Purpose: Point of care ultrasound (POCUS) brings high-quality patient care to thebedside but continues to be an expensive training to implement in a residencyprogram. There are multiple resources available to train providers inultrasound, but they are all associated with significant cost. The AccreditationCouncil for Graduate Medical Education (ACGME) mandates anesthesiology residentsto be competent in diagnostic and therapeutic uses of ultrasound. In this paper,we describe how an academic anesthesiology department implemented a POCUScurriculum for resident training. Methods: An anesthesiologist intensivistdirected program was created to train residents in POCUS. We started by traininga group of seven critical care trained anesthesiologists with the guidance ofcardiologists. These anesthesiologists participated in the training of ouranesthesiology residents. A hybrid curriculum consisting of a simulator as wellas hands-on scanning of patients was created. We recorded the time thatpersonnel spent in the training program as well as the money spent in acquiringequipment. Results: Seven faculty utilized a total of 270 hours of scanning andteaching time to train 48 residents who rotated through the ICU between July2017 and June 2018. Simulation technicians used 48 hours to guide residentsthrough simulation scenarios. The education administrator used 24 hours tocoordinate sessions for residents. The technician and coordinator were bothemployees of the department with no additional cost for their responsibilities.The cost of equipment, including the ultrasound machine and simulator, was$45,000. An additional charge of $3500 was incurred for technician trainingtime. Conclusion: Implementing a robust, sustainable POCUS curriculum requires asignificant investment of time and money. Simulators and e-learning can allowefficiency in resource allocation and control cost in orienting new students toultrasound. Having residents go through the simulator decreased the time thatfaculty would otherwise have spent going over basics with the students whileallowing students to master these skills at their own pace. Advances inultrasound technology have created newer, more affordable machines which candecrease cost considerably. It would serve departments well to consideralternatives and plan for resources when deciding to implement POCUS curriculumfor resident training.
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