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Despite decades of use, training often depends on brief workshops or ad hoc mentorship, leaving trainees with inadequate image-acquisition and interpretive competence. This commentary examines educational barriers through clinical cases where misinterpretation created substantial risk. It reviews challenges such as inconsistent curricula, unclear competencies, arbitrary scan-number targets, and limited supervision, notes variable accreditation, and highlights medico-legal concerns. 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A Commentary on WhatAils Point-of-care Ultrasound Education  \nArvind Rajamani1, Anthony McLean2, Kishore Pichamuthu3, Stephen Huang4  \nReceived on: 10 November 2025 ; Accepted on: 10 December 2025; Published on: 19 December 2025  \nAbstrAct  \nPoint‑of‑care ultrasound (PoCUS) has transformed bedside diagnostics in critical care, yet its educational framework remains fragmented. Despite decades of use, training often relies on short workshops or ad hoc mentorship, leaving many trainees with suboptimal image‑acquisition skills and/or interpretive competence. This commentary highlights barriers to effective PoCUS education, illustrated through clinical cases where misinterpretation posed significant risks. We identify systemic challenges including inconsistent curricula, poorly defined competencies, reliance on arbitrary scan numbers, and limited supervision. Accreditation processes remain variable, with guidelines offering aspirational statements but little implementation detail. Medicolegal concerns further underscore the need for structured training. We propose a way forward through longitudinal, competency‑based programs anchored in educational milestones, validated assessment tools, and quality assurance mechanisms. Global collaboration and standardized frameworks are essential to harmonize training and ensure safe practice. Addressing these gaps will strengthen PoCUS education and safeguard patient outcomes.  \nKeywords: Education, Medico legal issues, Point‑of‑care ultrasound.  \nIndian Journal of Critical Care Medicine (2025): 10.5005/jp‑journals‑10071‑25104  \nHigHligHts  \nPoint‑of‑care ultrasound (PoCUS), training remains fragmented and inconsistent despite decades of clinical use. Case examples illustrate risks from novice misinterpretation. Structured, longitudinal, competency‑based curricula, standardized assessment, and global collaboration are urgently needed to strengthen training and safeguard patient outcomes.  \nbAckground  \nPoint‑of‑care ultrasound, also known as emergency ultrasound or clinician‑performed ultrasound, refers to real‑time ultrasonography performed by the treating clinician during a patient encounter to guide diagnosis or procedures.1 Point‑of‑care ultrasound requires mastery of image acquisition, interpretation, and integration with clinical context and pretest probability. Although training began in the 1980s, significant challenges persist, including misdiagnosis risksand inconsistent training standards.2 This commentary outlines key barriers to PoCUS education and competence, illustrated through two clinical cases, and proposes practical solutions. This commentary presents the authors’ personal perspectives on the barriers and challenges that have impeded PoCUS training and competence and potential solutions to overcome them.  \ncAse descriptions Case 1  \nAn intensive care unit (ICU) trainee assessed a patient with chronic severe left ventricular (LV) dysfunction [left ventricular ejection fraction (LVEF) ~20%] presenting with acute hypoxemia, tachypnea, pink frothy sputum, and bilateral crepitations. She diagnosed cardiogenic pulmonary edema–supported by chest X‑ray findings– and initiated furosemide and continuous positive airway pressure (CPAP) . After 30 minutes, she found “severe right ventricular  \n1Department of Intensive Care Medicine, Nepean Hospital, Kingswood, New South Wales, Australia  \n2,4 Division of Critical Care Medicine, Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia  \n3Medical Intensive Care Unit, Christian Medical College, Vellore, Tamil Nadu, India  \nCorresponding Author: Arvind Rajamani, Department of Intensive Care Medicine, Nepean Hospital, Kingswood, New South Wales, Australia, Phone: +61247342000, e‑mail: [rrarvind@hotmail.com](rrarvind@hotmail.com)[ ](rrarvind@hotmail.com)[How to cite this article:](How to cite this article: Rajamani A)[ Rajamani A](How to cite this article: Rajamani A), [M","cbCaiiSns7Smufz9","https://ap.wps.com/l/cbCaiiSns7Smufz9","pdf",259203,"English","# Abstract\n# Highlights\n# Background\n# Case descriptions\n## Case 1\n## Case 2\n# Discussion","[{\"question\":\"What educational gaps in PoCUS training does the commentary emphasize?\",\"answer\":\"It highlights fragmented and inconsistent education, reliance on short workshops or informal mentorship, and insufficient competence in image acquisition and interpretation. It also notes unclear competencies and limited supervision.\"},{\"question\":\"How do the clinical cases illustrate the risks of PoCUS misinterpretation?\",\"answer\":\"Case 1 shows incorrect interpretation leading toward unnecessary fibrinolysis until the supervisor corrected foreshortening on the image. Case 2 shows an echocardiogram suggesting cardiogenic shock, while a formal study later identified missed tamponade.\"},{\"question\":\"What solution does the commentary propose for improving PoCUS education?\",\"answer\":\"It recommends longitudinal, competency-based training anchored to educational milestones, using validated assessment tools and quality assurance mechanisms. It further calls for global collaboration and standardized frameworks to harmonize training and support safe practice.\"}]","Point-of-care, Point-of-concern - A Commentary on What Ails Point-of-care Ultrasound Education | PDF",1790729311]