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The Impact of Retraining on Medium-Term (4 Month) Skill Retention Among PGY-1 and -2 Residents in a Cardiac Point-of-Care Ultrasound Curriculum: A Pilot Study
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The Impact of Retraining on Medium-Term (4 Month) Skill Retention Among PGY-1 and -2 Residents in a Cardiac Point-of-Care Ultrasound Curriculum: A Pilot Study

Satoshi Jujo, Daisuke Sugiyama, Akihisa Kataoka, Masaki Izumo, Kenya Kusunose, Jannet J. Lee-Jayaram, Benjamin W. Berg, Yuki Kataoka and Kenichi Ueda
Research Square
07/07/2026
DOI: 10.21203/rs.3.rs-9955451/v1
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Open Access CC BY V4.0

Abstract

Background: Medium- and long-term skill decay following a single cardiac point-of-care ultrasound (POCUS) training session remains an educational challenge. Spaced practice may address this issue. This pilot study investigated whether retraining 2 months after initial training improves medium-term skill retention among residents and which pre-training competency level benefits most from the retraining curriculum. Methods: We enrolled postgraduate year (PGY) -1 and -2 residents at a teaching hospital in a prospective, single-group, pre-post educational intervention study with blinded outcome assessment. Participants completed an initial cardiac POCUS curriculum consisting of 2-hour hands-on training and 10-minute supervised retraining 2 months later. Image acquisition skills of 5 cardiac views were assessed at pre-training, immediately post-training, 2-month post-training, and 4-month post-training using a validated 10-point scoring system rated by three blinded assessors. Participants’ competency levels were classified according to the skill test scores as follows: beginner (<5); intermediate (5 to <8); and advanced (≥8) for post-hoc subgroup analyses. Participants used a hand-held ultrasound (Butterfly iQ). Results: All 26 eligible PGYs participated in the study. Mean skill test scores were 6.03 (intermediate level) at pre-training, 8.69 (advanced level) at immediate post-training, 7.78 (intermediate level) at 2-month post-training, and 8.05 (advanced level) at 4-month post-training. The mean score differences were +2.67 points (95% CI, 1.87 to 3.47) from pre-training to immediate post-training, −0.93 points (95% CI, −1.63 to −0.24) from immediate post-training to 2-month post-training, and +0.20 points (95% CI, −0.59 to 0.99) from 2- to 4-month post-training. The intermediate pre-training competency level subgroup did not achieve an advanced level at 4 months, whereas the beginner subgroup did not. The advanced subgroup maintained an advanced level across all three post-training assessments. Conclusions: The spaced practice with retraining may mitigate skill decline and enhance medium-term skill retention. Participants with intermediate pre-training competency level may benefit the most from this curriculum, whereas those with beginner pre-training competency level may need additional retraining.
Curriculum Development Medical Education cardiac ultrasound point-of-care ultrasound retraining skill retention

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