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Robertson T, Meyer K, Kerr MS, Gibson J, Bradley L, Reeves R, Handler E. Ultrasound Incorporation in Gross Anatomy Labs in a Master of Medical Sciences Program: A Mixed-Methods Analysis of Student Performance and Perception. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:999-1011. [PMID: 38369775 DOI: 10.1002/jum.16427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES Teaching ultrasound imaging is on the rise in undergraduate medical anatomy education. However, there is little research exploring the use of ultrasound in preparatory graduate programs. The purpose of this study is to identify the effects of ultrasound imaging inclusion in a graduate gross anatomy course. METHODS Master of Medical Sciences students were enrolled in a prosection-based anatomy course that included pinned cadaver stations and an ultrasound station. Using ultrasound, teaching assistants imaged volunteers demonstrating anatomical structures students previously learned at cadaver stations. Students answered one ultrasound image question on each practical exam and were asked to participate in a pre- and post-course survey. Student practical and lecture exam scores and final course grades from the 2022 cohort were compared to a historical control cohort from 2021 via statistical analysis, including a survey administered to the 2022 cohort. RESULTS Two hundred students from the 2021 cohort and 164 students from the 2022 cohort participated in this study. Students in the 2022 cohort had significantly higher scores in 1 of the 5 practical exams (P < .05, d = .289), and 2 of the 5 written exams (P < .05, d = .207), (P < .05, d = .311). Survey data revealed increased (P < .05, d = 1.203) learning outcome achievement from pre-survey to post-survey in the intervention cohort. Students who correctly answered the ultrasound question performed significantly better on practical's 3 (P < .05) and 4 (P < .05) than those who missed the ultrasound question. CONCLUSIONS These findings suggest that ultrasound imaging in a cadaver lab is beneficial to graduate students' learning and understanding of gross anatomy.
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Affiliation(s)
- Taylor Robertson
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kimberly Meyer
- School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Marcel Satsky Kerr
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - John Gibson
- Department of Family Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Libby Bradley
- Department of Radiology, Division of Anatomy, Michigan State University, Lansing, MI, USA
| | - Rustin Reeves
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Emma Handler
- Department of Anatomy and Cell Biology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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Pless A, Hari R, Harris M. Why are medical students so motivated to learn ultrasound skills? A qualitative study. BMC MEDICAL EDUCATION 2024; 24:458. [PMID: 38671409 PMCID: PMC11046757 DOI: 10.1186/s12909-024-05420-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND The introduction of ultrasound (US) courses into medical undergraduate courses is usually met with a particularly high level of student motivation. The reasons for this are unclear. The aim of this study was to investigate the factors that contribute to undergraduate medical students' motivation to learn US skills. Understanding what motivates students to learn US will inform the efforts of faculty to foster students' motivation to learn. METHODS We carried out in-depth semi-structured one-to-one interviews with medical students participating in an optional US course at two Swiss universities. The interview guide consisted of 10 main questions. The content was informed by experts in the field of medical education and US, as well as by a literature review of motivation theories for learning, in particular by self-determination theory (SDT). SDT was used to guide the development of the interview guide and to reflect on the resulting themes in the discussion section. The interview guide was piloted with two medical students. The interviews lasted an average of 45 min and were audio recorded and transcribed. Thematic analysis was used to analyse the data. RESULTS Fourteen undergraduate medical students in their preclinical (year 3) and clinical studies (years 4 and 5) elaborated on a wide range of reasons for their high motivation to learn US. They were motivated for US training because of the positive nimbus of the US modality, emphasising the advantages of visualisation. Students acknowledged the potential professional benefits of learning US and described it as a fun, exciting group activity. CONCLUSIONS The four themes we found in our analysis can all be related to the three universal needs described in SDT. The strong focus on the visual aspect and the positive nimbus of the modality goes beyond that and reflects the visuo-centric Zeitgeist, which claims the superiority of visual information over other data. Educators should be aware that motivation to learn is affected by the Zeitgeist and ensuing preconceptions, such as the perception of the positive nimbus surrounding a topic. Other key elements that can be implemented to motivate students are just-in-time feedback, enabling group experiences and creating awareness of the clinical relevance of learning content.
