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Everad F, Seifert L, Mansour N, Hofauer B, Knopf A, Offergeld C. [Virtual training of practical competences in sonography]. HNO 2024; 72:350-356. [PMID: 38587663 PMCID: PMC11045615 DOI: 10.1007/s00106-024-01476-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE During the COVID-19 pandemic, a particular challenge in the transition to digital teaching was to teach practical skills such as sonography of the head and neck online. The aim of this study was to validate the digital sonography course for medical students established at the Freiburg University Hospital ENT Department. METHODS Participants were 178 students of human medicine. The study group simulated the sonography examination at home with a dummy transducer using the Peyton method under the guidance of a tutor via video seminar. In a subsequent learning success check, the results of the students in the online course were compared with those of the control group, who learned sonography in the classroom. RESULTS Students of the online course achieved comparable results to the classroom group. CONCLUSION This study shows that practical skills which require extensive equipment such as a sonography machine can be taught to a certain extent digitally or at least in a hybrid form.
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Affiliation(s)
- F Everad
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland.
| | - L Seifert
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - N Mansour
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - B Hofauer
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde Innsbruck, Innsbruck, Österreich
| | - A Knopf
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - C Offergeld
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
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Hari R, Kälin K, Birrenbach T, Tal K, Roumet M, Limacher A, Huwendiek S, Serra A, Walter R. Near-peer compared to faculty teaching of abdominal ultrasound for medical students - A randomized-controlled trial. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2024; 45:77-83. [PMID: 37257839 DOI: 10.1055/a-2103-4787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Medical schools increasingly rely on near-peer tutors for ultrasound teaching. We set out to compare the efficacy of a blended near-peer ultrasound teaching program to that of a faculty course in a randomized controlled trial. METHODS 152 medical students received 21 hours of ultrasound teaching either by near-peer teachers or medical doctors. The near-peer course consisted of blended learning that included spaced repetition. The faculty-led course was the European common course for abdominal sonography. The primary outcome measurement was the students' ultrasound knowledge at month 6, assessed by structured examination (score 0 to 50). Secondary outcomes included scores at month 0 and changes in scores after the course. RESULTS Students in the near-peer group scored 37 points, and students in the faculty group scored 31 points six months after course completion. The difference of 5.99 points (95% CI 4.48;7.49) in favor of the near-peer group was significant (p<0.001). Scores immediately after the course were 3.8 points higher in the near-peer group (2.35; 5.25, p<0.001). Ultrasound skills decreased significantly in the six months after course completion in the faculty group (-2.41 points, [-3.39; -1.42], p<0.001]) but barely decreased in the near-peer group (-0.22 points, [-1.19; 0.75, p=0.66]). CONCLUSION The near-peer course that combined blended learning and spaced repetition outperformed standard faculty teaching in basic ultrasound education. This study encourages medical schools to use peer teaching combined with e-learning and spaced repetition as an effective means to meet the increasing demand for ultrasound training.
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Affiliation(s)
- Roman Hari
- Faculty of Medicine, University of Bern Institute of Primary Health Care, Bern, Switzerland
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University School of Health Professions Education, Maastricht, Netherlands
| | - Kaspar Kälin
- Faculty of Medicine, University of Bern Institute of Primary Health Care, Bern, Switzerland
| | - Tanja Birrenbach
- Emergency Departement, Inselspital University Hospital Bern, Bern, Switzerland
| | - Kali Tal
- Faculty of Medicine, University of Bern Institute of Primary Health Care, Bern, Switzerland
| | - Marie Roumet
- Clinical Trials Unit (CTU), University of Bern, Bern, Switzerland
| | - Andreas Limacher
- Clinical Trials Unit (CTU), University of Bern, Bern, Switzerland
| | - Sören Huwendiek
- Institute for medical education, University of Bern Faculty of Medicine, Bern, Switzerland
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University School of Health Professions Education, Maastricht, Netherlands
| | - Andreas Serra
- Internal Medicine and Nephrology, Hirslanden Klinik Hirslanden, Zurich, Switzerland
| | - Robin Walter
- Faculty of Medicine, University of Bern Institute of Primary Health Care, Bern, Switzerland
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Bintaro S, Dietrich CF, Potthoff A. Principles for teaching sonography - current status. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:1628-1634. [PMID: 37142236 DOI: 10.1055/a-2059-4425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Since many young medical residents require sonographic skills early on during training, increased attention has been paid to including sonography classes in undergraduate medical education, among both professional societies and medical educators responsible for medical licensing exams. Medical schools worldwide have developed and implemented a variety of ultrasound teaching formats.This article addresses evidence-based solutions to crucial challenges in planning and implementing undergraduate sonography education. In order to achieve a sustainable increase in practical sonographic competence, we suggest small-group classes with sufficient individual hands-on scanning time for each student. We recommend concentrating on a circumscribed topic and teaching it thoroughly and practically rather than superficially outlining a broad subject area. Provided that peer teachers undergo adequate training, student peer teachers are not inferior to physicians as teachers, as far as student satisfaction, theoretical knowledge and practical skills acquisition are concerned. The assessment of acquired practical skills should consist of practical examinations, such as an objective structured clinical examination (OSCE) or a direct observation of procedural skills (DOPS). In contrast to using healthy volunteers as training models, simulation trainers allow the demonstration of pathological findings in authentic sonographic images, with the disadvantages of unrealistically easy image acquisition, as well as the lack of interaction with the patient.
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Affiliation(s)
- Sabine Bintaro
- Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Christoph F Dietrich
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Andrej Potthoff
- Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany
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Matschl J, Gembruch U, Strizek B, Recker F. Shaping the future of obstetric/gynecological ultrasound training. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023. [PMID: 38031232 DOI: 10.1002/uog.27554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023]
Affiliation(s)
- J Matschl
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - B Strizek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - F Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
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Zhao RT, Deng J, Ghanem G, Steiger A, Tang L, Haase D, Sadeghinejad SE, Shibata J, Chiem AT. Using tele-ultrasound to teach medical students: A randomised control equivalence study. Australas J Ultrasound Med 2023; 26:91-99. [PMID: 37252618 PMCID: PMC10225007 DOI: 10.1002/ajum.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Objectives Undergraduate ultrasound education is becoming increasingly important, but its expansion is limited by time, space and the availability of trained faculty. In order to validate an alternative and more accessible teaching model, our aim was to assess whether combining teleguidance and peer-assisted learning to teach ultrasound is as effective as traditional in-person methods. Methods Peer instructors taught 47 second-year medical students ocular ultrasound via either teleguidance or traditional in-person methods. Proficiency was assessed using a multiple-choice knowledge test and objective structured clinical examination (OSCE). Confidence, overall experience, and experience with a peer instructor were measured using a 5-point Likert scale. Two one-sided t-tests were used to measure equivalency between the two groups. The null hypothesis that the two groups were not different was rejected when P < 0.05. Results The teleguidance group performed as well as the traditional in-person group in terms of knowledge change, confidence change, OSCE time and OSCE score (p = 0.011, p = 0.006, p = 0.005 and = 0.004, respectively, indicating the two groups are statistically equivalent). The teleguidance group rated the experience highly overall (4.06/5), but less than the traditional group (4.47/5; P = 0.448, indicating statistical difference). Peer instruction was rated 4.35/5 overall. Conclusion Peer-instructed teleguidance was equivalent to in-person instruction with respect to knowledge change, confidence gain and OSCE performance in basic ocular ultrasound.
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Affiliation(s)
- Renee T. Zhao
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Jasmine Deng
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Ghadi Ghanem
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Athreya Steiger
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Lara Tang
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - David Haase
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Sima E. Sadeghinejad
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
| | - Jacqueline Shibata
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
- Department of Emergency MedicineOlive View‐UCLA Medical CenterSylmarCaliforniaUSA
| | - Alan T. Chiem
- Department of Emergency MedicineDavid Geffen School of Medicine at University of California‐Los AngelesLos AngelesCaliforniaUSA
- Department of Emergency MedicineOlive View‐UCLA Medical CenterSylmarCaliforniaUSA
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Weimer J, Rolef P, Müller L, Bellhäuser H, Göbel S, Buggenhagen H, Weimer A, Waezsada E, Kirchhoff F, Weinmann-Menke J. FoCUS cardiac ultrasound training for undergraduates based on current national guidelines: a prospective, controlled, single-center study on transferability. BMC MEDICAL EDUCATION 2023; 23:80. [PMID: 36726093 PMCID: PMC9893662 DOI: 10.1186/s12909-023-04062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION In emergency and critical-care medicine, focused cardiac ultrasound (FoCUS) is indispensable for assessing a patient's cardiac status. The aim of this study was to establish and validate a peer-to-peer-supported ultrasound course for learning FoCUS-specific skills during undergraduate studies at a German university. METHODS A 1-day, 12 teaching units training course was developed for students in the clinical section of medical college, with content based on the current national guidelines. A total of 217 students participated in the study (97 in the course group and 120 in the control group). The course and the participants' subjective assessment of improved skills were evaluated using a questionnaire (7-point Likert scale; 7 = complete agreement and 1 = no agreement at all). Objective learning gains were assessed by tests before and after the course. These consisted of a test of figural intelligence (eight items) and a test of technical knowledge (13 items). RESULTS The course participants experienced significant improvement (P < 0.001) from before to after the course, with a large effect size of η2part = 0.26. In addition, the course group had significantly better results (P < 0.001) than the control group in the post-test, with a medium to large effect size of η2part = 0.14. No significant differences (P = 0.27) were detected in the test section on figural intelligence. The evaluations showed that the participants had a high degree of satisfaction with the course approach, teaching materials, and tutors. There was also a positive increase in their subjective assessment of their own skills, including areas such as technical knowledge, ultrasound anatomy, and performance of the examination. CONCLUSION The results of both the objective learning assessment and the subjective evaluations suggest that a FoCUS course originally intended for qualified physicians is equally suitable for students. With the development and provision of modern digital teaching media, even more students will be able to benefit from this approach in the future.
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Affiliation(s)
- Johannes Weimer
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - Peter Rolef
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University of Mainz, Mainz, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Sebastian Göbel
- Department of Medicine II, Cardiology Center, Department of Medicine, University of Mainz, Mainz, Germany
| | - Holger Buggenhagen
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Andreas Weimer
- Center for Orthopedics, Emergency Surgery, and Paraplegics, Department of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Elias Waezsada
- Department of Cardiology, Kerckhoff Hospital, Bad Nauheim, Germany
| | - Friederike Kirchhoff
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Julia Weinmann-Menke
- Department of Medicine I, Nephrology Center, Department of Medicine, University of Mainz, Mainz, Germany
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Recker F, Schäfer VS, Holzgreve W, Brossart P, Petzinna S. Development and implementation of a comprehensive ultrasound curriculum for medical students: The Bonn internship point-of-care-ultrasound curriculum (BI-POCUS). Front Med (Lausanne) 2023; 10:1072326. [PMID: 37035342 PMCID: PMC10080124 DOI: 10.3389/fmed.2023.1072326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background Point-of-care ultrasound (POCUS) is rapidly gaining ground within different areas of applications. Despite the high and increasing relevance of ultrasound, the availability of structured training programs in medical schools is still limited. Therefore, many doctors keep acquiring all their ultrasound skills throughout their postgraduate training. As a result, new residents lack theoretical and practical ultrasound abilities that are critical in everyday clinical practice. In order to improve this, we created and implemented a complete ultrasound curriculum for all medical students throughout their internship year that focuses on hands-on abilities in ultrasound imaging. Methods We used Kern's six-step model of curricular development comprising (1) problem identification and general needs assessment, (2) needs assessment of the targeted learners, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback by board-certified ultrasound experts. A two rounds Delphi process with multilevel, self-completed questionnaires and individual using a 9-point Likert scale and free text comments was used to identify learning objectives and reach agreement on the content of the curriculum. Results The curriculum developed is aimed at students with no or little experience in their internship year and will be taught as part of their weekly-based internship training courses consisting of 2 hours of theory and 3 hours of practical training. The training will be conducted within a modular framework focusing on the key requirements of POCUS with increasing levels of complexity in accordance with the recommendations of the German Society for Ultrasound in Medicine (DEGUM), the European Federation of Societies for ultrasound in Medicine and Biology (EFSUMB) and the World Federation for ultrasound in Medicine and Biology (WFUMB). A longitudinal e-learning system will be implemented in addition to the practical and theoretical teaching units to track and examine the progress of the students. Conclusion Early integration of ultrasound training into medical education as part of a structured and standardized broad ultrasound curriculum enables medical students to acquire basic skills and apply them practically. Fundamental scanning skills are acquired by hands-on exercises in small, supervised groups as part of BI-POCUS. BI-POCUS therefore provides an excellent opportunity to improve the clinical skills of future physicians. More research is needed to analyze the learning outcomes for medical students and the improvement of the patient's outcome by establishing such an ultrasound curriculum.
