Purpose
Point-of-care ultrasound (POCUS) is increasingly essential in clinical practice, yet integration into undergraduate medical education remains inconsistent due to faculty shortages and curricular limitations. Peer-assisted learning (PAL) offers a scalable solution by training senior students to teach their junior peers. This study evaluated a structured PAL curriculum using fourth-year medical students as ultrasound teaching assistants (TAs) to teach the Focused Assessment with Sonography for Trauma (FAST) exam to second-year students.

Methods
Six TAs underwent an 8-week faculty-led training course covering abdominal ultrasound anatomy and image acquisition. Competency was assessed via written exams, anatomy practicals, and an ultrasound Objective Structured Clinical Examination (OSCE) with standardized patients. After training, TAs led hands-on abdominal focused FAST exam sessions for 171 second-year students. Surveys and assessments were used to evaluate TA performance, confidence, and student perceptions pre- and post-intervention. Another cohort of data is currently being collected.

Results
TAs demonstrated significant improvements in both written (65.0% to 82.8%, p=0.005) and anatomy practicals (51.7% to 81.1%, p=0.012). Self-reported comfort and confidence in teaching ultrasound also increased markedly amongst TAs. Second-year students showed significant gains in ultrasound comfort (2.18 to 3.82, p<0.001), confidence (1.82 to 3.48, p<0.001), and anatomical understanding. Nearly all students agreed that TAs enhanced their learning, and 97% supported broader ultrasound integration in the curriculum.

Conclusion
A structured PAL model using senior medical students as ultrasound TAs is an effective and scalable approach to enhance preclinical education with the integration of POCUS. This model improves technical and anatomical competency as well as teaching confidence in senior students, while boosting learning and engagement among junior learners.