Internal Medicine Residents' Retention of Knowledge and Skills in Bedside Ultrasound

J Grad Med Educ. 2016 Oct;8(4):553-557. doi: 10.4300/JGME-D-15-00383.1.


Background: The long-term retention of knowledge and skills in bedside ultrasound by internal medicine residents after ultrasound training is not well understood.

Objective: We sought to determine whether knowledge and skills acquired from focused training in bedside ultrasound are retained over time, and whether retention is related to independent practice.

Methods: We conducted a prospective observational trial of 101 internal medicine residents at an academic medical center who participated in a bedside ultrasound workshop followed by 12 months of independent practice. Performance was measured on image-based knowledge and skills assessment using direct observation, both before the workshop and 12 months later. Individual usage data were obtained along with a survey on attitudes toward bedside ultrasound.

Results: Participants' mean knowledge assessment score increased from a baseline of 63.7% to 84.5% immediately after training (P < .001). At 12 months, mean knowledge score fell to 73.0%, significantly different from both prior assessments (P < .001). Despite knowledge decline, the mean skills assessment score improved from a baseline of 30.5% to 50.4% at 12 months (P < .001). Residents reporting more ultrasound use (> 25 examinations) had higher scores in baseline knowledge and skills assessments than those with lower usage (< 25 examinations). Change in knowledge and image acquisition skills between assessments was equal in both subgroups.

Conclusions: Residents' knowledge of ultrasound improved after brief training but decayed over time, whereas skills showed marginal improvement over the study, with minimal support. Growth and retention of ultrasound abilities were not impacted by usage rates.

MeSH terms

  • Clinical Competence*
  • Education, Medical, Graduate / methods
  • Female
  • Humans
  • Internal Medicine / education*
  • Internship and Residency / methods*
  • Male
  • Prospective Studies
  • Ultrasonography / methods*
  • Ultrasonography / statistics & numerical data