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Affiliation(s)
- Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
- *Correspondence: Florian Recker,
| | - Valentin Sebastian Schäfer
- Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology, and Clinical Immunology, University Hospital Bonn, Bonn, Germany
| | | | - Peter Brossart
- Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology, and Clinical Immunology, University Hospital Bonn, Bonn, Germany
| | - Simon Petzinna
- Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology, and Clinical Immunology, University Hospital Bonn, Bonn, Germany
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Zhang H, Liao AWX, Goh SH, Wu XV, Yoong SQ. Effectiveness of peer teaching in health professions education: A systematic review and meta-analysis. NURSE EDUCATION TODAY 2022; 118:105499. [PMID: 35961134 DOI: 10.1016/j.nedt.2022.105499] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/26/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The reform in health professions education requires the focus to shift from fact memorization to exploring, analyzing, assimilating, and synthesizing information to promote active and collaborative learning. Peer teaching is one of the educational strategies. AIMS This review aimed to explore and synthesize quantitative evidence to determine the overall effect of peer teaching in enhancing students' theoretical knowledge and practical skills (e.g., procedural skills and resuscitation) in health professions education. METHODS PubMed, ScienceDirect, CINAHL, ERIC, ProQuest, reference lists of relevant studies, and reviews were searched till November 2021. Results were pooled using random-effects meta-analysis or narrative synthesis. RESULTS A total of 44 RCTs were included. This review showed a significant effect of peer teaching on procedural skills improvement and a comparable effect on theoretical knowledge and resuscitation skills acquisition compared to the conventional teaching method. Near-peer teaching seemed to be the most effective method for skill improvement. Subgroup analysis showed no significant differences between peer teaching and conventional teaching groups (e.g., expert/faculty teaching, self-study or lectures). CONCLUSIONS Peer teaching seems to be a promising teaching and learning strategy in health professions education, positively affecting theoretical knowledge and procedural skills. Future research should explore the effect of peer teaching in developing countries to provide a comprehensive picture of peer teaching.
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Affiliation(s)
- Hui Zhang
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | - Sam Hongli Goh
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Xi Vivien Wu
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Si Qi Yoong
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Teichgräber U, Ingwersen M, Ehlers C, Mentzel HJ, Redies C, Stallmach A, Behringer W, Guntinas-Lichius O. Integration of ultrasonography training into undergraduate medical education: catch up with professional needs. Insights Imaging 2022; 13:150. [PMID: 36153444 PMCID: PMC9509508 DOI: 10.1186/s13244-022-01296-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
Ultrasonography (US) has become the first-line imaging modality even for physicians who are not imaging specialists. The progress has not yet been sufficiently considered in medical education. The aim was to develop a curriculum that integrates US as a compulsory part into medical education directly from the start, to build up professional competencies toward residency.
Methods
Development was based on Kern’s six-step approach to identify problems, specify needs, define goals, outline strategies, and propose methods.
Results
The proposed curriculum follows a spiral course within which students should pass through four levels of training with increasing complexity. Students will be asked to independently prepare for courses by using learning videos. On the first training level, US should be closely linked to anatomy and physiology courses. Competency-centered courses should be held in small groups. On the second level, in the third year of education, students will apply point-of-care ultrasonography concerning multiple medical disciplines. On the third level, they will select a compulsory course in a specialty of their choice, held at five consecutive dates. From then on, US will be conducted in patients. Finally, during the final year, students are expected to use US under pro-active supervision with a large degree of independence and confidence. Throughout the curriculum, the discipline of radiology combines vertically with foundational sciences and horizontally with other medical specialties.
Conclusion
The conceptual proposal for a longitudinal US curriculum presented here has been developed by radiologists to equip students with competencies needed for contemporary patient care.
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Ultrasonography in undergraduate medical education: a comprehensive review and the education program implemented at Jichi Medical University. J Med Ultrason (2001) 2022; 49:217-230. [PMID: 35034230 PMCID: PMC8761092 DOI: 10.1007/s10396-021-01178-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/01/2021] [Indexed: 11/03/2022]
Abstract
The concept of point-of-care ultrasound has been widely accepted owing to the development of portable ultrasound systems and growing body of evidence concerning its extensive utility. Thus, it is reasonable to suggest that training to use this modality be included in undergraduate medical education. Training in ultrasonography helps medical students learn basic subjects such as anatomy and physiology, improve their physical examination skills, and acquire diagnostic and procedural skills. Technological advances such as simulators, affordable handheld devices, and tele-ultrasound systems can facilitate undergraduate ultrasound education. Several reports have indicated that some medical schools have integrated ultrasound training into their undergraduate medical curricula. Jichi Medical University in Japan has been providing medical students with ultrasound education to fulfill part of its mission to provide medical care to rural areas. Vertical integration of ultrasound education into a curriculum seems reasonable to ensure skill retention and improvement. However, several issues have hampered the integration of ultrasound into medical education, including a lack of trained faculty, the need to recruit human models, requisition of ultrasound machines for training, and limited curricular space; proposed solutions include peer teaching, students as trained simulated patients, the development of more affordable handheld devices, and a flipped classroom approach with access to an e-learning platform, respectively. A curriculum should be developed through multidisciplinary and bottom-up student-initiated approaches. Formulating national and international consensuses concerning the milestones and curricula can promote the incorporation of ultrasound training into undergraduate medical education at the national level.
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Recker F, Barth G, Lo H, Haverkamp N, Nürnberg D, Kravchenko D, Raupach T, Schäfer VS. Students' Perspectives on Curricular Ultrasound Education at German Medical Schools. Front Med (Lausanne) 2021; 8:758255. [PMID: 34901071 PMCID: PMC8655332 DOI: 10.3389/fmed.2021.758255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Despite ultrasound being an inherent part of medical education, only a few German medical schools have established a comprehensive ultrasound curriculum. This study aimed to explore medical students' perspectives on ultrasound in medical education (USMed). Results: Between January 1st, 2019 und June 30th, 2019, an online survey was conducted among German medical students via the students' associations and their respective teaching facilities. The survey consisted of 17 items regarding USMed. Statements were rated on a 4-point Likert scale for agreement. In total, 1040 students from 31 German medical faculties participated. The majority (1021, 98.2%) reported a very high to high interest in curricular USMed. Students agreed (n = 945, 90.9%) that USMed would be helpful along their entire course of medical studies. Considering the best starting time for USMed, the opinions of German medical students diverged: students studying in a model curriculum preferred to start in the second year (40.7%) while 49% of the students studying in a traditional curriculum preferred to start in the third year (p ≤ 0.001). An insufficient allotment of time for USMed in the planned curriculum (675, 65%) and a lack of courses run by medical faculty (305, 29.4%) were listed as perceived significant barriers to the participation in USMed. Peer teaching was regarded as an effective method in realizing USMed by 731 (70.3%) students. Conclusion: German medical students are very interested and willing to participate in USMed. There appears to be a high demand for US courses offered by medical schools.
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Affiliation(s)
- Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Gregor Barth
- Brandenburg Institute for Clinical Ultrasound (BICUS), Brandenburg Medical School (Theodor Fontane), Neuruppin, Germany
| | - Hendra Lo
- Brandenburg Institute for Clinical Ultrasound (BICUS), Brandenburg Medical School (Theodor Fontane), Neuruppin, Germany
| | | | - Dieter Nürnberg
- Brandenburg Institute for Clinical Ultrasound (BICUS), Brandenburg Medical School (Theodor Fontane), Neuruppin, Germany
| | - Dmitrij Kravchenko
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Tobias Raupach
- Institute for Medical Education, University Hospital Bonn, Bonn, Germany
| | - Valentin Sebastian Schäfer
- Clinic of Internal Medicine III, Department of Oncology, Hematology, Rheumatology and Clinical Immunology, University Hospital Bonn, Bonn, Germany
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Nourkami-Tutdibi N, Hofer M, Zemlin M, Abdul-Khaliq H, Tutdibi E. TEACHING MUST GO ON: flexibility and advantages of peer assisted learning during the COVID-19 pandemic for undergraduate medical ultrasound education - perspective from the "sonoBYstudents" ultrasound group. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc5. [PMID: 33659610 PMCID: PMC7899109 DOI: 10.3205/zma001401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/15/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
Background: Facing the global COVID-19 pandemic University teaching has been digitalized and German medical faculties took great effort to offer curricular contents online as they agreed that semesters during pandemic should not be suspended. Skill training is an essential part of medical education and cannot be fully digitalized nor should it be omitted. The pandemic demonstrates that skills like ultrasound are essential when treating critical ill patients. Medical faculties use peer assisted learning (PAL) concepts to teach skills, like ultrasound through specially trained student tutors. Aim: Here, we would like to share our experiences and elaborate how ultrasound teaching can be safely performed during the pandemic with an emphasis on adjustment of an existing PAL teaching concept. Method: At the hospital of Saarland University, we implemented a PAL teaching concept for abdominal, including emergency, ultrasound, and echocardiography, called "sonoBYstudents" to teach sonography to undergraduate medical students. Students are generally taught in small groups of 5 people in 90min sessions over a time of 8 weeks with an objective structured clinical exam (OSCE) at the end of the course program. Each semester nearly 50 students are taught in abdominal and emergency ultrasound and 30 students in echocardiography. Over five years, more than 600 students have been taught with at least 30 students being trained as student tutors. Given the pandemic, course size, course interval and total course time and total course time were adapted to the hygienic precautions. Results: 45 and 30 students were taught in abdominal ultrasound and echocardiography respectively achieving their learning goals measured via OSCE at the end of the courses. OSCE results were the same when compared to previous semesters. Conclusion: PAL as a teaching concept lives out of sustained educational strategies like practical and didactical trainings and an ongoing recruitment of new student tutors. Suspending PAL and its skill teaching would require starting from the beginning which is a time and cost consuming process. With sonoBYstudents we were able to demonstrate that an existing PAL concept can, with some effort, be adjusted to changing teaching circumstances. Apart from this ultrasound is a non-omittable part of medical skill training with easily appliable hygienic precautions during teaching sessions.
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Affiliation(s)
- Nasenien Nourkami-Tutdibi
- Saarland University Medical Center, Hospital for General Pediatrics and Neonatology, Homburg/Saar, Germany
- Saarland University Medical Center, Hospital for General Pediatrics and Neonatology, sonoBYstudents, Homburg/Saar, Germany
| | - M. Hofer
- University Spital Bern, Institute for Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern, Switzerland
| | - M. Zemlin
- Saarland University Medical Center, Hospital for General Pediatrics and Neonatology, Homburg/Saar, Germany
| | - H. Abdul-Khaliq
- Saarland University Medical Center, Hospital for Pediatric Cardiology, Homburg/Saar, Germany
| | - E. Tutdibi
- Saarland University Medical Center, Hospital for General Pediatrics and Neonatology, Homburg/Saar, Germany
- Saarland University Medical Center, Hospital for General Pediatrics and Neonatology, sonoBYstudents, Homburg/Saar, Germany
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13
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Eimer C, Duschek M, Jung AE, Zick G, Caliebe A, Lindner M, Weiler N, Elke G. Video-based, student tutor- versus faculty staff-led ultrasound course for medical students - a prospective randomized study. BMC MEDICAL EDUCATION 2020; 20:512. [PMID: 33327947 PMCID: PMC7741871 DOI: 10.1186/s12909-020-02431-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/07/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Ultrasound education is propagated already during medical school due to its diagnostic importance. Courses are usually supervised by experienced faculty staff (FS) with patient bedside examinations or students among each other but often overbooked due to limited FS availability. To overcome this barrier, use of teaching videos may be advantageous. Likewise, peer teaching concepts solely with trained student tutors have shown to be feasible and effective. The aim was to evaluate 1) objective learning outcomes of a combined video-based, student-tutor (ViST) as compared to a FS-led course without media support, 2) acceptance and subjective learning success of the videos. METHODS Two ultrasound teaching videos for basic and advanced abdominal ultrasound (AU) and transthoracic echocardiography (TTE) were produced and six students trained as tutors. Fourth-year medical students (N = 96) were randomized to either the ViST- or FS course (6 students per tutor). Learning objectives were defined equally for both courses. Acquired practical basic and advanced ultrasound skills were tested in an objective structured clinical examination (OSCE) using modified validated scoring sheets with a maximum total score of 40 points. Acceptance and subjective learning success of both videos were evaluated by questionnaires based on Kirkpatrick's evaluation model with scale-rated closed and open questions. RESULTS 79 of 96 medical students completed the OSCE and 77 could be finally analyzed. There was no significant difference in the mean total point score of 31.3 in the ViST (N = 42) and 32.7 in the FS course (N = 35, P = 0.31) or in any of the examined basic or advanced ultrasound skill subtasks. Of the 42 ViST participants, 29 completed the AU and 27 the TTE video questionnaire. Acceptance and subjective learning success of both videos was rated positively in 14-52% and 48-88% of the rated responses to each category, respectively. Attendance of either the student or faculty tutor was deemed necessary in addition to the videos. CONCLUSIONS A ViST versus FS teaching concept was able to effectively teach undergraduate students in AU and TTE, albeit acceptance of the teaching videos alone was limited. However, the ViST concept has the potential to increase course availability and FS resource allocation.
