Training Medical Residents in the Use of the Venous Excess UltraSound (VExUS) Score for Bedside Volume Assessment.

This randomized controlled trial evaluates the effectiveness of two training approaches (in-person versus remote) for teaching medical residents to apply the Venous Excess Ultrasound (VExUS) score for bedside volume assessment in patients with acute heart failure. Resident performance will be compared to that of expert physicians certified in abdominal and duplex sonography.

Accurate assessment of volume status is essential in managing acute heart failure but remains challenging in clinical practice. The VExUS score is a validated ultrasound-based tool integrating inferior vena cava diameter and Doppler assessment of hepatic, portal, and intrarenal veins. This single-center randomized controlled trial compares two training modalities (in-person vs. remote) in medical residents with basic ultrasound skills. Participants will be randomized 1:1 to either training method and compared to a control group of expert physicians. Primary outcomes include ultrasound image quality assessed using a standardized 100-point score. Secondary outcomes include time to acquisition, VExUS scoring accuracy, self-confidence, and acceptability of training methods.

Inclusion Criteria: * Medical residents in general internal medicine * Basic ultrasound skills (POCUS component 1 or ≥200 scans) * Working at study site during study period Exclusion Criteria: * SGUM certification in abdominal ultrasound * Advanced duplex ultrasound experience * Prior vascular/duplex training