Background: Point Of Care Ultra-Sound (POCUS) is an operator dependent modality. POCUS examinations usually include ‘Eyeballing’ the inspected anatomical structure without conducting accurate measurements due to complexity and insufficient time. Automatic real time measuring tools can make accurate measurements fast and simple and dramatically increase examination reliability while saving the operator much time and effort. In this study we aim to assess three automatic tools which are integrated into the Venue™ device by GE: the automatic ejection fraction, velocity time integral, and inferior vena cava tools in comparison to the gold standard—an examination by a POCUS expert. Methods: A separate study was conducted for each of the three automatic tools. In each study, cardiac views were acquired by a POCUS expert. Relevant measurements were taken by both an auto tool and a POCUS expert who was blinded to the auto tool’s measurement. The agreement between the POCUS expert and the auto tool was measured for both the measurements and the image quality using a Cohen’s Kappa test. Results: All three tools have shown good agreement with the POCUS expert for high quality views: auto LVEF (0.498; p < 0.001), auto IVC (0.536; p = 0.009), and the auto VTI (0.655; p = 0.024). Auto VTI has also shown a good agreement for medium quality clips (0.914; p < 0.001). Image quality agreement was significant for the auto EF and auto IVC tools. Conclusions: The Venue™ show a high agreement with a POCUS expert for high quality views. This shows that auto tools can provide reliable real time assistance in performing accurate measurements, but do not reduce the need of a good image acquisition technique.

Purpose Point-of-care ultrasonography (POCUS) is increasingly integrated into medical education. Traditionally taught at the bedside using a hands-on approach, POCUS is limited by cost, time, faculty availability, and access to POCUS resources. With the recent transition to digitalization in medical education, the authors compare lung POCUS performance and pathology identification among medical students to examine whether using an online, self-learning lung POCUS module is noninferior to traditional bedside, faculty-led lung POCUS training. Method This study assessed the performance of 51 medical students from August to October 2021 on an elearning lung POCUS course with traditional bedside training and no training. POCUS students were scored on use of a simulator to identify pathologies, ability to identify lung ultrasonographic pathological clips, and scanning technique. Results The elearning group had a significantly higher median (interquartile range [IQR]) total test score (15/18 [10.5-16] vs 12/18 [9-13]; P = .03) and scanning technique score (5/5 [4-5] vs 4/5 [3-4]; P = .03) compared with the standard curriculum group. The median (IQR) accuracy in the clip segment of the examination was 7.5 of 10 (4-9) in the self-learning group and 6 of 10 (4-7) in the standard curriculum group (P = .18). The median (IQR) grade on the simulator segment of the examination was 2 of 3 (2-3) in the self-learning group and 2 of 3 (1-2) in the standard curriculum group (P = .06). Conclusions This study suggests that self-directed elearning of lung POCUS is at least noninferior to bedside teaching and possibly even a superior method of learning lung POCUS. This teaching method POCUS is feasible for medical students to learn lung ultrasonography and has potential to complement or augment the traditional learning process or eliminate or lessen the requirement for bedside teaching by reaching a larger audience while minimizing costs and human resources.

Background: As point-of-care ultrasound (POCUS) becomes a standard of care procedure, medical schools around the world have started to seek the integration of POCUS courses into their curricula. This puts medical students in a unique position as they are trained in an area in which many physicians lack knowledge. This case series provides a glimpse into the capabilities of POCUS even when used by medical students. Methods: Fourth-year medical students at Ben-Gurion University of the Negev performed numerous POCUS exams during their first clinical rotation at Soroka University Medical Center in Israel. All students completed a course in basic POCUS training and were evaluated in a brief practical exam before entering their first clinical rotation. Four of the cases in which the students took part are presented in this case series. Results: The POCUS exam in the first case discovered pulmonary embolism in addition to the diagnosis of Cushing disease. In the second case, endocarditis could have been diagnosed three days earlier had a POCUS exam been performed. Case 3 demonstrates the additional contribution of POCUS to the decision-making process carried out by physicians and its superiority in quantifying and diagnosing pleural effusion compared to chest X-Ray. Case 4 indicated that POCUS is preferable over chest X-ray and auscultation for the diagnosis of pulmonary edema. Conclusion: This case series may emphasize the capabilities POCUS has when utilized in the standard physical examination and the importance of incorporating POCUS instruction in medical schools for new physicians to acquire this skill.

Background: Home rehabilitation improves patient satisfaction and reduces the need for specialist consultations. Hemodialysis is a costly post-ICU service that requires frequent monitoring. Previous studies have demonstrated the feasibility and accuracy of patients self-scanning their lungs with an ultrasound device within the hospital. Methods: In this single-center, prospective pilot study, we compared the quality of high-risk elderly patient-generated lung ultrasound images against physician-generated images as our primary outcome. The secondary outcome assessed image quality and B-line quantification between a home device and a gold standard device, when operated by the same clinician. Results: We enrolled nine participants (66% male, median age 76 years [IQR 66,79]). Analysis included 402 ultrasound clips (163 patient-generated, 239 physician-generated, and 237 in-clinic gold standard clips). Patient-generated images demonstrated high reliability (92% highly reliable or reliable) and were non-inferior to physician-generated images (p < 0.001). There was substantial agreement in B-line classification (Kw = 0.64, 95% CI: 0.46–0.82). The home device, when operated by the same physician, showed non-inferiority to the gold standard device (p < 0.001) with substantial B-line classification agreement (Kw = 0.64, 95% CI: 0.51–0.78). Conclusions: High-risk elderly patients can successfully generate self-scanned lung ultrasound images comparable to those produced by physicians. These promising results warrant further investigation through larger-scale and long-term studies.

Background The use of Cardiac Point Of Care Ultra-Sound is rapidly growing; so is the demand for quality POCUS teaching. POCUS teaching is usually conducted in small groups requiring much space and equipment. This study attempts to test whether providing students undergoing a POCUS course with access to a cardiac POCUS E-learning platform significantly increases students' image acquisition skills. If student performances improve, this could demonstrate the potential of E-learning technology at improving POCUS teaching without having to add extra hands-on teaching hours, making POCUS teaching cheaper, more efficient, and more accessible for all. Methods Two groups of medical students had undergone the same hands-on Cardiac POCUS course before their internal clerkship. During the clerkship, members of both study groups got to practice their newly acquired cardiac POCUS skills in the internal wards. The group was provided with accounts to a cardiac POCUS teaching E-learning platform (eMedical Academy©). A month and a half into their clerkship, both groups underwent a pre-validated ultrasound examination. The two groups' test results were then compared for each POCUS view and for the total exam score. Results The E-learning group performed significantly better than the course-only group in the six-minute exam total score, and at acquiring the following views: parasternal long axis view, apical four-chamber view, and the inferior vena cava view. Conclusion E-learning platforms can be an efficient tool for improving cardiac POCUS teaching. Using it as a supplement to a hands-on course provides better POCUS skills without the need of extra hands-on teaching.