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Affiliation(s)
- Christine Eimer
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Max Duschek
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Andreas Emanuel Jung
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Günther Zick
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Amke Caliebe
- Institute of Medical Informatics and Statistics, Christian-Albrechts-University Kiel, University Medical Center Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Matthias Lindner
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Norbert Weiler
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany
| | - Gunnar Elke
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus R3, 24105, Kiel, Germany.
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Prosch H, Radzina M, Dietrich CF, Nielsen MB, Baumann S, Ewertsen C, Jenssen C, Kabaalioğlu A, Kosiak W, Kratzer W, Lim A, Popescu A, Mitkov V, Schiavone C, Wohlin M, Wüstner M, Cantisani V. Ultrasound Curricula of Student Education in Europe: Summary of the Experience. Ultrasound Int Open 2020; 6:E25-E33. [PMID: 32885138 PMCID: PMC7458842 DOI: 10.1055/a-1183-3009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/13/2020] [Indexed: 12/13/2022] Open
Abstract
Background
Despite the increasing role of ultrasound, structured
ultrasound teaching is only slowly being integrated into the curricula of
medical schools and universities all over Europe.
Aim
To survey the current situation at European universities regarding
the integration of ultrasound in student medical education and to report on
models of student ultrasound training from selected European universities.
Methods
A questionnaire survey focusing on the implementation of
curricular ultrasound education was sent out to the 28 presidents of the
national ultrasound societies of the European Federation of Societies for
Ultrasound in Medicine and Biology (EFSUMB), who were asked to distribute the
questionnaires to the medical universities of their countries.
Results
Overall, 53 questionnaires were returned from 46 universities in
17 European countries. In most of the universities (40/46 universities,
87%), the theoretical background of ultrasound is taught. However, in
only a minority of universities is ultrasound integrated in anatomy courses
(8/46 universities, 17%) or basic science courses (16/46
universities, 35%). Practical skills in ultrasound are taught in
56% of the universities (26/46 universities) and tested in a
practical exam in seven of the responding universities (15%). The number
of hours in which ultrasound was taught ranged from one to 58 (mean, seven). The
respondents reported that lack of time and limited faculty funding were major
hurdles.
Conclusion
According to our survey, only a minority of European
universities has integrated ultrasound into the preclinical curriculum thus far.
Future EFSUMB initiatives will continue to promote the introduction of
ultrasound as an integrative part of the core curriculum of student medical
education, and the preparation of proper teaching material.
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Affiliation(s)
- Helmut Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Maija Radzina
- Riga Stradins University, Radiology department, Riga, Latvia.,University of Latvia, Medical Faculty, Paula Stradina clinical university hospital, Diagnostic Radiology Institute Riga, Latvia
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Michael Bachmann Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sven Baumann
- Department of Internal Medicine I, Ulm University Hospital, Ulm, Germany
| | | | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch-Oderland, Strausberg, and Brandenburg Institute for Clinical Ultrasound, Neuruppin, Germany
| | | | - Wojciech Kosiak
- Department of Paediatrics, Haematology and Oncology, Medical University of Gdansk, Poland
| | - Wolfgang Kratzer
- Department of Internal Medicine I, Ulm University Hospital, Ulm, Germany
| | - Adrian Lim
- Department of Imaging, Imperial College London and Healthcare Trust, UK
| | - Alina Popescu
- Department of Gastroenterology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Timișoara, Romania
| | - Vladimir Mitkov
- Diagnostic Ultrasound Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation)
| | - Cosima Schiavone
- Unit of Internistic Ultrasound, Department of Medicine and Science of Aging, "G. d'Annunzio" University, Chieti, Italy
| | - Martin Wohlin
- Department of Medical Sciences, Uppsala Universitet, Uppsala, Sweden
| | - Matthias Wüstner
- Central Interdisciplinary Sonography, Krankenhaus der Barmherzigen Brüder Trier, Germany
| | - Vito Cantisani
- Department of Radiological, Oncologic and Anatomo-pathologic Sciences, University of Rome La Sapienza, Roma, Italy
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15
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Team-based learning for teaching musculoskeletal ultrasound skills: a prospective randomised trial. Eur J Trauma Emerg Surg 2020; 47:1189-1199. [PMID: 31925451 DOI: 10.1007/s00068-019-01298-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/31/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this prospective randomised trial was to assess the impact of the team-based learning approach on basic musculoskeletal ultrasound skills in comparison to both peer-assisted and conventional teaching and to examine the influence of gender and learning style on learning outcomes. METHODS In this prospective randomised trial, we randomly assigned 88 students to 3 groups: team-based learning (n = 19), peer-assisted learning (n = 36) and conventional teaching (n = 33). Pre-existing knowledge was assessed using a multiple-choice (MC) exam. Student performance after completing the course was measured using an Objective Structured Clinical Examination (OSCE) and a second MC exam. Students were asked to complete Kolb's Learning Style Inventory and to evaluate the course. RESULTS There was a significant gain in theoretical knowledge for all students (p < 0.001). The team-based learning groups' performance proved to be significantly superior on the OSCE (p = 0.001). As gender had no significant effect on practical or theoretical performance, learning style was linked to differences in the practical outcome. An evaluation showed overall satisfaction with the course and with the respective teaching methods. CONCLUSION Team-based learning proved to be superior to peer-assisted and conventional teaching of musculoskeletal ultrasound skills.
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16
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Hari R, Kälin K, Harris M, Walter R, Serra A. Comparing Blended Learning with Faculty-Led Ultrasound Training: Protocol for a Randomised Controlled Trial (The SIGNATURE Trial). PRAXIS 2020; 109:636-640. [PMID: 32517596 DOI: 10.1024/1661-8157/a003497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background: Ultrasound is increasingly used in clinical practice as a bedside tool. As medical graduates first encounter the technique in early residency, ultrasound training needs to be integrated into the undergraduate curriculum. In Switzerland, abdominal ultrasound skills have been taught by a faculty-led, 21-hour course. However, this course does not have sufficient capacity to meet the increasing demand, and there have been doubts about its effectiveness as a teaching method. We therefore developed a 21-hour blended-learning course, comprising five hours of e-learning and 16 hours of near-peer tutoring. This study investigates whether this new teaching format is as good as, or superior to, the faculty-led method. Methods: The SIGNATURE study is an investigator-initiated, two-arm, randomised controlled trial, enrolling 152 medical students at the Universities of Bern, Fribourg and Zurich. Stratified by study site, students are 1:1 randomised to either the blended-learning course or the faculty-led 2.5-day ultrasound course. Students undergo a six-station objective structured clinical examination (OSCE) and complete an online questionnaire immediately after the course and 6 months later. Discussion: If demonstrated to be effective, the blended-learning course would allow an increase in the number of undergraduate medical students that can acquire ultrasound skills before starting their residencies.
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Affiliation(s)
- Roman Hari
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
| | - Kaspar Kälin
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
| | - Michael Harris
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
- College of Medicine & Health, University of Exeter, UK
| | - Robin Walter
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
| | - Andreas Serra
- Clinic of General Internal Medicine and Nephrology, Klinik Hirslanden Zurich, Switzerland
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17
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Jeker L, Birrenbach T, Walter R, Hari R. [Peer Teaching in Ultrasound Education - A Narrative Review]. PRAXIS 2020; 109:631-635. [PMID: 32517595 DOI: 10.1024/1661-8157/a003498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Peer Teaching in Ultrasound Education - A Narrative Review Abstract. Learning about ultrasound is becoming an increasingly important component of the undergraduate medical curriculum. However, teaching about this is very time-consuming, which is why many universities use peer teaching in ultrasound training. Peer teaching has various advantages that go beyond reducing specialists' teaching time: students may learn more from their peers because their cognitive schemata are more congruent and they are more likely to be open about their learning deficits. In addition, the process of teaching leads to increased learning and motivation in the peer teachers themselves. Most studies that compare peer teaching with teaching from medically qualified tutors show comparable learning effects, with different advantages for the two settings.
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Affiliation(s)
- Lia Jeker
- Berner Institut für Hausarztmedizin, Universität Bern, Bern
| | - Tanja Birrenbach
- Universitäres Notfallzentrum, Inselspital, Universitätsspital, Universität Bern, Bern
| | - Robin Walter
- Berner Institut für Hausarztmedizin, Universität Bern, Bern
| | - Roman Hari
- Berner Institut für Hausarztmedizin, Universität Bern, Bern
- Department of Educational Development and Research, Maastricht University, Maastricht, Niederlande
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18
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Celebi N, Griewatz J, Ilg M, Zipfel S, Riessen R, Hoffmann T, Malek NP, Pauluschke-Fröhlich J, Debove I, Muller R, Fröhlich E. Three different ways of training ultrasound student-tutors yield significant gains in tutee's scanning-skills. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc77. [PMID: 31844649 PMCID: PMC6905374 DOI: 10.3205/zma001285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/26/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
Aim: Many medical universities rely these days on trained student tutors to enable faculty-wide undergraduate ultrasound training. However, there is neither consensus on an optimal method nor any developed and agreed standard in the training of these student tutors. Usually internships and courses are employed which have both a specific set of advantages and disadvantages. We conducted a prospective quasi-randomized study of assess the effects of three types of tutor training on the resulting improvement in scanning skills of their tutees. Methods: Three batches of student tutors were trained by a course only (C-group), by an internship only (I-group) or by a course and an internship (CI-group). The respective gains in ultrasound scanning skills of the tutees were measured prospectively. A total 75 of the 124 5th year medical students (60.5%) who attended the mandatory ultrasound course completed both pre- and post-exams on a voluntary basis. Within a limit of eight minutes and three images, they were asked to depict and label a maximum of 14 anatomical structures. Two blinded raters independently awarded two points for each label with an identifiable structure and one point for each label with a possibly identifiable structure. Results: In all three groups, the tutees improved significantly by more than doubling their pre-score results and comparably (Gains: C-group 9.19±5.73 points, p<.0001, I-group 9.77±4.81 points, p<.0001, CI-group 8.97±5.49 points, p<.0001). Conclusion: Student tutors, who were trained with a course or an internship or a course and an internship could teach scanning skills to 5th year medical students very effectively and with similar success.