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Affiliation(s)
- Anina Pless
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
| | - Roman Hari
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Michael Harris
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
- College of Medicine & Health, University of Exeter Medical School, Exeter, UK
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Schnure N, Elfadil MM, Chan W, Baston C, Shofer F, Panebianco N. Trends in Point of Care Ultrasound Familiarity Among Undergraduate Medical Clerkship Educators. POCUS JOURNAL 2024; 9:80-86. [PMID: 38681158 PMCID: PMC11044932 DOI: 10.24908/pocus.v9i1.16678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVES Despite growing use of point of care ultrasound (POCUS), there remains a paucity of data about familiarity with POCUS among educators who dictate curricular content in undergraduate medical education. This paper aims to longitudinally characterize the level of comfort and frequency of POCUS use among faculty involved in undergraduate clerkship education. METHODS A web-based cross-sectional survey assessing comfort, frequency of use, and awareness of indications for POCUS among faculty involved in Internal Medicine, Family Medicine, and Surgery undergraduate clerkship education in a single urban academic medical center in 2016 and again in 2022. RESULTS A total of 45 responses from 2016 and 30 responses from 2022 are included. The percentage of faculty "not comfortable" with performing POCUS decreased from 78% to 46%, although the overall change in comfort was not statistically significant. Comfort interpreting POCUS images, frequency of POCUS use, and familiarity with the clinical applications of POCUS all improved. Faculty identified multiple barriers to more frequent POCUS use. CONCLUSIONS Over a six-year period at one urban, academic medical center, comfort with POCUS and frequency of use have increased slightly but remain low among core faculty responsible for clerkship education. There are still large gaps in knowledge and very few faculty regularly use POCUS, which can be attributed to multiple different barriers.
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Affiliation(s)
- Nilan Schnure
- Section of Hospital Medicine, University of PennsylvaniaPhiladelphia, PAUSA
| | | | - Wilma Chan
- Division of Emergency Ultrasound, Department of Emergency Medicine, University of PennsylvaniaPhiladelphia, PAUSA
| | - Cameron Baston
- Department of Medicine, Perelman School of Medicine, University of PennsylvaniaPhiladelphia, PAUSA
| | - Frances Shofer
- Division of Emergency Ultrasound, Department of Emergency Medicine, University of PennsylvaniaPhiladelphia, PAUSA
| | - Nova Panebianco
- Division of Emergency Ultrasound, Department of Emergency Medicine, University of PennsylvaniaPhiladelphia, PAUSA
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Nassar SM, Almubrik SA, Alyahya L, Alshalan M, Alhashem HM. Perception, Knowledge, Indications, and Future Prospects of Point-of-Care Ultrasound Among Medical Students in Saudi Arabia. Cureus 2024; 16:e57704. [PMID: 38586231 PMCID: PMC10998434 DOI: 10.7759/cureus.57704] [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] [Accepted: 04/06/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Point-of-care ultrasound (POCUS) has become integral across medical specialties globally, addressing clinical queries, guiding procedures, and bridging the gap between physical examination and advanced imaging. Early ultrasound training for medical students enhances clinical decision-making and reduces diagnostic errors. Aims To evaluate the knowledge and attitude of senior medical students towards POCUS and to assess knowledge gaps and difficulties encountered by senior medical students to assist in the development of future curricula. Methodology This is an observational, cross-sectional approach to evaluate knowledge, attitude, and practice of POCUS among senior medical students in the Kingdom of Saudi Arabia. The study was conducted from January to September 2023. An electronic questionnaire was distributed through online platforms utilizing medical school databases across various regions. The survey encompassed sociodemographics, training methods, diagnostic indications, and participants' self-reported proficiency and attitudes toward POCUS. The data was chiefly collected