• Arvind Rajamani, Kavitha Shetty, Jinal Parmar, Stephen Huang, Johnson Ng, Sutrisno Gunawan, Gunawan Gunawan, and SPARTAN Collaborative (Small Projects, Audits and Research Projects – Australia/New Zealand).
• Nepean Clinical School, University of Sydney, Kingswood, NSW, Australia. Electronic address: rrarvind@hotmail.com.
• Chest. 2020 Sep 1; 158 (3): 1079-1089.

BackgroundCompetence in point-of-care ultrasound (PoCUS) is widely recommended by several critical care societies. Despite numerous introductory short courses, very few doctors attain PoCUS competence because of the challenges in establishing longitudinal competence programs.Research QuestionTo evaluate the methodologic quality of the literature on basic PoCUS competence processes in critical care.Study Design And MethodsA systematic review to identify manuscripts meeting predefined inclusion criteria was performed using three medical databases (PubMed, OVID Embase, and Web of Science); using extra references from original articles, review articles, and expert panel guidelines; and by directly contacting authors for further information if required. The objectives, domains, and inclusion and exclusion criteria of the review were determined during discussions between experienced PoCUS educators. Data extraction and analyses were performed independently by three reviewers.ResultsOf the 5,408 abstracts extracted, 42 met the inclusion criteria for longitudinal PoCUS competence. Each study was described along four broad categories: general information, study design, and trainee characteristics; description of introductory course; description of longitudinal competence program; and grading of overall methodologic quality on a 4-point Likert scale. Thirty-nine studies (92.9%) were from a single center. Most studies lacked important details on study methodology such as prior ultrasound experience, pre- and postcourse tests, models for hands-on sessions, ratio of instructors to trainees, competence assessment criteria, number of scans performed by individual trainees, and formative and summative assessments. The studies were rated as follows: poor = 19 (45.2%), average = 15 (35.7%), good = 4 (9.5%), and excellent = 4 (9.5%).InterpretationTher is very little high-quality evidence on PoCUS competence. To help frame policy guidelines to improve PoCUS education, there is a need for well-designed longitudinal studies on PoCUS competence.Trial RegistryPROSPERO database; No.: CRD42018094033; URL: https://www.crd.york.ac.uk/PROSPERO/.Copyright © 2020 American College of Chest Physicians. All rights reserved.

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