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Affiliation(s)
| | - Jan Griewatz
- Competence Centre for University Teaching in Medicine, Baden-Württemberg, Tübingen, Germany
| | - Madeleine Ilg
- Eberhard-Karls University, Medical faculty, Tübingen, Germany
| | - Stephan Zipfel
- University Hospital Tübingen, Department of Internal Medicine VI, Tübingen, Germany
| | - Reimer Riessen
- University Hospital Tübingen, Department of Internal Medicine VIII, Tübingen, Germany
| | - Tatjana Hoffmann
- University Hospital Tübingen, Department of Internal Medicine I, Tübingen, Germany
| | - Nisar Peter Malek
- University Hospital Tübingen, Department of Internal Medicine I, Tübingen, Germany
| | | | - Ines Debove
- University Hospital Bern, Department of Neurology, Bern, Switzerland
| | | | - Eckhart Fröhlich
- University Hospital Tübingen, Department of Internal Medicine I, Tübingen, Germany
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19
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Wolf R, Geuthel N, Gnatzy F, Rotzoll D. Undergraduate ultrasound education at German-speaking medical faculties: a survey. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc34. [PMID: 31544134 PMCID: PMC6737263 DOI: 10.3205/zma001242] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 03/24/2019] [Accepted: 04/15/2019] [Indexed: 05/21/2023]
Abstract
Background: The purpose of this study was twofold: to assess the status of undergraduate medical ultrasound (US) education in the German-speaking area and to suggest a possible framework for a longitudinal undergraduate medical US curriculum based on the study results and a literature review. Methods: The survey included 44 medical faculties in the German-speaking area: 37 in Germany, four in Austria and three in German-speaking Switzerland. A standardized questionnaire focused on the following aspects of undergraduate medical US education: general information, organization, resources, assessment methods and evaluation. Results: Data from 28 medical faculties were analysed. 26 out of 28 medical faculties offered US courses, 21 offered compulsory as well as elective courses, four offered compulsory and one elective courses only. 27 medical faculties supported US skills implementation. Abdominal US (n=25) was most common in teaching basic US skills. A learning objective catalogue was provided at 15 medical faculties. At 22 medical faculties, medical specialists were involved in undergraduate medical US education. 24 out of 26 medical faculties thought that peer-teaching is important to convey US skills. Medical faculties used the following methods to assess US skills: objective structured clinical examination (OSCE, n=7), non-standardized practical exams (n=4), non-standardized combined oral-practical exams (n=2) or direct observation of procedural skills (DOPS, n=1). 25 out of 26 medical faculties evaluated their US courses and 19 made suggestions for improvements in undergraduate medical US education. Conclusion: Medical faculty members in the German-speaking area have recognized the relevance of undergraduate medical US education. So far, courses are offered heterogeneously with rather short hands-on scanning time and high student-instructor ratio. Based on the results of this study and a literature review we suggest a possible framework and milestones on the way to a longitudinal undergraduate medical US curriculum.
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Affiliation(s)
- Robert Wolf
- University of Leipzig, Faculty of Medicine, Skills and Simulation Centre LernKlinik Leipzig, Leipzig, Germany
| | - Nicole Geuthel
- University Hospital Leipzig, Department of Paediatrics, Clinic for Paediatric Surgery, Leipzig, Germany
| | - Franziska Gnatzy
- St. Elisabeth Hospital Leipzig, Clinic for Internal Medicine II, Leipzig, Germany
| | - Daisy Rotzoll
- University of Leipzig, Faculty of Medicine, Skills and Simulation Centre LernKlinik Leipzig, Leipzig, Germany
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20
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Evans DK, Thiessen MEW. Novel Approach to Introducing an Ultrasonography Curriculum With Limited Instructor Resources. J Osteopath Med 2019; 119:533-540. [PMID: 31355892 DOI: 10.7556/jaoa.2019.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Context Ultrasonography is becoming more prevalent in clinical practice, but medical schools looking to implement preclinical training are limited by financial and faculty resources. Objective To design a single-instructor model to save faculty resources and to determine whether this model is effective at teaching ultrasonography to preclinical medical students. Methods This single-instructor model included 3 components: (1) flipped classroom, where students watched an online lecture covering examination techniques; (2) in-person scanning sessions, where students scanned each other after the instructor went through lecture content and pathologic images, a video camera to show probe placement and examination technique, and a live feed from an ultrasonography demonstration; and (3) feedback on written examination questions and course evaluations. Results When compared with a traditional ultrasonography curriculum, which requires approximately 600 instruction hours annually, this program required 96 hours. Students reported appreciation of exposure to ultrasonography but expressed desire for smaller group sizes and greater individual instruction. Students performed well on written test questions, with the first-year class answering 88% correctly and the second-year class answering 90.6% correctly. Conclusions Although this educational format was used successfully to teach introductory ultrasonography to preclinical students, feedback suggested that students would prefer more individual instruction. The authors look toward implementing a peer-instructor format, forming smaller laboratory groups, and improving skill assessment.
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Dietrich CF, Hoffmann B, Cantisani V, Dong Y, Hari R, Nisenbaum H, Nicholls D, Nolsøe CP, Radzina M, Recker F, Serra A, Sweet L, Westerway S, Blaivas M. Medical Student Ultrasound Education, a WFUMB Position Paper, Part I, response to the letter to the Editor. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1857-1859. [PMID: 30981532 DOI: 10.1016/j.ultrasmedbio.2019.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 02/27/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Christoph F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany; Ultrasound Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Beatrice Hoffmann
- Department of Emergency Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Vito Cantisani
- Department of Imaging Diagnostics, Policlinico Umberto I, University Sapienza, Rome, Italy
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Roman Hari
- Berner Institut für Hausarztmedizin (BIHAM), Universität Bern, Bern, Switzerland
| | - Harvey Nisenbaum
- Department of Medical Imaging, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
| | - Delwyn Nicholls
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Christian Pállson Nolsøe
- Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital Copenhagen Academy for Medical Education and Simulation Ultrasound Section, University of Copenhagen, Copenhagen, Denmark
| | - Maija Radzina
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, And Radiology Research Laboratory, Riga Stradins University University of Latvia, Riga, Latvia
| | - Florian Recker
- Department of Obstetrics and Gynecology And Sono Education Academy, University Hospital Bonn, Bonn, Germany
| | - Andreas Serra
- Department of Internal Medicine and Nephrology, EFSUMB Learning Center, Klinik Hirslanden, Zürich, Switzerland
| | - Linda Sweet
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Sue Westerway
- School of Dentistry & Health Science, Charles Sturt University, New South Wales, Australia
| | - Michael Blaivas
- University of South Carolina School of Medicine, Department of Emergency Medicine, St. Francis Hospital, Columbus, Georgia, USA
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Celebi N, Griewatz J, Malek NP, Krieg S, Kuehnl T, Muller R, Pauluschke-Fröhlich J, Debove I, Riessen R, Zipfel S, Fröhlich E. Development and implementation of a comprehensive ultrasound curriculum for undergraduate medical students - a feasibility study. BMC MEDICAL EDUCATION 2019; 19:170. [PMID: 31138197 PMCID: PMC6537195 DOI: 10.1186/s12909-019-1611-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/17/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Ultrasound is one of the most important imaging techniques in clinical medicine with unique advantages. Skills in ultrasound imaging are very usefull for physicians including novices and thus also mandated by the Task Force "National Competence-Based Learning Objectives for Undergraduate Medical Education" (NKLM) in Germany and as well as by the German Ultrasound Society (Deutsche Gesellschaft für Ultraschall in der Medizin, DEGUM). Since ultrasound is best learned hands-on in very small supervised groups, we developed and implemented a comprehensive ultrasound-curriculum for all undergraduate medical students of our faculty using a peer-teaching concept. METHODS We used Kern's six-step model of curricular development comprising (1) problem identification and general needs assessment, (2) needs assessment of the targeted learners, (3) goals and objectives, (4) educational stategies, (5) implementation, and (6) evaluation and feedback. RESULTS The developed curriculum covers basic ultrasound of the abdomen and the throat, eFAST (Extended Focused Assessment with Sonography for Trauma), lung-ultrasound, FEEL (Focused Echocardiography in Emergency Life Support) and compression duplex sonography of the thigh deep vein system. All 5th year medical students receive a 90 min lecture on ultrasound basics by a faculty member and then a 12.5 h hands-on course divided into three sessions with one student tutor for every 4 students. The students are provided with a script (PDF-File) that covers all the learning goals, including example images of pathologies. The student tutors are trained during a 1 week ultrasound course and a 21-day rotation through seven different ultrasound laboratories. In addition, they undergo a standardized 1.5 day didactical training. Prior to the implementation for all students, the overall course was tested on 27 volunteer students. These students rated (on a 6-point Likert scale from 1 = excellent to 6 = very poor) the satisfaction with the student tutors and the faculty members as 1.4 ± .9 (mean ± stddev) and 1.3 ± .5 respectively. CONCLUSION A comprehensive ultrasound curriculum for all undergraduate medical students using a peer-teaching concept is feasible. Further studies are needed to evaluate in detail the learning outcomes for students and student tutors.
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Affiliation(s)
- Nora Celebi
- PHV Dialysis Center Waiblingen, Beinsteiner Straße 8/3, 71334 Waiblingen, Germany
| | - Jan Griewatz
- Eberhard-Karls University, Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Elfriede-Aulhorn-Str. 10, D-72076 Tuebingen, Germany
| | - Nisar P. Malek
- Department of Internal Medicine I (Gastroenterology, Hepatology, Infectious Diseases), University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
| | - Sarah Krieg
- Medical Faculty, Eberhard-Karls University, Geissweg 5/3, 72076 Tübingen, Germany
| | - Toni Kuehnl
- Medical Faculty, Eberhard-Karls University, Geissweg 5/3, 72076 Tübingen, Germany
| | - Reinhold Muller
- Professorial Research Fellow AITHM, James Cook University, 1/14-88 McGregor Rd, Smithfield, QLD 4878 Australia
| | - Jan Pauluschke-Fröhlich
- Department of Gynecology, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
| | - Ines Debove
- Department of Neurology, Inselspital, Freiburgstrasse 18, 3010 Bern, Switzerland
| | - Reimer Riessen
- Department of Internal Medicine, Intensive Care Unit, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
| | - Stephan Zipfel
- Department of Internal Medicine VI (Psychosomatic medicine), University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Eckhart Fröhlich
- Department of Internal Medicine I (Gastroenterology, Hepatology, Infectious Diseases), University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
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Celebi N, Griewatz J, Malek NP, Hoffmann T, Walter C, Muller R, Riessen R, Pauluschke-Fröhlich J, Debove I, Zipfel S, Fröhlich E. Outcomes of three different ways to train medical students as ultrasound tutors. BMC MEDICAL EDUCATION 2019; 19:125. [PMID: 31046757 PMCID: PMC6498570 DOI: 10.1186/s12909-019-1556-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 04/15/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND In order to provide faculty-wide undergraduate ultrasound training in times of scarce resources, many medical faculties employ trained peer-student tutors to oversee the hands-on training. However, data to guide the training of ultrasound peer-student tutors are scarce. We conducted a prospective quasi-randomized study to assess the gain in theoretical knowledge and practical scanning skills of peer-student tutors who were trained with a course only, an internship only, or the combination of a course and an internship. METHODS A total of 44 peer-student tutors were trained by a one-week course only (C-Group, n = 21), by an internship only (I-Group, n = 10) or by a course and an internship (CI-Group, n = 13). Prior to and after the completion of the training the peer-student tutors completed an MC-test (theoretical knowledge) and an OSCE (practical scanning skills). RESULTS With all three education concepts, the peer-student tutors had significant and comparable gains in theoretical knowledge (C-group + 90%, I-group + 61.5%, CI-group + 114.0%) and practical scanning skills (C-group + 112.0%, I-group + 155.0% and CI-group + 123.5%), all p < 0.001. CONCLUSION Peer-student tutors, who were trained with a course or an internship or a course and internship improved their theoretical knowledge and their practical scanning skills significantly and to a comparable degree.
