Point-of-care ultrasound education in nephrology during the COVID-19 pandemic

Background: The COVID-19 pandemic led to changes in the way people taught and learned, with higher reliance on online learning. Unfortunately, point of care ultrasound is a difficult topic to teach without hands-on practice. Here we discuss the implementation of a novel ultrasound curriculum during the COVID-19 pandemic. Methods: The curriculum was based on published curriculum on point of care ultrasound for the nephrologist, with focus on four fundamental exams: kidney, lung, cardiac, and volume status. We employed a flip the classroom approach with pre-reading and videos, a pre-session quiz, followed by hands on application of skills. Standardized patients or volunteers would have been used for the hands-on session, but this was eschewed for safety concerns. The fellows and instructors themselves modeled, with proper sanitation and PPE. The hands-on sessions were well received and attended by all fellows. The skills were then applied on the wards. Results: As the restrictions lifted and vaccines were available, standardized patients were available in small groups. The learners were scheduled for two hour-long sessions with standardized patients, for practice of the skills acquired as well as the Objective structured clinical examination (OSCE). After the first session with all learners, we added a third session focused on OSCEs, as well as line placement as requested by the learners. By the end of the third session, all learners felt more confident in their skills and had passed their OSCEs. Conclusions: Given the positive reception, this course is planned to continue as currently structured as well as expanded upon by rising fellows. The use of flipped classroom helped maximize the time of supervised scanning by learners. The use of ultrasound by fellows has risen and will continue to climb with further development of this important curriculum.