs will be related to administrative and technical tasks, including EPA form incorporation into existing electronic systems. The following year, after fine-tuning, Quebec schools will extend the framework to incoming cohorts, after which the system can be expanded nation-wide. 

The educational impact will be assessed by comparing learner progression across Canadian cohorts and institutions. Residents and physicians will monitor POCUS preparedness of incoming clerks and residents via surveys. Stakeholders include medical students, UGME curriculum committees, and national bodies such as cPOCUS and the Medical Council of Canada.

This EPA-based model offers a feasible and scalable strategy to standardize UGME POCUS education nationally, ensuring all medical graduates possess the foundational skills required for clinical practice.

References

1. Ma IWY, Steinmetz P, Weerdenburg K, et al. The Canadian Medical Student Ultrasound Curriculum: A Statement From the Canadian Ultrasound Consensus for Undergraduate Medical Education Group. J Ultrasound Med. 2020;39(7):1279-1287. doi:10.1002/jum.15218

2. Ten Cate O, Taylor DR. The recommended description of an entrustable professional activity: AMEE Guide No. 140. Med Teach. 2021;43(10):1106-1114. doi:10.1080/0142159X.2020.1838465

3. Pangaro L, ten Cate O. Frameworks for learner assessment in medicine: AMEE Guide No. 78. Med Teach. 2013;35(6):e1197-e1210. doi:10.3109/0142159X.2013.788789

4. Shorey S, Lau TC, Lau ST, Ang E. Entrustable professional activities in health care education: a scoping review. Med Educ. 2019;53(8):766-777. doi:10.1111/medu.13879

5. Violato C, Englander R, Dale E, Gauer JL. Implementing Core Entrustable Professional Activities in Undergraduate Medical Education: A Psychometric Study. Acad Med. 2025;100(5):585-591. doi:10.1097/ACM.0000000000005907

6. Brown DR, Moeller JJ, Grbic D, et al. Comparing Entrustment Decision-Making Outcomes of the Core Entrustable Professional Activities Pilot, 2019-2020. JAMA Netw Open. 2022;5(9):e2233342. Published 2022 Sep 1. doi:10.1001/jamanetworkopen.2022.33342

7. Shorey S, Lau TC, Lau ST, Ang E. Entrustable professional activities in health care education: a scoping review. Med Educ. 2019;53(8):766-777. doi:10.1111/medu.13879

8. Recker F, Schäfer VS, Holzgreve W, Brossart P, Petzinna S. Development and implementation of a comprehensive ultrasound curriculum for medical students: The Bonn internship point-of-care-ultrasound curriculum (BI-POCUS). Front Med (Lausanne). 2023;10:1072326.10.3389/fmed.2023.1072326.

9. Kelm DJ, Ratelle JT, Azeem N, Bonnes SL, Halvorsen AJ, Oxentenko AS, et al. Longitudinal Ultrasound Curriculum Improves Long-Term Retention Among Internal Medicine Residents. J Grad Med Educ. 2015;7(3):454-7.10.4300/jgme-14-00284.1.

10. Zeitouni F, Matejka C, Boomer M, Lee VH, Brower GL, Hewetson A, et al. Integration of point of care ultrasound into undergraduate medical education at Texas Tech University Health Sciences Center school of medicine: a 6 year review. BMC Med Educ. 2024;24(1):1476.10.1186/s12909-024-06483-y.

11. Steinmetz P, Oleskevich S, Lewis J. Acquisition and Long-term Retention of Bedside Ultrasound Skills in First-Year Medical Students. J Ultrasound Med. 2016;35(9):1967-75.10.7863/ultra.15.09088.

12. Society CPoCUS. CPoCUS Tracks – Acute Care CORE (AC CORE)  [Available from: https://cpocus.ca/acute-care-core/.