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Affiliation(s)
- Nora Celebi
- PHV dialysis center Waiblingen, Beinsteiner Straße 8/3, 71334 Waiblingen, Germany
| | - Jan Griewatz
- Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Elfriede-Aulhorn-Str. 10, D-72076 Tuebingen, Germany
| | - Nisar Peter Malek
- Department of Internal Medicine I (Gastroenterology, Hepatology, Infectious Diseases), University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
| | - Tatjana Hoffmann
- Department of Internal Medicine I (Gastroenterology, Hepatology, Infectious Diseases), University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
| | - Carina Walter
- Eberhard-Karls University, Geissweg 5/3, 72076 Tübingen, Germany
| | - Reinhold Muller
- James Cook University, 1/14-88 McGregor Rd, Smithfield, QLD 4878 Australia
| | - Reimer Riessen
- Department of Internal Medicine VIII (Intensive Care Unit), University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
| | - Jan Pauluschke-Fröhlich
- Department of Womens Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
| | - Ines Debove
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, CH Switzerland
| | - Stephan Zipfel
- Department of Internal Medicine VI (Psychosomatic Medicine), University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Eckhart Fröhlich
- Department of Internal Medicine I (Gastroenterology, Hepatology, Infectious Diseases), University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
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Introduction of a student tutor-based basic obstetrical ultrasound screening in undergraduate medical education. Arch Gynecol Obstet 2019; 300:59-66. [PMID: 31044300 DOI: 10.1007/s00404-019-05161-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 04/10/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND While there is an increasing interest in incorporating ultrasound in undergraduate medical education and the use of student tutors in conveying this medical skill to assist faculty members, little is known about undergraduate ultrasound teaching in obstetrics and gynecology. METHODS After a 3 week training of the student tutors, the student tutors joined an undergraduate ultrasound educational program to teach practical round students. After being certified, the student tutors organized a pre-test, gave a presentation about ultrasound, and then supervised the hands on ultrasound course under faculty staff supervision for round students. Finally, the practical round students had to answer a post-test with image recognition. The practical round students had to evaluate the course using a Likert scale. RESULTS 111 students joined this ultrasound course. The objective theoretical and practical multiple-choice questions' (MCQ) test showed a statistically significant improvement (50 vs. 90%, p < 0.05). The practical round students expressed a high acceptance (Likert 1.7) and subjective medical skill learning (Likert 1.8). The students also positively graded the student tutors (Likert 1.3). CONCLUSION Student tutor-based undergraduate obstetrical and gynecological ultrasound course is a useful method to teach a medical skill and is well accepted by students.
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Ebner F, De Gregorio A, Schochter F, Bekes I, Janni W, Lato K. Effect of an Augmented Reality Ultrasound Trainer App on the Motor Skills Needed for a Kidney Ultrasound: Prospective Trial. JMIR Serious Games 2019; 7:e12713. [PMID: 31042155 PMCID: PMC6658324 DOI: 10.2196/12713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/05/2019] [Accepted: 03/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background Medical education is evolving from "learning by doing" to simulation-based hands-on tutorials. Objective The aim of this prospective 2-armed study was to evaluate a newly developed augmented reality ultrasound app and its effect on educational training and diagnostic accuracy. Methods We recruited 66 medical students and, using imaging and measuring a kidney as quality indicators, tested them on the time they needed for these tasks. Both groups used textbooks as preparation; in addition, the study group had access to a virtual ultrasound simulation app for mobile devices. Results There was no significant difference between the study arms regarding age (P=.97), sex (P=.14), and previous ultrasound experience (P=.66). The time needed to complete the kidney measurements also did not differ significantly (P=.26). However, the results of the longitudinal kidney measurements differed significantly between the study and control groups, with larger, more realistic values in the study group (right kidney: study group median 105.3 mm, range 86.1-127.1 mm, control group median 92 mm, range 50.4-112.2 mm; P<.001; left kidney: study group median 100.3 mm, range 81.7-118.6 mm, control group median 85.3 mm, range 48.3-113.4 mm; P<.001). Furthermore, whereas all students of the study group obtained valid measurements, students of the control group did not obtain valid measurements of 1 or both kidneys in 7 cases. Conclusions The newly developed augmented reality ultrasound simulator mobile app provides a useful add-on for ultrasound education and training. Our results indicate that medical students’ use of the mobile app for training purposes improved the quality of kidney measurements.
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Affiliation(s)
- Florian Ebner
- Helios Amper Klinikum, Dachau, Germany.,University of Ulm, Ulm, Germany
| | | | | | - Inga Bekes
- Obstetrics and Gynecology Department, University of Ulm, Ulm, Germany
| | - Wolfgang Janni
- Obstetrics and Gynecology Department, University of Ulm, Ulm, Germany
| | - Krisztian Lato
- Obstetrics and Gynecology Department, University of Ulm, Ulm, Germany
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Ben-Sasson A, Lior Y, Krispel J, Rucham M, Liel-Cohen N, Fuchs L, Kobal SL. Peer-teaching cardiac ultrasound among medical students: A real option. PLoS One 2019; 14:e0212794. [PMID: 30917143 PMCID: PMC6436682 DOI: 10.1371/journal.pone.0212794] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/08/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Teaching cardiac ultrasound (CU) image acquisition requires hands-on practice under qualified instructors supervision. We assessed the efficacy of teaching medical students by their previously trained classmates (teaching assistants [TAs]) compared to teaching by expert trainers (cardiologists or diagnostic medical sonographers. METHODS Sixty-six students received 8-hour CU training: 4-hour lectures on ultrasound anatomy and imaging techniques of 6 main CU views (parasternal long [PLAV] and short axis [PSAV]; apical 4-chamber [4ch], 2-chamber [2ch], and 3-chamber [3ch]; and sub costal [SC]) followed by 4 hours of hands-on exercise in groups of ≤5 students under direct supervision of a TA (group A: 44 students) or a qualified trainer (group B: 22 students). Students' proficiency was evaluated on a 6-minute test in which they were required to demonstrate 32 predetermined anatomic landmarks spread across the 6 views and ranked on a 0-100 scale according to a predetermined key. RESULTS The 6-minute test final grade displayed superiority of group A over group B (54±17 vs. 39±21, respectively [p = 0.001]). This trend was continuous across all 6 main views: PLAV (69±18 vs. 54±23, respectively), PSAV (65±33 vs. 41±32, respectively), 4ch (57±19 vs. 43±26, respectively), 2ch (37±29 vs. 33±27, respectively), 3ch (48±23 vs. 35±25, respectively), and SC (36±27 vs. 24±28, respectively). CONCLUSIONS Teaching medical students CU imaging acquisition by qualified classmates is feasible. Moreover, students instructors were superior to senior instructors when comparing their students' capabilities in a practical test. Replacing experienced instructors with TAs could help medical schools teach ultrasound techniques with minimal dependence on highly qualified trainers.
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Affiliation(s)
- Alon Ben-Sasson
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yotam Lior
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
- * E-mail:
| | - Jonathan Krispel
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Moshe Rucham
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Noah Liel-Cohen
- Cardiology Department, Soroka University Medical Center, Beer-Sheva, Israel
| | - Lior Fuchs
- Medical Intensive Care, Soroka University Medical Center, Beer-Sheva, Israel
| | - Sergio L. Kobal
- Cardiology Department, Soroka University Medical Center, Beer-Sheva, Israel
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Abstract
BACKGROUND Point-of-care ultrasound has gained widespread use in developing countries due to decreased cost and improved telemedicine capabilities. Ultrasound training, specifically image acquisition skills, is occurring with more frequency in non-medical personnel with varying educational levels in these underdeveloped areas. This study evaluates if students without a high school education can be trained to acquire useful FAST images, and to determine if an 8th grade student can teach peers these skills. METHODS The 8th grade students at a small middle school were divided into two groups. One group received training by a certified medical sonographer, while the other group received training by a peer 8th grade student trainer who had previously received training by the sonographer. After training, each student was independently tested by scanning the four FAST locations. A blinded ultrasound expert evaluated these images and deemed each image adequate or inadequate for clinical use. RESULTS Eighty video image clips were obtained. The overall image adequacy rate was 74%. The splenorenal window had the highest rate at 95%, followed by retrovesical at 90%, hepatorenal at 75%, and subxiphoid cardiac at 35%. The adequacy rate of the sonographer-trained group was 78%, while the adequacy rate of the student-trained group was 70%. The difference in image adequacy rate between the two groups was not significant (P-value 0.459). CONCLUSION The majority of 8th graders obtained clinically adequate FAST images after minimal training. Additionally, the student-trained group performed as well as the sonographer-trained group.
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Affiliation(s)
- Alexander S Kwon
- Sage Hill School, 20402 Newport Coast Drive, Newport Coast, California 92657, USA
| | - Shadi Lahham
- Department of Emergency Medicine, UC Irvine Medical Center, UC Irvine School of Medicine, Irvine, Orange, California 92868, USA
| | - John C Fox
- Department of Emergency Medicine, UC Irvine Medical Center, UC Irvine School of Medicine, Irvine, Orange, California 92868, USA
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Medical Student Ultrasound Education: A WFUMB Position Paper, Part I. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 45:271-281. [PMID: 30497768 DOI: 10.1016/j.ultrasmedbio.2018.09.017] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 02/06/2023]
Abstract
The introduction of ultrasound into medical student education is well underway in many locations around the world, but is still in its infancy or has yet to begin in others. Proper incorporation of ultrasound education into medical training requires planning and resources, both capital and human. In this article, we discuss the state of the art of ultrasound in medical education throughout the world, as well as various methodologies utilized to improve student education and to incorporate ultrasound into every facet of training. Experiences from various educational systems and available evidence regarding the impact of ultrasound education are summarized. Representing multiple societies and specialties throughout the world, we discuss established modern as well as novel education structures and different successful approaches.
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Hamza A, Radosa J, Meyberg-Solomayer G, Solomayer EF, Takacs Z, Juhasz-Boess I, Krasteva-Christ G, Tschernig T, Maxeiner S. Trial integration of combined ultrasound and laparoscopy tuition in an undergraduate anatomy class with volunteer participation - A pilot study. Ann Anat 2018; 221:101-107. [PMID: 30300688 DOI: 10.1016/j.aanat.2018.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Abstract
Anatomy is a cornerstone of medical undergraduate curricula. Due to increasing changes in various medical fields, a lot of new subjects were introduced in undergraduate curricula, while the teaching areas of basic sciences, i.e. anatomy, were reduced. The introduction of advanced diagnostic and therapeutic devices, i.e. ultrasound and laparoscopy, with outstanding imaging quality will be increasingly introduced in basic sciences. In our project, we examined the effect integrating ultrasound and laparoscopy in an anatomy undergraduate course to illustrate the female pelvis. Anatomy students that completed their practicum and cadaver dissection course were enrolled in our project. They received a theoretical introduction followed by a practical course of ultrasound or laparoscopy in the department of obstetrics and gynaecology. Following the course the students had to answer two questionnaires that evaluated their satisfaction, subjective knowledge-gain, problems and content of the course. At the end, a closing briefing was done to discuss the clinical skills and the course. The answers of the questionnaire were summed up in a Likert scale. 25 students were enrolled in the project. 52% attended laparoscopy operations, while 48% attended ultrasound examinations. After analysing the questionnaires using Likert scales (1=strongly agree, 5=strongly disagree) a general satisfaction of 1.5, a subjective knowledge gain of 2.4 and a thrive to extend these clinical skill programs in gynaecology and other specialities in basic science of 1.5 and 1.2, respectively, was reported. There were no statistically significant differences in the Likert scores between both groups (p>0.05). The introduction of ultrasound and laparoscopy in undergraduate basic science teaching programs is a promising method and should be further evaluated, standardized and expanded.
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Affiliation(s)
- Amr Hamza
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | - Julia Radosa
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | | | - Erich-Franz Solomayer
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | - Zoltan Takacs
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | - Ingolf Juhasz-Boess
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | - Gabriela Krasteva-Christ
- Institute of Anatomy, Cell and Developmental Biology of the University of Saarland, 66421 Homburg, Germany
| | - Thomas Tschernig
- Institute of Anatomy, Cell and Developmental Biology of the University of Saarland, 66421 Homburg, Germany.
| | - Stephan Maxeiner
- Institute of Anatomy, Cell and Developmental Biology of the University of Saarland, 66421 Homburg, Germany
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Siegel-Richman Y, Kendall J. Establishing an Ultrasound Curriculum in Undergraduate Medical Education: How Much Time Does It Take? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:569-576. [PMID: 28877363 DOI: 10.1002/jum.14371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/27/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Over the years, the use of ultrasound in the medical profession has become a common occurrence. As a result, many medical schools are considering an ultrasound curriculum for first- and second-year medical students. The question posed by many of these programs is how much time and effort are required to establish such a curriculum. We at the University of Colorado School of Medicine sought to quantify the resources and time required. METHODS We conducted a cohort study that analyzed the time spent teaching, as well as the types of instructors (eg, faculty, resident, and peer student) that contributed to our ultrasound curriculum. The study population consisted of instructors who participated in the curriculum during the 2014-2015 academic year. We analyzed the amount of time that facilitators spent teaching and tabulated these data using their specialty. RESULTS Our data revealed that within an academic year, a combined total of 484 hours were spent teaching ultrasound to first- and second-year medical students combined. A total of 6 days were required to teach ultrasound to first-year medical students, and a total of 5 days were required for second-year medical students. It required 1 instructor for every 8 students, and most the faculty who volunteered time were from the field of emergency medicine, followed by family medicine and radiology. CONCLUSIONS We describe the number of hours and instructors required to implement an ultrasound curriculum for undergraduate medical education.
