Sarah Bilgasem*; Mahma Ahmed; Shehla Choudhary; Noor Qureshi

Schulich School of Medicine & Dentistry, Western University, London, ON, Canada

*Corresponding Author: Sarah Bilgasem (email: sbilgasem2028@meds.uwo.ca)

Download article PDF – POCUS Journal 2026;11(1):10-11

DOI: https://doi.org/10.24908/pocusj.v11i01.20506

Conference Abstract – Séguin Canadian POCUS Education Conference 2025

Identification and Rationale for the Chosen Barrier

Across Canadian medical schools, integration of point of care ultrasound (POCUS) in undergraduate medical education remains inconsistent and insufficiently standardized. A national review found that only half of undergraduate medical education programs offer formal ultrasound teaching, and typically under five hours per year [1]. Meanwhile, 76% of internal medicine trainees report using POCUS in clinical practice despite minimal training, revealing a disconnect between undergraduate preparation and clinical expectations [2]. Although the Canadian Medical Student Ultrasound Curriculum (CMSUC) outlines national competencies, few schools have implemented standardized instruction or validated assessment [3]. This gap limits competency development and prevents students from applying ultrasound diagnostically.

Proposed Initiative

This initiative embeds POCUS directly into system-based Clinical Skills, taught alongside traditional examination maneuvers. During the Respiratory block, students pair auscultation with lung ultrasound to identify pleural effusion and pulmonary edema—conditions with >90% sensitivity and specificity, outperforming both percussion and auscultation [4–8]. Emphasizing high-yield, high–pretest-probability conditions such as left ventricular dysfunction, pericardial effusion, and abdominal aortic aneurysm, enables learners to apply ultrasound to answer diagnostic questions and integrate imaging into bedside reasoning [4]. Competence will be evaluated using the Objective Structured Assessment of Ultrasound Skills (OSAUS)—a validated global rating scale for ultrasound performance and diagnostic integration [9–12].

Implementation Plan

We will coordinate with block leads, secure ultrasound machines from institutional inventory, and train clinical skills teaching assistants (senior students/residents) as near-peer instructors. The pilot will launch in the Respiratory block, dedicating one hour per session to hands-on POCUS teaching. Feedback from students and facilitators will guide evaluation and integration into the team observed structured clinical examination (TOSCE), where students perform targeted scans to answer diagnostic questions. Findings will inform refinement and expansion to Cardiovascular and Abdominal systems. The initiative will leverage existing resources and infrastructure [14,15].

Evaluation Strategy and Scalability

Within the TOSCE, OSAUS will assess diagnostic scanning and interpretation, with success defined as a mean score of ≥3.5/5, a validated competency threshold [9,13]. Pre- and post-session knowledge assessments will measure improvement, while anonymous surveys will evaluate confidence. Curriculum effectiveness will be determined by the proportion of students meeting the competency standard and inter-rater reliability (ICC > 0.8) [13,16]. Findings will guide expansion toward a sustainable, evidence-based framework for POCUS education in undergraduate medicine.

References

1. Steinmetz P, Dobrescu O, Oleskevich S, Lewis J. Bedside ultrasound education in Canadian medical schools: a national survey. Can Med Educ J. 2016;7(1):e78-e86.

2. Ailon J, Mourad O, Nadjafi M, Cavalcanti R. Point-of-care ultrasound as a competency for general internists: a survey of internal medicine training programs in Canada. Can Med Educ J. 2016;7(2):e51-e69.

3. Ma IWY, Steinmetz P, Weerdenburg K, Woo MY, Olszynski P, Heslop CL, Miller S, Sheppard G, Daniels V, Desy J, Valois M, Devine L, Curtis H, Romano MJ, Martel P, Jelic T, Topping C, Thompson D, Power B, Profetto J, Tonseth P. 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

4. Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011;364(8):749-757. doi: 10.1056/NEJMra0909487.

5. Andersen CA, Holden S, Vela J, Rathleff MS, Jensen MB. Point-of-care ultrasound in general practice: a systematic review. Ann Fam Med. 2019;17(1):61-69. doi: 10.1370/afm.2330

6. Arnold MJ, Jonas CE, Carter RE. Point-of-care ultrasonography. Am Fam Physician. 2020;101(5):275–285.

7. Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine. Ann Emerg Med. 2023;82(3):115-155. doi: 10.1016/j.annemergmed.2023.06.005

8. Al Deeb M, Barbic S, Featherstone R, Dankoff J, Barbic D. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843-852. doi: 10.1111/acem.12435

9. Tolsgaard MG, Ringsted C, Dreisler E, Klemmensen A, Loft A, Sorensen JL, Ottesen B, Tabor A. Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology. Ultrasound Obstet Gynecol. 2014;43(4):437-443. doi: 10.1002/uog.13198

10. Todsen T, Tolsgaard MG, Olsen BH, Henriksen BM, Hillingsø JG, Konge L, Jensen ML, Ringsted C. Reliable and valid assessment of point-of-care ultrasonography. Ann Surg. 2015;261(2):309-315. doi: 10.1097/SLA.0000000000000552

11. Todsen T, Melchiors J, Charabi B, Henriksen B, Ringsted C, Konge L, von Buchwald C. Competency-based assessment in surgeon-performed head and neck ultrasonography: a validity study. Laryngoscope. 2018;128(6):1346-1352. doi: 10.1002/lary.26841

12. Gomes SH, Trindade M, Petrisor C, Costa D, Correia-Pinto J, Costa PS, Pêgo JM. Objective structured assessment ultrasound skill scale for hyomental distance competence: psychometric study. BMC Med Educ. 2023;23(1):177. doi: 10.1186/s12909-023-04146-y

13. Höhne E, Recker F, Dietrich CF, Schäfer VS. Assessment methods in medical ultrasound education. Front Med (Lausanne). 2022;9:871957. doi: 10.3389/fmed.2022.871957

14. Winter L, Neubauer R, Weimer J, Dietrich CF, Wittek A, Schiestl L, Marinova M, Schäfer VS, Strizek B, Recker F. Peer teachers as ultrasound instructors? a systematic literature review of peer teaching concepts in undergraduate ultrasound education. BMC Med Educ. 2024;24(1):1369. doi: 10.1186/s12909-024-06345-7

15. hockalingam L, Hammar D, Ortiz-Lopez C, Fleshner M, Keniston A, McBeth L, Baduashvili A. Developing point-of-care ultrasound curricula for internal medicine residency programs: consensus-based recommendations on skills, teaching methods, and evaluation strategies. Ann Intern Med. 2025;178(11):1624-1631. doi: 10.7326/ANNALS-25-02271

16. Schober P, Mascha EJ, Vetter TR. Statistics from A (agreement) to Z (z score): a guide to interpreting common measures of association, agreement, diagnostic accuracy, effect size, heterogeneity, and reliability in medical research. Anesth Analg. 2021;133(6):1633-1641. doi: 10.1213/ANE.0000000000005773