Toward a sustainable model for novice ultrasound training: mixed-methods analysis of student portfolios and objective outcomes in Korean Medicine.

Ultrasound imaging has exerted a profound and sustained impact across modern medicine, with its clinical applications continually expanding into diverse specialties. As ultrasound provides real-time imaging without radiation exposure, it is not only inherently safe but has also become an indispensable tool for diagnosis and procedural guidance—particularly in point-of-care ultrasound (POCUS) settings where it can address specific clinical questions instantaneously [, ]. Accordingly, proficiency in ultrasound is now regarded as essential clinical competency in various fields, including emergency medicine, internal, and family medicine, general surgery, and anesthesiology. Furthermore, the potential role of POCUS in improving the accessibility of diagnostic imaging in resource-limited environments has been increasingly emphasized []. From an educational perspective, ultrasound serves as more than just a diagnostic instrument; it is an effective tool that facilitates the understanding of anatomical and physiological structures, physical examination, and procedural skills acquisition. In recent decades, ultrasound has been increasingly integrated into medical school curricula worldwide [, ]. Specifically, it is valued for strengthening the link between basic anatomical knowledge and clinical application, as it allows students to apply their understanding of gross and cross-sectional anatomy in real time. However, ultrasound training requires hands-on practice with equipment before students can perform image acquisition, and its implementation often faces barriers such as the high cost of equipment and limited faculty resources []. Specifically, little is known about how students experience and evaluate the introductory phase of ultrasound training in non-traditional settings, such as Korean Medicine (KM) education. In South Korea, following a Supreme Court ruling in December 2022 supporting the use of diagnostic ultrasound by Korean Medicine doctors, there has been a surge in demand for ultrasound education among both graduates and undergraduates []. In clinical practice, where musculoskeletal disorders constitute a substantial proportion of traditional medicine care, ultrasound imaging has emerged as a key modality for enhancing the anatomical accuracy and safety of acupuncture and interventional procedures []. As legal authorization and clinical necessity align, systematic and structured ultrasound education has become increasingly important [].