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Affiliation(s)
| | - John Kendall
- University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado, USA
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Smith JP, Kendall JL, Royer DF. Improved medical student perception of ultrasound using a paired anatomy teaching assistant and clinician teaching model. ANATOMICAL SCIENCES EDUCATION 2018; 11:175-184. [PMID: 28817242 DOI: 10.1002/ase.1722] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 07/11/2017] [Accepted: 07/22/2017] [Indexed: 06/07/2023]
Abstract
This study describes a new teaching model for ultrasound (US) training, and evaluates its effect on medical student attitudes toward US. First year medical students participated in hands-on US during human gross anatomy (2014 N = 183; 2015 N = 182). The sessions were facilitated by clinicians alone in 2014, and by anatomy teaching assistant (TA)-clinician pairs in 2015. Both cohorts completed course evaluations which included five US-related items on a four-point scale; cohort responses were compared using Mann-Whitney U tests with significance threshold set at 0.05. The 2015 survey also evaluated the TAs (three items, five-point scale). With the adoption of the TA-clinician teaching model, student ratings increased significantly for four out of five US-items: "US advanced my ability to learn anatomy" increased from 2.91 ± 0.77 to 3.35 ± 0.68 (P < 0.0001), "Incorporating US increased my interest in anatomy" from 3.05 ± 0.84 to 3.50 ± 0.71 (P < 0.0001), "US is relevant to my current educational needs" from 3.36 ± 0.63 to 3.54 ± 0.53 (P = 0.015), and "US training should start in Phase I" from 3.36 ± 0.71 to 3.56 ± 0.59 (P = 0.010). Moreover, more than 84% of students reported that TAs enhanced their understanding of anatomy (mean 4.18 ± 0.86), were a valuable part of US training (mean 4.23 ± 0.89), and deemed the TAs proficient in US (mean 4.24 ± 0.86). By using an anatomy TA-clinician teaching team, this study demonstrated significant improvements in student perceptions of the impact of US on anatomy education and the relevancy of US training to the early stages of medical education. Anat Sci Educ 11: 175-184. © 2017 American Association of Anatomists.
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Affiliation(s)
- Jacob P Smith
- Master of Science Program in Modern Human Anatomy, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - John L Kendall
- Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado
- University of Colorado School of Medicine, Aurora, Colorado
| | - Danielle F Royer
- Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, Colorado
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Tarique U, Tang B, Singh M, Kulasegaram KM, Ailon J. Ultrasound Curricula in Undergraduate Medical Education: A Scoping Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:69-82. [PMID: 28748549 DOI: 10.1002/jum.14333] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/20/2017] [Indexed: 05/20/2023]
Abstract
The clinical applications of point-of-care ultrasound (US) have expanded rapidly over the past decade. To promote early exposure to point-of-care US, there is widespread support for the integration of US curricula within undergraduate medical education. However, despite growing evidence and enthusiasm for point-of-care US education in undergraduate medical education, the curricular design and delivery across undergraduate medical education programs remain variable without widely adopted national standards and guidelines. This article highlights the educational and teaching applications of point-of-care US with a focus on outcomes. We then review the evidence on curricular design, delivery, and integration and the assessment of competency for point-of-care US in undergraduate medical education.
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Affiliation(s)
- Usman Tarique
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Brandon Tang
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Manni Singh
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Kulamakan Mahan Kulasegaram
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Wilson Center and Undergraduate Medical Education, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan Ailon
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of General Internal Medicine and Palliative Care, Saint Michael's Hospital, Toronto, Ontario, Canada
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Krause C, Krause R, Krause R, Gomez N, Jafry Z, Dinh VA. Effectiveness of a 1-Hour Extended Focused Assessment With Sonography in Trauma Session in the Medical Student Surgery Clerkship. JOURNAL OF SURGICAL EDUCATION 2017; 74:968-974. [PMID: 28479071 DOI: 10.1016/j.jsurg.2017.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/15/2017] [Accepted: 03/24/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To demonstrate the effectiveness of incorporating 1 hour of ultrasound training on the extended focused assessment with sonography in trauma (eFAST) into the year-3 medical student surgical clerkship. DESIGN A prospective cohort study where participants served as self-controls. One hour of instruction in the eFAST examination, along with 3 required observed examinations, was incorporated into the year-3 surgery clerkship. Effectiveness of the training was evaluated by a preliminary and posttraining assessment. An online survey was used assessing comfort based on a 5-point Likert scale. An online quiz was used assessing knowledge, and a 2-part objective structured clinical examination (OSCE) was used assessing skill and speed. Participants also logged 3 eFAST examinations during the 10-week clerkship where they reported their comfort in performing and interpreting the eFAST on a 5-point Likert scale. Postassessment was held during the last week of the clerkship and included the same online quiz, survey, and 2-part OSCE. SETTING The study was performed at Loma Linda University and affiliated hospitals where surgical clerkship students rotate. PARTICIPANTS A total of 148 year-3 medical students completed the study. RESULTS All testing modalities showed improvement. The mean average of the OSCE improved from 46% ± 27% to 81% ± 18%. The percentage of participants able to perform the examination in less than 6 minutes increased from 18% ± 27% to 84% ± 36%. Participants' comfort level in recognizing eFAST pathology increased from a mean of 2.40 ± 0.94 to 3.55 ± 0.87 out of 5. Comfort in performing the eFAST examination improved from 2.81 ± 0.79 to 3.77 ± 0.68. Comfort in interpreting the eFAST examination improved from 2.88 ± 0.87 to 3.65 ± 0.72. CONCLUSIONS This study demonstrates that incorporating 1 hour of eFAST training into the general surgery clerkship is feasible and may lead to improved competency in performing and interpreting the eFAST examination.
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Affiliation(s)
- Cassandra Krause
- Department of Surgery, Loma Linda University, Loma Linda School of Medicine, Loma Linda, California.
| | - Reed Krause
- Department of Surgery, Loma Linda University, Loma Linda School of Medicine, Loma Linda, California
| | - Raymond Krause
- Department of Surgery, Loma Linda University, Loma Linda School of Medicine, Loma Linda, California
| | - Nephtali Gomez
- Department of Surgery, Loma Linda University, Loma Linda, California
| | - Zan Jafry
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California
| | - Vi Am Dinh
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California; Department of Medicine, Loma Linda University, Loma Linda, California
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Gradl-Dietsch G, Menon AK, Gürsel A, Götzenich A, Hatam N, Aljalloud A, Schrading S, Hölzl F, Knobe M. Basic echocardiography for undergraduate students: a comparison of different peer-teaching approaches. Eur J Trauma Emerg Surg 2017; 44:143-152. [PMID: 28717985 DOI: 10.1007/s00068-017-0819-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/11/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND The aim of this study was to assess the impact of different teaching interventions in a peer-teaching environment on basic echocardiography skills and to examine the influence of gender on learning outcomes. METHODS We randomly assigned 79 s year medical students (55 women, 24 men) to one of four groups: peer teaching (PT), peer teaching using Peyton's four-step approach (PPT), team based learning (TBL) and video-based learning (VBL). All groups received theoretical and practical hands-on training according to the different approaches. Using a pre-post-design we assessed differences in theoretical knowledge [multiple choice (MC) exam], practical skills (Objective Structured Practical Examination, OSPE) and evaluation results with respect to gender. RESULTS There was a significant gain in theoretical knowledge for all students. There were no relevant differences between the four groups regarding the MC exam and OSPE results. The majority of students achieved good or very good results. Acceptance of the peer-teaching concept was moderate and all students preferred medical experts to peer tutors even though the overall rating of the instructors was fairly good. Students in the Video group would have preferred a different training method. There was no significant effect of gender on evaluation results. CONCLUSIONS Using different peer-teaching concepts proved to be effective in teaching basic echocardiography. Gender does not seem to have an impact on effectiveness of the instructional approach. Qualitative analysis revealed limited acceptance of peer teaching and especially of video-based instruction.
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Affiliation(s)
- G Gradl-Dietsch
- Department of Orthopaedic Trauma, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany.,Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR Clinic, University of Essen, 21 Wickenburgstreet, 45147, Essen, Germany
| | - A K Menon
- Department Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany
| | - A Gürsel
- Department Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany
| | - A Götzenich
- Department Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany
| | - N Hatam
- Department Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany
| | - A Aljalloud
- Department Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany
| | - S Schrading
- Department of Radiology, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany
| | - F Hölzl
- Department of Interdisciplinary Emergency Medical Care, Medical Center Marienhöhe, 25 Mauerfeldchen, 52146, Würselen, Germany
| | - M Knobe
- Department of Orthopaedic Trauma, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany.
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Royer DF, Kessler R, Stowell JR. Evaluation of an innovative hands-on anatomy-centered ultrasound curriculum to supplement graduate gross anatomy education. ANATOMICAL SCIENCES EDUCATION 2017; 10:348-362. [PMID: 27870531 DOI: 10.1002/ase.1670] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/17/2016] [Accepted: 11/02/2016] [Indexed: 06/06/2023]
Abstract
Ultrasound (US) can enhance anatomy education, yet is incorporated into few non-medical anatomy programs. This study is the first to evaluate the impact of US training in gross anatomy for non-medical students in the United States. All 32 master's students enrolled in gross anatomy with the anatomy-centered ultrasound (ACUS) curriculum were recruited. Mean Likert ratings on pre- and post-course surveys (100% response rates) were compared to evaluate the effectiveness of the ACUS curriculum in developing US confidence, and gauge its impact on views of US. Post-course, students reported significantly higher (P < 0.001) mean confidence ratings in five US skills (pre-course versus post-course mean): obtaining scans (3.13 ±1.04 versus 4.03 ±0.78), optimizing images (2.78 ±1.07 versus 3.75 ±0.92), recognizing artifacts (2.94 ±0.95 versus 3.97 ±0.69), distinguishing tissue types (2.88 ±0.98 versus 4.09 ±0.69), and identifying structures (2.97 ±0.86 versus 4.03 ±0.59), demonstrating the success of the ACUS curriculum in students with limited prior experience. Views on the value of US to anatomy education and to students' future careers remained positive after the course. End-of-semester quiz performance (91% response rate) provided data on educational outcomes. The average score was 79%, with a 90% average on questions about distinguishing tissues/artifacts, demonstrating positive learning outcomes and retention. The anatomy-centered ultrasound curriculum significantly increased confidence with and knowledge of US among non-medical anatomy students with limited prior training. Non-medical students greatly value the contributions that US makes to anatomy education and to their future careers. It is feasible to enhance anatomy education outside of medical training by incorporating US. Anat Sci Educ 10: 348-362. © 2016 American Association of Anatomists.
