Point-of-Care Ultrasound (PoCUS) Teleeducation Curriculum for Hospital-at-home Care
NCT ID: NCT07182162
Last Updated: 2025-12-17
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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NOT_YET_RECRUITING
NA
100 participants
INTERVENTIONAL
2026-04-01
2027-12-31
Brief Summary
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This two-year study will create a PoCUS curriculum and outcome-assessment tools tailored to HAH, adapting previously validated Entrustable Professional Activities (EPA) instruments to three HAH scenarios: pneumonia, urinary tract infection, and soft-tissue infection. Year 1 will develop scenario-based simulation courses and matching EPA tools, and train peer instructors who receive full PoCUS instruction for the three scenarios. Year 2 will randomly assign learners to compare two teaching models-peer training with remote supervision and scenario simulation versus traditional PoCUS training-evaluated with an Objective Structured Clinical Examination (OSCE) scored by EPA forms across multiple domains.
The project aims to establish normative standards for PoCUS training and assessment in HAH, confirm the feasibility of peer training with remote supervision, and provide a platform to train HAH medical teams nationwide, including those in rural areas.
Detailed Description
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PoCUS has evolved from hospital-based imaging to bedside diagnostic support, enabling rapid, problem-oriented assessments across trauma, shock, dyspnea, and resuscitation scenarios as portable devices matured in image quality and accessibility.
Recent medical education trends emphasize competency-based medical education (CBME), milestones, and EPAs, requiring structured assessment of indications, image acquisition, interpretation, and integration into management for skill-intensive technologies such as ultrasound.
Near-peer training can scale instruction without loss of effectiveness compared with faculty-led teaching, while remote supervision and simulation address logistical limits. However, online environments can attenuate nonverbal cues, underscoring the need for purposeful instructional design and validated evaluation tools.
Taiwan's National Health Insurance (NHI) launched a HAH pilot program in July 2024 focusing on acute infections-pneumonia, urinary tract infection (UTI), and soft tissue infection-where portable diagnostics and PoCUS can substitute or complement in-hospital imaging for timely home-based decisions.
Clinicians transitioning from hospital workflows to patients' homes and care facilities face new operational constraints, motivating scenario-based, high-fidelity simulation to rehearse dynamic conditions and multi-skill tasks that mirror real HAH care.
Objectives
The study aims to compare the effectiveness of a PoCUS curriculum using near-peer training with remote supervision and high-fidelity scenario simulation versus traditional on-site, in-person PoCUS teaching in the HAH context.
The study also aims to determine whether remote OSCE combined with EPA assessments are consistent with in-person evaluations and feasible for high-stakes skill appraisal. EPA-based assessment levels across four domains-Indication, Acquisition, Interpretation, and Integration-are anchored to OSCE cases aligned with HAH pneumonia, urinary tract infection, and soft tissue infection scenarios.
Methods
This is a two-year, prospective, randomized educational intervention study.
* Year 1: Development of HAH-focused scenario-based curricula; design of OSCE and EPA tools through expert consensus; and training of near-peer instructors who undergo rehearsal teaching with faculty observation and immediate feedback to qualify for Year 2 delivery roles.
* Year 2: Randomization of Post-Graduate Year (PGY) residents to receive either traditional PoCUS instruction (didactics plus on-site faculty-supervised hands-on training) or the new model (didactics plus near-peer hands-on training with remote supervision and scenario simulation). Outcomes will be measured by OSCE performance scored using EPA instruments.
Participants
The target population comprises PGY residents, internal medicine residents, and family medicine residents at National Taiwan University Hospital who volunteer to enroll, with a planned Year 2 sample size of approximately 100 participants.
Inclusion criteria are the above-mentioned residency trainees aged 20 years or older. Exclusion criteria include unwillingness to participate.
Outcomes
* Primary outcomes: Learning outcomes between traditional and near-peer training with remote supervision and simulation. Learning outcomes include self-assessment questionnaires and EPA-based OSCE scores.
* Secondary outcomes:
1. Technology Acceptance Model (TAM) survey: Learners' feedback on the new curriculum, collected after the PoCUS course and before OSCE testing.
2. OSCE survey: A post-OSCE survey on learner feedback regarding the examination itself.
3. Inter-rater variability: Agreement between remote and in-person EPA-based OSCE ratings to establish feasibility and equivalence of the remote assessment tool.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
DOUBLE
Study Groups
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Remote supervision + Simulation
This group will experience didactics plus near-peer hands-on with remote supervision and scenario simulation (lecture + on-site near-peer instructor hands-on + simulation). The PoCUS teacher will not be physically present but will supervise remotely via video conferencing to monitor and communicate in real-time.
Remote supervision + simulation
teacher use remote supervision to assist peer training Hospital-at-Home scenario simulation
Control
This group will follow the conventional teaching model, didactics plus on-site faculty-supervised hands-on (lecture + on-site teacher supervised hands-on).
No interventions assigned to this group
Interventions
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Remote supervision + simulation
teacher use remote supervision to assist peer training Hospital-at-Home scenario simulation
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
20 Years
ALL
Yes
Sponsors
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National Science and Technology Council
FED
National Taiwan University Hospital
OTHER
Responsible Party
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National Taiwan University Clinical Trial Center
Attending physician, National Taiwan University Hospital
Locations
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National Taiwan University Hospital
Taipei, , Taiwan
Countries
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Central Contacts
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National Taiwan University Hospital Research Ethics Committee
Role: CONTACT
Facility Contacts
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Other Identifiers
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202501195RINB
Identifier Type: -
Identifier Source: org_study_id