Point-of-Care Ultrasound (PoCUS) Teleeducation Curriculum for Hospital-at-home Care

NCT ID: NCT07182162

Last Updated: 2025-12-17

Study Results

Results pending

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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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-04-01

Study Completion Date

2027-12-31

Brief Summary

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Since July 2024, the National Health Insurance Administration (NHIA) has been implementing a pilot Hospital-at-Home (HAH) Acute Care Program to curb hospital admissions. Point-of-Care Ultrasound (PoCUS) is considered the most promising imaging tool for this model. Replicating the hospital's familiar environment-its staffing patterns, diagnostic workflows, and medication protocols-in a patient's home or nursing facility is almost impossible, posing a major challenge to care teams. Medical-simulation training offers a solution, yet current PoCUS courses remain organ-based and lack scenario-based simulations that prepare physicians for HAH practice.

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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Background

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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Educational Problems

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Participants Outcome Assessors

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.

Group Type EXPERIMENTAL

Remote supervision + simulation

Intervention Type OTHER

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).

Group Type NO_INTERVENTION

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

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

â–  PGY, internal medicine, and family medicine residents at National Taiwan University Hospital.

Exclusion Criteria

â– Unwillingness to participate in the study.
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Science and Technology Council

FED

Sponsor Role collaborator

National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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National Taiwan University Clinical Trial Center

Attending physician, National Taiwan University Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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National Taiwan University Hospital

Taipei, , Taiwan

Site Status

Countries

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Taiwan

Central Contacts

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National Taiwan University Hospital Research Ethics Committee

Role: CONTACT

+886-2-23123456 ext. 263506

Nin-Chieh Hsu, MD, PhD

Role: CONTACT

+886-972653088

Facility Contacts

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Nin-Chieh Hsu, MD, PhD

Role: primary

+886-2-23123456 ext. 65130

Yu-Feng Lin, MD

Role: backup

+886-972653086

Other Identifiers

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202501195RINB

Identifier Type: -

Identifier Source: org_study_id