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Affiliation(s)
- Danielle F Royer
- Department of Cell and Developmental Biology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ross Kessler
- Department of Emergency Medicine, University of Michigan Health System, Ann Arbor, Michigan
| | - Jeffrey R Stowell
- Department of Emergency Medicine, Maricopa Integrated Health System, Phoenix, Arizona
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Klima S, Hepp P, Löffler S, Cornwall J, Hammer N. A novel phased-concept course for the delivery of anatomy and orthopedics training in medical education. ANATOMICAL SCIENCES EDUCATION 2017; 10:372-382. [PMID: 28002644 DOI: 10.1002/ase.1675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 11/17/2016] [Accepted: 11/19/2016] [Indexed: 06/06/2023]
Abstract
Integration of anatomy and clinical teaching is a theoretical ideal, yet there is a worldwide paucity of such amalgamation. These teaching models provide support for medical trainees, an important element in Germany where orthopedic intern numbers have declined and anecdotal evidence suggests disinterest in orthopedics. The aim of the study was to develop an integrated anatomy-surgical course for undergraduate medical training, assess the model developed, and explore how medical students perceive orthopedics as a career. The course was to deliver medical anatomy and clinical orthopedic training, focusing on interdisciplinary teaching and learning, vertical integration of clinical knowledge and skills, and professional interaction. Survey evaluation of the course and students' perceptions of orthopedic careers was performed, including Likert-type responses rating variables of interest. A phased-concept program of five courses, each optional and under one-week in duration, was developed parallel to the undergraduate medical program. Delivered by anatomists and surgeons, courses included biomechanics, advanced dissection, surgical approaches, casts and implants, and sports medicine. Course data indicate positive support for course format, stimulation of interest, and high clinical relevance. Students are generally interested in surgery, and identify hierarchy, lawsuits, bureaucracy and physical stress as barriers to orthopedic careers. This novel phased-concept successfully delivers combined anatomy and surgery training in a vertically-integrated format while addressing students' clinical and professional skills. The format facilitates an appreciation of potential career options in orthopedics, while fostering professional skills during medical training. Barriers to careers in orthopedics can now be addressed in future courses. Anat Sci Educ 10: 372-382. © 2016 American Association of Anatomists.
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Affiliation(s)
- Stefan Klima
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany
| | - Pierre Hepp
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany
| | - Sabine Löffler
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Jon Cornwall
- Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand
| | - Niels Hammer
- Department of Anatomy, University of Otago, Dunedin, New Zealand
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Kobal SL, Lior Y, Ben-Sasson A, Liel-Cohen N, Galante O, Fuchs L. The feasibility and efficacy of implementing a focused cardiac ultrasound course into a medical school curriculum. BMC MEDICAL EDUCATION 2017; 17:94. [PMID: 28558692 PMCID: PMC5450418 DOI: 10.1186/s12909-017-0928-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 05/11/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Teaching cardiac ultrasound to medical students in a brief course is a challenge. We aimed to evaluate the feasibility of teaching large groups of medical students the acquisition and interpretation of cardiac ultrasound images using a pocket ultrasound device (PUD) in a short, specially designed course. METHODS Thirty-one medical students in their first clinical year participated in the study. All were novices in the use of cardiac ultrasound. The training consisted of 4 hours of frontal lectures and 4 hours of hands-on training. Students were encouraged to use PUD for individual practice. Finally, the students' proficiency in the acquisition of ultrasound images and their ability to recognize normal and pathological states were evaluated. RESULTS Sixteen of 27 (59%) students were able to demonstrate all main ultrasound views (parasternal, apical, and subcostal views) in a six-minute test. The most obtainable view was the parasternal long-axis view (89%) and the least obtainable was the subcostal view (58%). Ninety-seven percent of students correctly differentiated normal from severely reduced left ventricular function, 100% correctly differentiated a normal right ventricle from a severely hypokinetic one, 100% correctly differentiated a normal mitral valve from a rheumatic one, and 88% correctly differentiated a normal aortic valve from a calcified one, while 95% of them correctly identified the presence of pericardial effusion. CONCLUSIONS Training of medical students in cardiac ultrasound during the first clinical year using a short, focused course is feasible and enables students with modest ability to acquire the main transthoracic ultrasound views and gain proficiency in the diagnosis of a limited number of cardiac pathologies.
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Affiliation(s)
- Sergio L Kobal
- Cardiology Department, Soroka University Medical Center, Beer-Sheva, Israel.
| | - Yotam Lior
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Alon Ben-Sasson
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Noah Liel-Cohen
- Cardiology Department, Soroka University Medical Center, Beer-Sheva, Israel
| | - Ori Galante
- Medical Intensive Care Unit, all at Soroka University Medical Center and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lior Fuchs
- Medical Intensive Care Unit, all at Soroka University Medical Center and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Arias Felipe A, Doménech García J, Sánchez Los Arcos I, Luordo D, García Sánchez FJ, Villanueva Martínez J, Forero de la Sotilla A, Villena Garrido V, Torres Macho J, García de Casasola Sánchez G. Teaching the basics of echocardiography in the undergraduate: Students as mentors. Rev Clin Esp 2017; 217:245-251. [PMID: 28318521 DOI: 10.1016/j.rce.2017.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/21/2017] [Accepted: 02/05/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To analyse the ability of medical students to incorporate the practical teaching of basic echocardiography planes using a peer mentoring design. METHODOLOGY Thirty-six medical students previously trained in obtaining echocardiography planes (mentors) taught the other 5th-year students (n=126). The teaching methodology included three stages: theory (online course), basic training (three 15h sessions of practical experience in ultrasound and at least 20 echocardiographic studies per mentor) and objective structured clinical assessment (OSCA), which scored the appropriateness of the basic ultrasound planes and the correct identification of 16 cardiac structures. RESULTS The students' weighted mean score in the OSCA was 8.66±1.98 points (out of 10). Only 10 students (8.4%) scored less than 5, and 15 (12.6%) scored less than 7. Fifty students (42%) scored 10 points. The most easily identified structure was the left ventricle in the short-axis parasternal plane, with 89.9% of correct answers. The most poorly identified structure was the mitral valve in the subxiphoid plane, with 69.7% of correct answers. CONCLUSIONS Peer mentoring-based teaching achieves an appropriate level of training in obtaining basic echocardiography planes. The training period is relatively short. The peer mentoring system can facilitate the implementation of teaching on basic aspects of ultrasound to a large number of undergraduate students.
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Affiliation(s)
- A Arias Felipe
- Facultad de Medicina, Universidad Complutense, Madrid, España
| | | | | | - D Luordo
- Facultad de Medicina, Universidad Complutense, Madrid, España; Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna, Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, España
| | - F J García Sánchez
- Facultad de Medicina, Universidad Complutense, Madrid, España; Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna, Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, España
| | - J Villanueva Martínez
- Facultad de Medicina, Universidad Complutense, Madrid, España; Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna, Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, España
| | - A Forero de la Sotilla
- Facultad de Medicina, Universidad Complutense, Madrid, España; Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna, Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, España
| | - V Villena Garrido
- Facultad de Medicina, Universidad Complutense, Madrid, España; Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España; CIBERES, España
| | - J Torres Macho
- Facultad de Medicina, Universidad Complutense, Madrid, España; Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna, Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, España
| | - G García de Casasola Sánchez
- Facultad de Medicina, Universidad Complutense, Madrid, España; Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna, Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, España.
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Jamniczky HA, Cotton D, Paget M, Ramji Q, Lenz R, McLaughlin K, Coderre S, Ma IWY. Cognitive load imposed by ultrasound-facilitated teaching does not adversely affect gross anatomy learning outcomes. ANATOMICAL SCIENCES EDUCATION 2017; 10:144-151. [PMID: 27533319 DOI: 10.1002/ase.1642] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 05/14/2023]
Abstract
Ultrasonography is increasingly used in medical education, but its impact on learning outcomes is unclear. Adding ultrasound may facilitate learning, but may also potentially overwhelm novice learners. Based upon the framework of cognitive load theory, this study seeks to evaluate the relationship between cognitive load associated with using ultrasound and learning outcomes. The use of ultrasound was hypothesized to facilitate learning in anatomy for 161 novice first-year medical students. Using linear regression analyses, the relationship between reported cognitive load on using ultrasound and learning outcomes as measured by anatomy laboratory examination scores four weeks after ultrasound-guided anatomy training was evaluated in consenting students. Second anatomy examination scores of students who were taught anatomy with ultrasound were compared with historical controls (those not taught with ultrasound). Ultrasound's perceived utility for learning was measured on a five-point scale. Cognitive load on using ultrasound was measured on a nine-point scale. Primary outcome was the laboratory examination score (60 questions). Learners found ultrasound useful for learning. Weighted factor score on "image interpretation" was negatively, but insignificantly, associated with examination scores [F (1,135) = 0.28, beta = -0.22; P = 0.61]. Weighted factor score on "basic knobology" was positively and insignificantly associated with scores; [F (1,138) = 0.27, beta = 0.42; P = 0.60]. Cohorts exposed to ultrasound had significantly higher scores than historical controls (82.4% ± SD 8.6% vs. 78.8% ± 8.5%, Cohen's d = 0.41, P < 0.001). Using ultrasound to teach anatomy does not negatively impact learning and may improve learning outcomes. Anat Sci Educ 10: 144-151. © 2016 American Association of Anatomists.
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Affiliation(s)
- Heather A Jamniczky
- Department of Cell Biology and Anatomy, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darrel Cotton
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael Paget
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Qahir Ramji
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ryan Lenz
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kevin McLaughlin
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sylvain Coderre
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Irene W Y Ma
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Ward of the 21st Century (W21C), University of Calgary/Calgary Zone of Alberta Health Services, Calgary, Alberta, Canada
- Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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So S, Patel RM, Orebaugh SL. Ultrasound imaging in medical student education: Impact on learning anatomy and physical diagnosis. ANATOMICAL SCIENCES EDUCATION 2017; 10:176-189. [PMID: 27286419 DOI: 10.1002/ase.1630] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 05/18/2016] [Accepted: 05/18/2016] [Indexed: 05/28/2023]
Abstract
Ultrasound use has expanded dramatically among the medical specialties for diagnostic and interventional purposes, due to its affordability, portability, and practicality. This imaging modality, which permits real-time visualization of anatomic structures and relationships in vivo, holds potential for pre-clinical instruction of students in anatomy and physical diagnosis, as well as providing a bridge to the eventual use of bedside ultrasound by clinicians to assess patients and guide invasive procedures. In many studies, but not all, improved understanding of anatomy has been demonstrated, and in others, improved accuracy in selected aspects of physical diagnosis is evident. Most students have expressed a highly favorable impression of this technology for anatomy education when surveyed. Logistic issues or obstacles to the integration of ultrasound imaging into anatomy teaching appear to be readily overcome. The enthusiasm of students and anatomists for teaching with ultrasound has led to widespread implementation of ultrasound-based teaching initiatives in medical schools the world over, including some with integration throughout the entire curriculum; a trend that likely will continue to grow. Anat Sci Educ 10: 176-189. © 2016 American Association of Anatomists.
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Affiliation(s)
- Sokpoleak So
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rita M Patel
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven L Orebaugh
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Garcia-Casasola G, Sánchez FJG, Luordo D, Zapata DF, Frías MC, Garrido VV, Martínez JV, de la Sotilla AF, Rojo JMC, Macho JT. Basic Abdominal Point-of-Care Ultrasound Training in the Undergraduate: Students as Mentors. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2483-2489. [PMID: 27738292 DOI: 10.7863/ultra.15.11068] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/28/2016] [Indexed: 05/18/2023]
Abstract
OBJECTIVES To analyze the ability of medical students to be integrated in the teaching of basic abdominal ultrasound using a peer-mentoring design. METHODS Thirty medical students previously trained in basic abdominal ultrasound (mentors) had to teach all fourth-year students (n = 136) from a single academic year the same training they had received. There were 3 stages to the ultrasound teaching: theoretical (online course); basic training (3 practical sessions in which students were guaranteed to have had a minimum of 15 hours of practical experience with ultrasound and performed at least 20 basic abdominal ultrasound studies); and evaluation (objective structured clinical examination in which students had to obtain the basic abdominal views and to identify 17 structures). RESULTS The mean grade ± SD obtained was 8.71 ± 1.53 of a possible 10 points. Only 2 students (1.56%) obtained a grade lower than 5, and 14 students (10.86%) obtained a grade lower than 7. A total of 33 students (25.5%) achieved the maximum grade. The structures most easily identified were the liver, the right kidney, and the urinary bladder, with 97.7% of correct answers. Students obtained the poorest results when trying to identify the left and right cardiac cavities (subxiphoid view), with only 53.5% and 55.8% of correct answers, respectively. CONCLUSIONS Teaching based on peer mentoring achieved an adequate level of training in basic abdominal ultrasound. The students acquired these skills in a relatively short training period. These results suggest that peer mentoring can facilitate the large-scale implementation of ultrasound teaching in undergraduate students.