using the Likert scale. Descriptive statistics were used to describe the quantitative and categorical variables. Bivariate and multivariate analyses were used to examine correlations. Results A total of 359 senior medical students completed the survey. Most responders were females (57.9%) with the predominating age group being ≤ 24 years (83.6%). The students predominantly were from the Central region of Saudi Arabia (75.5%). Ultrasound training varied among responders; 31.5% received formal courses (median duration: two hours) and 23.4% informal courses (median duration: four hours). Around 17.3% practiced POCUS self-teaching (median duration: four hours). A total of 3.6% had formal POCUS accreditation. A gargantuan 82.2% never used POCUS in their attached hospital for a variety of reasons. Multivariable logistic binary regression analysis showed a positive correlation between students' self-teaching of POCUS and their perceived difficulty performing an ultrasound examination for patients in daily practice. Discussion A comparable study was done at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in 2022 surveying 229 senior medical students by Rajendram et al. In their study, 21.4% completed formal courses and 12.7% took informal courses. While many students in our study were not exposed to POCUS (82.2%), KSAU-HS reported a higher percentage reaching 94.8%. A study by Russel et al. demonstrated more than half of 154 surveyed medical schools in the United States have implemented POCUS into their students' curriculum. Conclusion POCUS stands as a valuable skill that can enhance the educational journey of undergraduate medical students. Considering that a significant number of participants haven't yet taken formal medical school courses suggests a lack of awareness about its significance in the medical field. Offering additional courses with practical components could enhance the proficiency, confidence, and outlook of medical students toward POCUS.
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Affiliation(s)
- Saeed M Nassar
- Department of Emergency Medicine, King Saud University Medical City, Riyadh, SAU
| | - Sarah A Almubrik
- Department of Emergency Medicine, King Saud University Medical City, Riyadh, SAU
| | - Lama Alyahya
- Department of Emergency Medicine, King Saud University, Riyadh, SAU
| | | | - Hussain M Alhashem
- Department of Emergency Medicine, King Saud University Medical City, Riyadh, SAU
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Allen R, Paz-Soldan G, Wilson M, Huang J, Omer T, Mailhot T, Sajed D. Incidental Renal Cysts Found by Point-of-Care Ultrasound: A Retrospective Chart Review. J Emerg Med 2024:S0736-4679(24)00082-9. [PMID: 38816260 DOI: 10.1016/j.jemermed.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/09/2024] [Accepted: 03/06/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Incidental findings are unrelated to a patient's complaint, found on diagnostic imaging, such as point-of-care ultrasound (POCUS). Incidental findings represent potential harms to patients and may lead to increased patient anxiety and health care costs related to downstream testing and surveillance. STUDY OBJECTIVES In this study, we aimed to calculate the rate of incidental renal cysts found by POCUS. Further, we hoped to describe how emergency physicians relay the findings to patients. Lastly, we hoped to examine if patients suffered harms in the 12 months following identification of an incidental renal cyst. METHODS From our single-center, academic emergency department (ED), we reviewed renal POCUS images from 1000 consecutive adult ED patients to determine if there was a renal cyst. Next, we performed manual chart review to determine if patients were informed of the incidental renal cyst or suffered any patient harms. RESULTS We found the prevalence of renal cysts to be 6.5% (95% confidence interval: 4.9%-8.4%). Those with cysts were more likely to be older compared to those without (63 ± 14 vs. 49 ± 15 years of age). Only 8% of patients had evidence that they were informed of their incidental renal cyst. No patients received a biopsy or were diagnosed with renal cell carcinoma or polycystic kidney disease. CONCLUSION Incidental renal cysts are common and are more likely to be found in older adults. In our study, physicians infrequently informed patients of their incidental finding.
