Training Nonexpert Users in Cardiopulmonary Point-of-Care Ultrasound Using a Virtual Curriculum and a Teleconsultation Model: A Multicentre Study.

Background: Disparities in access to postgraduate cardiopulmonary point-of-care ultrasound (POCUS) training have limited uptake by nonspecialists in remote care centres. This multicentre pre-post study evaluated the skill improvement of learners after they participated in a longitudinal and virtual POCUS training program. Methods: Nonexpert POCUS users were recruited at urban teaching hospitals and geographically remote hospitals/nursing stations across 4 Canadian provinces. The 3-week educational program consisted of e-learning, independent imaging practice, and point-of-care tele-ultrasound (tele-POCUS) consultations with experts during clinical encounters. Standardized assessments were used to evaluate skill improvement in image acquisition, image quality, and image interpretation for cardiac and lung/pleura POCUS (as measured on a 5-point Likert scale) after program completion and receipt of remotely delivered guidance via tele-POCUS. Results: Among 29 learners, 17 (41% female) completed the training program, of whom 7 practiced in remote hospitals/nursing stations. For cardiac POCUS, pre- and post-training assessments revealed improvements in image acquisition (mean scores: 3.02 to 4.48, P < 0.01), quality (2.49 to 4.06, P < 0.01), and interpretation (3.03 to 4.44, P < 0.01). Improvements in image acquisition (3.27 to 4.63, P < 0.01), quality (3.25 to 4.53, P < 0.01), and interpretation (3.35 to 4.65, P < 0.01) also occurred for lung/pleura POCUS. A total of 153 tele-POCUS consultations (77 cardiac and 76 lung/pleura) were performed. Image acquisition improved after remote guidance was provided to learners using tele-POCUS (all P < 0.01). Results were similar in analyses stratified by geographic setting. Conclusions: Cardiopulmonary POCUS can be taught successfully to learners in diverse geographic settings using a virtual training format and tele-POCUS.