Point-of-care ultrasound as an integral component of clinical evaluation: A report on training at the Ahamdu Bello University Teaching Hospital Zaria, Nigeria

Abstract

Background: Point-ofcare ultrasound (POCUS) is increasingly recognized as an essential tool in clinical practice, providing real-time, bedside imaging that can enhance diagnostic accuracy and improve patient outcomes. Over the past two decades, POCUS has achieved widespread acceptance in clinical medicine across numerous regions and subspecialties. Its use in neonatology (Neo POCUS) has recently gained momentum, with neonatologists in Europe, America, and Asia participating in training sessions to enhance their knowledge and skills and to advance neonatal care. However, formal POCUS training for neonatologists and/or paediatricians in Nigeria remains limited. 
Objectives: This report aims to describe an eight-week intensive POCUS training held at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria, targeted at paediatricians from four tertiary institutions. The training focused on skills development in lung, abdominal, cardiac, vascular, and cranial scans. Methods: Nineteen POCUS-naïve paediatric healthcare professionals from four tertiary hospitals participated. The training comprised seven weeks of virtual sessions followed by a one-week in-person workshop. The virtual component included weekly didactic lectures, demonstrations, quizzes, and hands-on assignments, with participants uploading scanned images for instructor feedback. The in-person component focused on supervised hands-on practice covering key POCUS applications. We incorporated all the learners into the training hands on part by having the observers be either the drivers of the image  changing or the person pointing out the structures while the third person was the probe movers thus engaging multiple learners during the sessions. Competency was assessed using a standardised checklist evaluating (1) diagnostic image quality acquisition (2) machine handling and (3) identification of ≥ 80% key anatomical landmarks and pathologies. Participants completed pre-and post-training assessing selfreported confidence using a 5- point Likert Scale. Certification was awarded to those who met the defined criteria. 
Results: All participants reported low or no confidence before the training. Post-training, 85% (n=16) reported moderate to high confidence in performing lung and abdominal scans; 40% (n=7) felt similarly for cardiac and cranial scans. Eighteen of 19 participants met the criterion for certification, defined as scoring ≥ 80% on the practical skills assessment checklist. A virtual network was created for image sharing and mentorship, promoting skill retention and continuous learning. 
Conclusion: The training successfully improved participants' subjective confidence and showed measurable skill acquisition through objective competency assessment. To ensure sustainabil sustainability, such programmes should be scaled nationally, integrated into paediatric residency curricula in Nigeria and supported through mentorship, accessibility to user-friendly devices and collaborative networking for ongoing training/refresher training.