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Affiliation(s)
- Robert Allen
- Department of Emergency Medicine, Los Angeles General Medical Center, Los Angeles, California.
| | - Gonzalo Paz-Soldan
- Department of Emergency Medicine, Los Angeles General Medical Center, Los Angeles, California
| | - Melissa Wilson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles General Medical Center, Los Angeles, California
| | - Jennifer Huang
- Department of Emergency Medicine, Los Angeles General Medical Center, Los Angeles, California
| | - Talib Omer
- Department of Emergency Medicine, Los Angeles General Medical Center, Los Angeles, California
| | - Thomas Mailhot
- Department of Emergency Medicine, Los Angeles General Medical Center, Los Angeles, California
| | - Dana Sajed
- Department of Emergency Medicine, Los Angeles General Medical Center, Los Angeles, California
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Dupriez F, Hall A, Diop T, Collard A, de Castro BR, Smets F, Penaloza A, Vanpee D. Point-of-Care Ultrasound training in undergraduate education in the European Union: current situation and perspectives. Ultrasound J 2024; 16:9. [PMID: 38349580 PMCID: PMC10864236 DOI: 10.1186/s13089-024-00361-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Given the widespread use of Point-of-Care UltraSound (PoCUS) in clinical practice, with ultrasound machines becoming more portable and affordable, recommendations and position statements from ultrasound societies now promote teaching PoCUS in the undergraduate curriculum. Nevertheless, surveys about PoCUS teaching in European medical schools are lacking. This survey aims to overview the current and future undergraduate PoCUS courses in the European Union (EU). RESULTS A questionnaire was sent to medical schools in 26 of the 27 countries of the EU; Luxembourg is the only country without a medical school. The survey was completed by the dean or a member of the medical school with knowledge of the medical curriculum. Of the 58 medical schools from 19 countries that responded to the survey, 18 (31.0%) from 13 (68.4%) EU countries reported the existence of an undergraduate PoCUS curriculum and a further 16 (27.6%) from 12 (41.4%) EU countries intended to offer it in the future. No significant difference was observed between the current and future PoCUS curricula regarding its content and purpose. Less than 40 h of theoretical teaching is provided in all the medical schools and less than 40 h of practical training is provided in 12 (75%) of the 16 medical schools which answered this specific question. Of the 40 (69%) surveyed medical schools that do not currently teach PoCUS, 20 (50%) intend to offer PoCUS courses in the future. CONCLUSION Although the lack of teaching hours in curricula suggests that most PoCUS courses are introductory in nature and that medical students are possibly not trained to become autonomous in clinical practice, evaluating the feasibility and impact of PoCUS teaching on clinical practice should be promoted. The medical schools that intend to develop this curriculum should be encouraged to implement validated tools to objectively assess their programs and students' performances.
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Affiliation(s)
- Florence Dupriez
- Emergency Department, Cliniques Universitaires Saint Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium.
