Table 3.

Expected milestones according to level of proficiency in point-of-care ultrasonography

Competency	Level I	Level II	Level III
Technical skills/image interpretation	Obtain adequate grayscale images of vascular access, lung, lower urinary tract, bladder, abdomen (for ascites), and kidney	Obtain adequate grayscale and color Doppler images of heart (images such as internal vena cava)	Obtain adequate spectral images of cardiovascular system (heart, vascular access, abdominal veins)
	Distinguish normal/abnormal structures	Locate common abnormalities	Identify rarely encountered findings
	Appropriate guide of internal jugular/femoral dialysis access placement
Practice-based learning and professionalism	Appropriate explanation and consideration when discussing with patients and their families	Identify and improve on gaps in knowledge and skill set	Integrate clinical practice guidelines to create plan for management from POCUS results
	Inform POCUS staff of upcoming scan in timely manner	Sound understanding of when to present POCUS patients based on nephrology literature	Understand and apply appropriate billing compliance and policies
	Encourage feedback from staff for improvement	Report incidental findings to POCUS staff in timely manner while taking responsibility for scans	Integrate findings for publication in medical journal or presentation at a conference
	Handle/store equipment in appropriate fashion

POCUS, point-of-care ultrasound.