A novel 6-month POCUS curriculum was designed and implemented for 17 first-year EM residents (no prior formal POCUS training) at Muhimbili National Hospital in Tanzania, including digital didactics, hands-on sessions, independent scanning with cloud-based longitudinal image review, and QA training for 5 local faculty — evaluated via pre/post knowledge tests, OSCE scores, scan quality, accuracy, and inter-rater agreement.
Knowledge assessment scores rose 38.9 points (95% CI: 32.9–54.0) and OSCE scores rose 40.7 points (95% CI: 35.6–45.8). Across 4,557 reviewed studies, image quality improved by 0.12 on the ACEP 5-point scale (95% CI: 0.06–0.18) and accuracy by 3.3% (95% CI: 1.3–5.3). Local faculty agreed with fellowship-trained external faculty on study accuracy with a kappa of 0.83, but only fair agreement on overall image score (kappa 0.30).
- Single-site study at one Tanzanian EM residency limits generalizability. - No post-curriculum QA for clinical scans, so long-term skill retention and real-world scanning volume were not assessed. - Some scans were performed on patients without suspected pathology or on healthy volunteers, potentially skewing abnormal-findings data.
A structured POCUS curriculum combining asynchronous digital didactics, brief intensive hands-on training, and cloud-based longitudinal image review can produce large, measurable gains in EM resident competency in a low-resource African setting. Training local faculty in QA image review is feasible and critical for program sustainability without reliance on visiting external experts.
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