| | - Audrey Hall
- Emergency Department, Cliniques Universitaires Saint Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Toumane Diop
- Emergency Department, Cliniques Universitaires Saint Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Alix Collard
- Statistical Support Unit, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Françoise Smets
- Faculty of Medicine and Dental Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Andrea Penaloza
- Faculty of Medicine and Dental Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Dominique Vanpee
- Institute of Health and Society and CHU UCL Namur, UCLOUVAIN, Brussels, Belgium
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Nagi A, Boots R, Ajlouni O, Nair S, Werhan A, Ivey R, Misasi P. The Effectiveness of Different Teaching Modalities for the Detection of Heart Murmurs in Undergraduate Medical Education: A Review. Cureus 2024; 16:e53013. [PMID: 38410315 PMCID: PMC10895079 DOI: 10.7759/cureus.53013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
One of the many physical exam skills introduced to medical students during their pre-clerkship education is cardiac auscultation, one purpose of which is to teach the detection and identification of heart murmurs. Cardiac auscultation with a stethoscope has been the standard method of teaching. Another method, point-of-care ultrasound (POCUS), has been recently introduced as another modality by which students learn to detect and identify murmurs. The emerging popularity of POCUS in undergraduate medical curricula has led many institutions to include it in their curricula; however, doing so is challenging. Not only is cost a major factor, but reorganizing curricula to allow sufficient time for POCUS training has proven to be difficult. Additionally, the presence of notable gaps in the literature regarding the efficacy of POCUS for teaching the detection and identification of heart murmur has increased scrutiny of its value. Studies that assessed teaching cardiac auscultation to medical students in their pre-clinical years via stethoscope have used different teaching methods. However, evaluation of these studies identified numerous limitations, one being little long-term retention of cardiac auscultation knowledge. Furthermore, several barriers to integration of POCUS in undergraduate medical education were identified. The purpose of this review is to synthesize the literature comparing the effectiveness of these different tools of a cardiac exam for detection of heart murmurs in undergraduate medical education and identify gaps in literature requiring future exploration.
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Affiliation(s)
- Alvin Nagi
- Research, Kansas Health Science Center - Kansas College of Osteopathic Medicine, Wichita, USA
| | - Rachel Boots
- Research, Kansas Health Science Center - Kansas College of Osteopathic Medicine, Wichita, USA
| | - Omar Ajlouni
- Research, Kansas Health Science Center - Kansas College of Osteopathic Medicine, Wichita, USA
| | - Sharad Nair
- Research, Kansas Health Science Center - Kansas College of Osteopathic Medicine, Wichita, USA
| | - Abigail Werhan
- Research, Kansas Health Science Center - Kansas College of Osteopathic Medicine, Wichita, USA
| | - Ryan Ivey
- Research, Kansas Health Science Center - Kansas College of Osteopathic Medicine, Wichita, USA
| | - Paul Misasi
- Research, Kansas Health Science Center - Kansas College of Osteopathic Medicine, Wichita, USA
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Cohen K, Kidd J, Schiller E, Kantorowska A, Kinzler W, Chavez M. Obstetric-Focused POCUS Training for Medical Students. POCUS JOURNAL 2023; 8:109-112. [PMID: 38099174 PMCID: PMC10721283 DOI: 10.24908/pocus.v8i2.16316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Point of care ultrasound (POCUS) is rapidly expanding throughout the United States. Due to its ability to quickly and accurately diagnose and guide therapy for critical conditions, POCUS is becoming routine in many specialties, with established guidelines in fields such as emergency medicine and critical care 1, 2, 3. For example, a study entitled "Ultrasound Integration in Undergraduate Medical Education: Comparison of Ultrasound Proficiency Between Trained and Untrained Medical Students" initiated an Emergency Medicine POCUS curriculum for first-year medical students that showed an increase in ultrasound capability 4. In short, as POCUS becomes more common practice, medical schools are beginning to implement POCUS training into their undergraduate medical education; studies from these institutions demonstrate that implementing a formal ultrasound curriculum into preclinical medical education significantly increases medical students' POCUS capabilities4, 5 and assisted in their understanding and learning of anatomy 6, 7.
