Hands-On Ultrasound Training for Radiology Residents: The Impact of an Ultrasound Scanning Curriculum

Published:March 12, 2023DOI:

      Rationale and Objectives

      Radiologists are responsible for interpreting ultrasound (US) images accurately, troubleshooting, aiding sonographers, and advancing technology and research. Despite this, most radiology residents do not feel confident performing US independently. The purpose of this study is to evaluate the impact of an abdominal US scanning rotation and digital curriculum on radiology residents’ confidence and skills in performing US.

      Materials and Methods

      All residents who were rotating in pediatric US at our institution for the first time were included (PGY 3–5). Those who agreed to participate were recruited sequentially from July 2018 to 2021 into (A) control and (B) intervention. B had a 1-week US scanning rotation and US digital course. Both groups completed a pre-and post-confidence self-assessment. Pre-and post-skills were objectively assessed by an expert technologist while participants scanned a volunteer. At completion, B completed an evaluation of the tutorial. Descriptive statistics summarized the demographics and closed questions. Pre-and post-test results were compared using paired-T tests, and effect size (ES) with Cohen's d. Open-ended questions were thematically analyzed.


      PGY-3 and 4 residents participated, and were enrolled in A (N = 39) and B (N = 30). Scanning confidence significantly improved in both groups, with a greater ES in B (p < 0.01). Scanning skills significantly improved in B (p < 0.01) but not A. Eighty per cent of questionnaire responders used the integrative US tutorial and found it helpful. Free text responses were grouped into themes: 1) Technical issues, 2) Didn't complete course, 3) Didn't understand project, 4) Course was detailed and thorough.


      Our scanning curriculum improved residents’ confidence and skills in pediatric US and may encourage consistency in training, thus promoting stewardship of high-quality US.

      Key Words


      US (Ultrasound), POCUS (Point of care ultrasound), ACGME (Accreditation Council for Graduate Medical Education), PGY (Postgraduate year), TRV (Transverse), SAG (Sagittal)
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        • Horrow MM
        Is there a future for real-time ultrasound scanning by radiologists?.
        J Am Coll Radiol. 2005; 2: 110-113
        • Chung CY
        • Alson MD
        • Duszak R
        • et al.
        From imaging to reimbursement: what the pediatric radiologist needs to know about health care payers, documentation, coding and billing.
        Pediatr Radiol. 2018; 48: 904-914
        • Tahir B
        • Peterson DM
        • Heitkamp DE
        • et al.
        Taking resident feedback seriously: a hands-on ultrasound course.
        Acad Radiol. 2016; 23: 1610-1613
        • Suarez-Weiss KE
        • Yang H
        • Beland MD
        Reclaiming hands-on ultrasound for radiology with a simulation-based ultrasound curriculum for radiology residents.
        Ultrasound Q. 2020; 36: 268-274
        • Yu TT
        • Wnorowski AM
        • Lane BF
        • et al.
        Performing a basic US examination: road map for radiology residents.
        Radiographics. 2019; 39: 1075-1076
        • Anstey JE
        • Jensen TP
        • Afshar N
        Point-of-care ultrasound needs assessment, curriculum design, and curriculum assessment in a large academic internal medicine residency program.
        South Med J. 2018; 111: 444-448
        • Freitas ML
        • Frangos SG
        • Frankel HL
        The status of ultrasonography training and use in general surgery residency programs.
        J Am Coll Surg. 2006; 202: 453-458
        • Abuhamad A
        • Minton KK
        • Benson CB
        • et al.
        Obstetric and gynecologic ultrasound curriculum and competency assessment in residency training programs: consensus report.
        Am J Obstet Gynecol. 2018; 218: 29-67
        • Stolz LA
        • Stolz U
        • Fields JM
        • et al.
        Emergency medicine resident assessment of the emergency ultrasound milestones and current training recommendations.
        Acad Emerg Med. 2017; 24: 353-361
        • Mansoori B
        • Golnari P
        • Sharifi A
        • et al.
        Ultrasound training in radiology residency programs: a national survey.
        J Ultrasound Med. 2021; 40: 731-740
        • Bailey JE
        • Ladner J
        • Balfe D
        • et al.
        ACGME program requirements for graduate medical education in diagnostic radiology.
        Radiology Program Requirements. 2021 (Accessed 2 Dec 2021)
        • Back SJ
        • Gurian MS
        • Reid JR
        • et al.
        How and how well do pediatric radiology fellows learn ultrasound skills? A national survey.
        Pediatr Radiol. 2014; 44: 1058-1064
        • Uetake C
        • Nakamoto A
        • Suda T
        • et al.
        Abdominal ultrasound examinationtraining using an ultrasound phantom and volume navigation system.
        J Med Ultrason. 2016; 43: 381-386
        • Dinh VA
        • Dukes WS
        • Prigge J
        • et al.
        Ultrasound integration in undergraduate medical education: comparison of ultrasound proficiency between trained and untrained medical students.
        J Ultrasound Med. 2015; 34: 1819-1824
        • García de Casasola Sánchez G
        • Torres Macho J
        • Casas Rojo JM
        • et al.
        Abdominal ultrasound and medical education.
        Rev Clin Esp (Barc). 2014; 214: 131-136
        • Back SJ
        • Darge K
        • Bedoya MA
        • et al.
        Ultrasound tutorials in under 10 minutes: experience and results.
        AJR Am J Roentgenol. 2016; 207: 653-660
      1. RSNA Education :: Catalog. Accessed 22 Mar 2022

      2. Ultrasonography training, ultrasound simulator, ultrasound education | SonoSim. Accessed 22 Mar 2022

        • Saul D
        What it means “to teach” as a radiologist in the modern era: a personal perspective.
        Pediatr Radiol. 2018; 48: 1381-1387
        • Ricotta DN
        • Richards JB
        • Atkins KM
        • et al.
        Self-directed learning in medical education: training for a lifetime of discovery.
        Teach Learn Med. 2021; 34: 1-11