An alternate focus of POCUS in medical education: how anatomy knowledge is essential for ultrasound skills, rather than how ultrasound can improve anatomy learning

Anatomy is a foundational science in medical education and anatomical knowledge is central to the practice of medicine. However, there is concern about declining curricula time devoted to anatomy and reduced perceived importance of cadaveric anatomy by many university administrations. The importance of anatomy education and research is evident during the current COVID-19 pandemic and should be emphasized. Medical diagnostic imaging is crucial in the diagnosis and ongoing assessment of affected patients; therefore, anatomy expertise is paramount. Point-of-care ultrasound (POCUS) is effective not only in triage of critically ill and infectious patients in emergency departments, but also in rural and remote medicine. Accurate ultrasound image acquisition and interpretation relies on sound anatomical knowledge, particularly surface anatomy and anatomical relations between structures. Incorporating ultrasound into medical curricula provides an opportunity for multimodal, active, experiential learning in a clinical context, increasing students' engagement and motivation. However, although ultrasound is promoted to enhance anatomy learning, there is limited evidence of this. It is proposed here that the focus of POCUS in medical education is reversed, to instead highlight the importance of anatomical education as a prerequisite for ultrasound skills. Using ultrasound as formative assessment and clinical application of anatomical knowledge is pedagogically sound, but importantly, is also a way to promote and preserve anatomy. Emphasizing that anatomy expertise underpins ultrasound (and other imaging) competence, physical examination, and therefore medical care can help to re-establish the central importance of anatomy education and research in medical education and for optimal medical practice around the world.