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Affiliation(s)
- Koral Cohen
- NYU Grossman School of MedicineMineola, NYUSA
| | - Jennifer Kidd
- NYU Grossman School of MedicineMineola, NYUSA
- Department of Obstetrics and Gynecology, NYU Langone Health-Long IslandMineola, NYUSA
- Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempstead, NYUSA
| | | | - Agata Kantorowska
- NYU Grossman School of MedicineMineola, NYUSA
- Department of Obstetrics and Gynecology, NYU Langone Health-Long IslandMineola, NYUSA
| | - Wendy Kinzler
- NYU Grossman School of MedicineMineola, NYUSA
- Department of Obstetrics and Gynecology, NYU Langone Health-Long IslandMineola, NYUSA
| | - Martin Chavez
- NYU Grossman School of MedicineMineola, NYUSA
- Department of Obstetrics and Gynecology, NYU Langone Health-Long IslandMineola, NYUSA
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Dasani R, Pai VV, Noh CY, Vallandingham-Lee S, Davis AS, Bhombal S. POCUS increases successful placement of peripheral arterial lines in neonates by less experienced providers. Eur J Pediatr 2023; 182:4977-4982. [PMID: 37615892 DOI: 10.1007/s00431-023-05160-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
To assess success of peripheral arterial line (PAL) placement after implementing a point-of-care ultrasound (POCUS) program in a neonatal intensive care unit. This was a retrospective chart review of infants who underwent successful PAL placement from January 2019 to March 2021. Outcomes included first-attempt success and the number of attempts with and without the use of POCUS. Among 80 PALs, 36% were POCUS-guided. All POCUS-guided lines were placed by providers with < 5 years neonatology experience. Among infants ≥ 2.5 kg, the use of POCUS was associated with fewer attempts compared to non-POCUS PAL placement (1 vs. 2, p = 0.035). Conclusions: Use of POCUS for PAL placement was associated with fewer attempts for successful placement in infants ≥ 2.5 kg by providers with less neonatology experience compared with traditional method. What is Known: • Arterial line placement in neonates has been traditionally done by palpation and can be technically challenging. • POCUS is an emerging tool in the NICU with increasing number of less clinically experienced providers in the NICU having access to ultrasound. What is New: • Use of POCUS by less experienced clinicians for arterial line placement resulted in fewer attempts compared to the traditional landmark-based approach in a cohort of neonates.
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Affiliation(s)
- Reedhi Dasani
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, 453 Quarry Rd, Palo Alto, Stanford, CA, 94304, USA.
| | - Vidya V Pai
- Division of Neonatology, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Caroline Y Noh
- Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Shelby Vallandingham-Lee
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, 453 Quarry Rd, Palo Alto, Stanford, CA, 94304, USA
| | - Alexis S Davis
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, 453 Quarry Rd, Palo Alto, Stanford, CA, 94304, USA
| | - Shazia Bhombal
- Division of Neonatology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA
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Weimer JM, Rink M, Vieth T, Lauff J, Weimer A, Müller L, Stäuber M, Reder SR, Buggenhagen H, Bellhäuser H, Kloeckner R, Künzel J, Hoffmann EM, Würde A. Development and evaluation of a point-of-care ocular ultrasound curriculum for medical students - a proof-of-concept study. BMC MEDICAL EDUCATION 2023; 23:723. [PMID: 37789302 PMCID: PMC10548604 DOI: 10.1186/s12909-023-04723-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Point-of-care Ocular Ultrasound (POCOUS) has gained importance in emergency medicine and intensive care in recent years. This work aimed to establish and evaluate a dedicated ultrasound education program for learning POCOUS-specific skills during medical studies at a university hospital. METHODS The blended learning-based program (6 teaching units) based on recent scientific publications and recommendations was developed for students in the clinical part of their medical studies. Experts and trainers consisted of physicians from the Ear-Nose-Throat, radiology, ophthalmology and neurology specialties as well as university educational specialists. Lecture notes containing digital video links for preparation was produced as teaching material. In total, 33 students participated in the study. The education program, including the teaching materials, motivation and subjective gain in competency, was evaluated with the aid of a questionnaire (7-point Likert response format). Objective learning success was assessed on the basis of pre- and post-tests. These covered the skill areas: "anatomical basics", "ultrasound basics", "understanding of cross-sectional images", "normal findings" and "pathology recognition". RESULTS In the objective assessment of image interpretation, the participants improved significantly (p < 0.001) from pre- to post-test with a large effect size (Cohen's d = 1.78, effect size r = 0.66). The evaluations revealed a high level of satisfaction with the course concept, teaching materials and the tutors. In addition, a high level of motivation was recorded in relation to continuing to study "ultrasound diagnostics" and "ophthalmologic diseases". A significant (p < 0.01) positive gain was also achieved in terms of the subjective assessment of competency. This covers areas such as expertise, sonographic anatomy and performing a POCOUS examination as well as recognizing retinal detachment, globe perforation and increased optic nerve sheath diameter. CONCLUSION The results of this feasibility study show that medical students accept and support a POCOUS-specific education program and are able to develop a higher objective and subjective level of competency. Future transfer to other sites and larger groups of participants seems feasible.