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Affiliation(s)
- Gonzalo Garcia-Casasola
- Internal Medicine Unit, Infanta Cristina Teaching Hospital, Madrid, Spain
- Complutense University, Madrid, Spain
- Clinical Ultrasound Working Group, Spanish Society of Internal Medicine, Madrid, Spain
| | - Francisco Javier García Sánchez
- Internal Medicine Unit, Infanta Cristina Teaching Hospital, Madrid, Spain
- Complutense University, Madrid, Spain
- Clinical Ultrasound Working Group, Spanish Society of Internal Medicine, Madrid, Spain
| | - Davide Luordo
- School of Medicine, Complutense University, Madrid, Spain
| | | | | | - Victoria Villena Garrido
- Complutense University, Madrid, Spain
- Pulmunology Unit, 12 de Octubre Teaching Hospital, Madrid, Spain
| | - Javier Villanueva Martínez
- Internal Medicine Unit, Infanta Cristina Teaching Hospital, Madrid, Spain
- Complutense University, Madrid, Spain
- Clinical Ultrasound Working Group, Spanish Society of Internal Medicine, Madrid, Spain
| | - Alberto Forero de la Sotilla
- Internal Medicine Unit, Infanta Cristina Teaching Hospital, Madrid, Spain
- Complutense University, Madrid, Spain
- Clinical Ultrasound Working Group, Spanish Society of Internal Medicine, Madrid, Spain
| | - José Manuel Casas Rojo
- Internal Medicine Unit, Infanta Cristina Teaching Hospital, Madrid, Spain
- Complutense University, Madrid, Spain
- Clinical Ultrasound Working Group, Spanish Society of Internal Medicine, Madrid, Spain
| | - Juan Torres Macho
- Internal Medicine Unit, Infanta Cristina Teaching Hospital, Madrid, Spain
- Complutense University, Madrid, Spain
- Clinical Ultrasound Working Group, Spanish Society of Internal Medicine, Madrid, Spain
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Sammaraiee Y, Mistry RD, Lim J, Wittner L, Deepak S, Lim G. Peer-assisted learning: filling the gaps in basic science education for preclinical medical students. ADVANCES IN PHYSIOLOGY EDUCATION 2016; 40:297-303. [PMID: 27445276 DOI: 10.1152/advan.00017.2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/04/2016] [Indexed: 05/12/2023]
Abstract
In contrast to peer-assisted learning (PAL) in clinical training, there is scant literature on the efficacy of PAL during basic medical sciences teaching for preclinical students. A group of senior medical students aimed to design and deliver clinically oriented small-group tutorials after every module in the preclinical curriculum at a United Kingdom medical school. Twenty tutorials were delivered by senior students throughout the year to first- and second-year students. A baseline questionnaire was delivered to inform the development of the program followed by an end-point questionnaire the next year (n = 122). Quizzes were administered before and after five separate tutorials to assess changes in mean student scores. Additionally, each tutorial was evaluated via a questionnaire for participants (n = 949). All five posttutorial quizzes showed a significant improvement in mean student score (P < 0.05). Questionnaires showed students found the program to be relevant and useful for revision purposes and appreciated how tutorials contextualized basic science to clinical medicine. Students appreciated the interactive nature of the sessions and found receiving personalized feedback about their learning and consolidating information with someone familiar with the material to be useful. With the inclusion of the program, students felt there were now an adequate number of tutorials during the year. In conclusion, this study shows that senior medical students can design and deliver a program that adds value to the mostly lecture-based formal preclinical curriculum. We hope that our study can prompt further work to explore the effect of PAL on the teaching of basic sciences during preclinical studies.
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Affiliation(s)
- Yezen Sammaraiee
- University College London Medical School, London, United Kingdom
| | - Ravi D Mistry
- University College London Medical School, London, United Kingdom
| | - Julian Lim
- University College London Medical School, London, United Kingdom
| | - Liora Wittner
- University College London Medical School, London, United Kingdom
| | - Shantal Deepak
- University College London Medical School, London, United Kingdom
| | - Gareth Lim
- University College London Medical School, London, United Kingdom
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Hamza A, Solomayer EF, Takacs Z, Juhasz-Boes I, Joukhadar R, Radosa JC, Mavrova R, Marc W, Volk T, Meyberg-Solomayer G. Introduction of basic obstetrical ultrasound screening in undergraduate medical education. Arch Gynecol Obstet 2016; 294:479-85. [DOI: 10.1007/s00404-015-4002-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
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Fu JY, Krause C, Krause R, Mccoy J, Schindler A, Udrea DS, Villarreal LA, Jafry Z, Am Dinh V. Integration of Point-of-Care Ultrasound Training into Undergraduate Medical Curricula--A Perspective from Medical Students. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2016; 3:10.4137_JMECD.S38240. [PMID: 29349317 PMCID: PMC5736279 DOI: 10.4137/jmecd.s38240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 05/16/2023]
Abstract
The utility of point of care ultrasound training during medical school is becoming more and more evident. At the Loma Linda University School of Medicine, we have formally integrated ultrasound education into the curriculum of all four years. Exposure begins in the first few months of Year 1 and takes form in a variety of educational mediums through Year 4. Whether students receive training through mandatory sessions during physical diagnosis courses or extracurricular workshops provided through the Ultrasound Interest Group--the experience equips learners of at all different skill levels with the confidence to apply what they have learned to patient care. The successful integration of ultrasound training into the medical curriculum can be attributed to progressive administration, devoted faculty and eager students. The perspective of medical students during the integration process is described in this paper.
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Affiliation(s)
- Jasmine Y. Fu
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Cassie Krause
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Reed Krause
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Josh Mccoy
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - April Schindler
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Daniel S. Udrea
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | | | - Zan Jafry
- Department of Emergency Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Vi Am Dinh
- Department of Emergency Medicine, Loma Linda University, Loma Linda, CA, USA
- Department of Medicine, Division of Pulmonary and Critical Care, Loma Linda University, Loma Linda, CA, USA
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Ahn JS, French AJ, Thiessen MEW, Browne V, Deutchman M, Guiton G, Madigosky W, Kendall JL. Using Ultrasound to Enhance Medical Students' Femoral Vascular Physical Examination Skills. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:1771-6. [PMID: 26324754 DOI: 10.7863/ultra.15.14.11014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 12/29/2014] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To determine whether the addition of ultrasound to traditional physical examination instruction improves junior medical students' abilities to locate the femoral pulse. METHODS Initially, 150 second-year medical students were taught the femoral pulse examination using traditional bedside teaching on standardized patients and online didactic videos. Students were then randomized into 2 groups: group 1 received ultrasound training first and then completed the standardized examination; and group 2 performed the standardized examination first and then received ultrasound training. On the standardized patients, the femoral artery was marked with invisible ink before the sessions using ultrasound. Compared to these markers, students were then evaluated on the accuracy of femoral artery pulse palpation and the estimated location of the femoral vein. All students completed a self-assessment survey after the ultrasound sessions. RESULTS Ultrasound training improved the students' ability to palpate the femoral pulse (P= .02). However, ultrasound did not facilitate correct estimation of the femoral vein's anatomic location (P = .09). Confidence levels in localizing the femoral artery and vein were equal between groups at baseline, and both increased after the ultrasound sessions. CONCLUSIONS The addition of ultrasound teaching to traditional physical examination instruction enhanced medical student competency and confidence with the femoral vascular examination. However, understanding of anatomy may require emphasis on precourse didactic material, but further study is required.
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Affiliation(s)
- Justin S Ahn
- Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA
| | - Andrew J French
- Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA
| | - Molly E W Thiessen
- Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA
| | - Vaughn Browne
- Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA
| | - Mark Deutchman
- Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA
| | - Gretchen Guiton
- Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA
| | - Wendy Madigosky
- Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA
| | - John L Kendall
- Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada (J.S.A.); Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA (A.J.F., M.E.W.T., J.L.K.); and Departments of Emergency Medicine (A.J.F., M.E.W.T., V.B., J.L.K.), Family Medicine (M.D., W.M.), and Medicine (G.G.), University of Colorado School of Medicine, Aurora, Colorado USA.
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Panchal A, Bahner D. Teaching clinical ultrasonography to undergraduates. A need for systematic training programs. Rev Clin Esp 2015; 215:219-20. [DOI: 10.1016/j.rce.2015.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 01/11/2015] [Indexed: 11/27/2022]
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García de Casasola Sánchez G, González Peinado D, Sánchez Gollarte A, Muñoz Aceituno E, Peña Vázquez I, Torres Macho J. Teaching of clinical ultrasonography to undergraduates: Students as mentors. Rev Clin Esp 2015. [DOI: 10.1016/j.rceng.2014.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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García de Casasola Sánchez G, González Peinado D, Sánchez Gollarte A, Muñoz Aceituno E, Peña Vázquez I, Torres Macho J. Teaching of clinical ultrasonography to undergraduates: students as mentors. Rev Clin Esp 2015; 215:211-6. [PMID: 25583252 DOI: 10.1016/j.rce.2014.11.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 11/22/2014] [Accepted: 11/30/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ultrasonography is a highly useful diagnostic technique that supplements traditional physical examinations. OBJECTIVE To demonstrate that students previously trained in clinical ultrasonography are capable of instructing other students in a similar manner in a short period of time ("peer mentoring"). METHODOLOGY Five medical students in their 5th year, trained in abdominal and cardiac ultrasonography by physicians with experience, instructed 24 other students in the same procedure. The training consisted of an online theoretical course and practical training lasting about 12hours, in which each student had to perform 6 basic abdominal planes and 4 basic cardiac planes on 20 healthy volunteers. Subsequently, the students underwent an objective assessment test on healthy models performed by expert physicians in clinical ultrasonography. RESULTS The students managed to correctly identify 90.2% of the basic abdominal planes, except for the left coronal (spleen and left kidney) and subcostal (gallbladder) planes, with slightly lower success rates of 82.5% and 80%, respectively. Due to the greater difficulty of obtaining cardiac planes, the success rate was lower: 70.3%, in the subxiphoid, short parasternal and four chamber planes. The cardiac plane with the fewest errors in identification was the parasternal long plane (90% success). We observed no statistically significant differences between the results (teaching capacity) of the various mentors. CONCLUSION Medical students are capable of instructing other colleagues (peer mentoring) on the basic aspects of abdominal and cardiac ultrasonography after a relatively short training period.
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Affiliation(s)
- G García de Casasola Sánchez
- Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, España; Facultad de Medicina, Universidad Complutense, Madrid, España; Grupo de Trabajo de Ecografía Clínica, Sociedad Española de Medicina Interna.
| | | | | | | | - I Peña Vázquez
- Facultad de Medicina, Universidad Complutense, Madrid, España
| | - J Torres Macho
- Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, España; Facultad de Medicina, Universidad Complutense, Madrid, España; Grupo de Trabajo de Ecografía Clínica, Sociedad Española de Medicina Interna
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Patten D. Using ultrasound to teach anatomy in the undergraduate medical curriculum: an evaluation of the experiences of tutors and medical students. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2014; 23:18-28. [PMID: 27433233 DOI: 10.1177/1742271x14542173] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper describes the experiences of staff and students at two UK medical schools, who introduced portable ultrasound (PU) as an imaging technology to deliver clinical anatomy teaching and to aid skill development in interpretation of cross-sectional anatomy (CSA). A sonographer contributed to curriculum design and teaching, but mostly anatomy tutors delivered the teaching. This case study method evaluates staff and student perspectives on the ultrasound-based anatomy teaching. Quantitative data and qualitative data were collected and analysed. Staff were positive about the experience. They described their expectations for students and solutions for practical issues regarding the teaching, but were concerned about their competency in scanning and wanted bespoke training for sonoanatomy teaching. Curriculum development was accelerated through engagement with a sonographer and an ultrasound champion. Students were extremely positive about their experience; they valued the expertise of a sonographer who taught more challenging sonoanatomy, but were equally positive regarding teaching sessions led by well-trained anatomy tutors who taught more simple sonoanatomy. Students affirmed most tutors' expectations that ultrasound could reinforce existing anatomical knowledge, added clinical contextualisation, but not that use of ultrasound (US) assisted in interpreting CSA. Students valued the introduction to the technology and found sonoimage interpretation challenging, but not insurmountable. Students wanted more instruction on ultrasound physics, an expansion of ultrasound curriculum, with smaller groups and opportunities to scan volunteers. These data support the case for the use of PU to deliver anatomy teaching and to prime medical students for later clinical encounters with PU.
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Affiliation(s)
- Debra Patten
- Medical Education, Newcastle University, Framlington Place, Newcastle, NE2 4HH, UK
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