POCUS for the People: A Rounds-Integrated Point-of-Care Ultrasound Curriculum for Medical Students at a Guatemalan Public Hospital.

Abstract

Internal medicine (IM) education in resource-limited hospitals is constrained by heavy workloads and imaging limited to plain radiography. Point-of-care ultrasound (POCUS) supports experiential learning and diagnostic reasoning, yet no rounds-integrated IM curricula have been described in Latin America, and most programs stop short of practice-based bedside assessment. To implement and evaluate a rounds-integrated POCUS curriculum in a resource-limited IM setting. Hospital Nacional de Coatepeque (228-bed Guatemalan public hospital). Eight final-year medical students without formal ultrasound training. The curriculum combined flipped-classroom prework, a 2-day course focused on pleural and abdominal fluid detection, and a 2-month longitudinal program embedding POCUS into daily rounds, with Butterfly Cloud portfolio review, WhatsApp-based feedback, and designation of three learners as local "champions" in a train-the-trainer model. Knowledge and confidence gains largely persisted at 2 months. Hands-on performance was strongest for pelvic/bladder view acquisition, artifact recognition, and image optimization, and lowest for spine sign recognition and probe orientation and manipulation. Barriers included probe scarcity and limited institutional support; champions emerged as key drivers of peer learning. Rounds-integrated POCUS training is feasible in resource-limited settings and may support early skill development when paired with longitudinal mentorship and local champion development.