Sound Decisions: Advancing Emergency Ultrasound in Nablus

This study aims to evaluate the impact of a longitudinal hybrid training program at Rafidia Surgical Hospital in Nablus, a major referral center for the northern West Bank. A hybrid (online and in-person) course was conducted for residents in emergency medicine, anesthesiology, and general surgery. Trainee confidence and clinical integration were assessed via 5-point Likert scale surveys (1=Strongly Agree to 5=Strongly Disagree) before and after the course. Foundational knowledge and image recognition were measured using pre- and post-course tests. The differences were analyzed using the Wilcoxon ranked sum test and paired t-tests, respectively. Participants showed statistically significant improvements across all domains. Mean knowledge scores rose from 41% to 57% (V=171, p <0.001). Trainee confidence for basic ultrasound principles (Q4) improved from 4.00 to 2.47 (|Δ|= 1.53 (95% CI 0.76- 2.3, p <0.001), while confidence in using ultrasound for diagnosis (Q5) improved from 3.70 to 2.59 (|Δ| = 1.11, 95% CI 0.37 - 1.88, p =0.006). There was also a significant shift in intent to incorporate POCUS into clinical practice (Q6), with mean scores improving from 3.70 to 2.76 (|Δ|= 0.94, 95% CI 0.23 - 1.65, p =0.009). Implementing a structured, longitudinal hybrid POCUS model is an effective and sustainable approach to improving clinical knowledge and learner confidence in resource-limited environments. Despite challenges such as cognitive fatigue from clinical duties, these findings support this hybrid format of POCUS training to enhance emergency care systems.