• Charles A Rappaport, Bryan C McConomy, Nicholas R Arnold, Aaron T Vose, Gregory A Schmidt, and Boulos Nassar.
• Division of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA.
• Crit. Care Med. 2019 Dec 1; 47 (12): e948-e952.

ObjectivesTo identify the time at which point of care ultrasound static image recognition and image acquisition skills decay in novice learners.SettingThe University of Iowa Hospitals and Clinics.SubjectsTwenty-four subjects (23 first-year medical students and one first-year physician assistant student).DesignThe subjects completed an initial didactic and hands-on session with immediate testing of learned image acquisition and static image identification skills.InterventionsRetesting occurred at 1, 4, and 8 weeks after the initial training session with no retraining in between. Image acquisition skills were obtained on the same healthy male volunteers, and the students were given no immediate feedback on their performance. The image identification skills were assessed with a 10 question test at each follow-up session.Measurements And Main ResultsFor pleural ultrasound by 4 weeks, there was a significant decline of the ability to identify A-lines (p = 0.0065). For pleural image acquisition, there was no significant decline in the ability to demonstrate lung sliding. Conversely, cardiac image recognition did not significantly decline throughout the study, while the ability to demonstrate cardiac images at 4 weeks (parasternal short axis view) did (p = 0.0008).ConclusionsMotor and cognitive skills decay at different times for pleural and cardiac images. Future ultrasound curricula should retrain skills at a maximum of 8 weeks from initial training. They should focus more on didactic sessions related to image identification for pleural images, and more hands-on image acquisition training for cardiac images, which represents a novel finding.

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