Overall Proficiency Assessment in Point-of-Care Ultrasound Interventions: The Stopwatch is not Enough

With the shift in the medical education curriculum to a competencybased model, objective proficiency assessment is necessary. In this work, we use exploratory factor analysis to assess which primitive metrics convey unique information about proficiency in point-of-care ultrasound applications. We retrospectively validate the proposed methods on three datasets: FAST examination, femoral line, and lumbar puncture. We identify a minimal set of metrics for proficiency assessment in each application. Furthermore, we validate that overall proficiency assessment methods are unaffected by the removal of redundant metrics. This work demonstrates that proficiency in point-of-care ultrasound applications is multi-faceted, and that measuring completion time alone is not enough and application-specific metrics have added value in proficiency assessment.