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Affiliation(s)
- Johannes Matthias Weimer
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Maximilian Rink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Thomas Vieth
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jonas Lauff
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Weimer
- Center of Orthopedics, Trauma Surgery, and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, Heidelberg, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marie Stäuber
- Department of Anesthesia, Intensive Care Medicine, Emergency medicine, Pain medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sebastian R Reder
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein - Campus Lübeck, Lübeck, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Esther M Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Anna Würde
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
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Schroeder AN, Amin I, Bowen BJ, Callender SS, Ferderber M, Kerr HA, Phillips SF, Romero JM, Rudolph L, Vidlock K, Waterbrook AL, Kruse RC. Implementing a Sports Ultrasound Curriculum in Undergraduate Medical Education. Curr Sports Med Rep 2023; 22:328-335. [PMID: 37678352 DOI: 10.1249/jsr.0000000000001099] [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: 09/09/2023]
Abstract
ABSTRACT The utilization of sports ultrasound in the clinical practice of sports medicine physicians is growing rapidly. Simultaneously, ultrasound is being increasingly implemented as a teaching tool in undergraduate medical education. However, a sports ultrasound curriculum for medical students has not been previously described. In this article, we describe methods as well as barriers to implementing a sports ultrasound curriculum at the medical school level. Recommended content for the curriculum also is discussed. While educational goals and resources will vary among institutions, this article may serve as a general roadmap for the creation of a successful curriculum.
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Affiliation(s)
| | - Idris Amin
- Department of Neurology and Orthopaedics, University of Maryland School of Medicine, Baltimore, MD
| | - Brady J Bowen
- Department of Medicine, Albany Medical College, Albany, NY
| | | | - Megan Ferderber
- Department of Family Medicine, East Carolina University Brody School of Medicine, Greenville, NC
| | - Hamish A Kerr
- Department Medicine, Albany Medical College, Albany, NY
| | - Shawn F Phillips
- Family and Community Medicine and Orthopedics and Rehabilitation, Penn State College of Medicine, Hershey, PA
| | - Joshua M Romero
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | | | - Kathryn Vidlock
- Family Medicine and Ultrasound, Rocky Vista University, Parker, CO
| | - Anna L Waterbrook
- Sports and Emergency Medicine, The University of Arizona, Tucson, AZ
| | - Ryan C Kruse
- Department of Orthopedics and Rehabilitation, University of Iowa Sports Medicine, Iowa City, IA
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Kulas P, Schick B, Helfrich J, Bozzato A, Hecker DJ, Pillong L. Assessing the Use of Telepresence-Guided Video-Based Head and Neck Ultrasound Training: A Step towards Minimizing Dependence on Human Resources? Diagnostics (Basel) 2023; 13:2828. [PMID: 37685366 PMCID: PMC10487032 DOI: 10.3390/diagnostics13172828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
The acquisition of ultrasound skills is an essential part of any medical student's education. University access restrictions in the context of the COVID-19 pandemic have highlighted the need for digitization in teaching. However, teaching manual skills in online courses has proven to be challenging, not least in terms of human resources. Therefore, the aim of this study was to set up a hybrid head and neck ultrasound course consisting of a preface of video-based self-study followed by supportive instruction by a tutor in telepresence and to evaluate the quality, effectiveness, and feasibility of this teaching method. Thirty-five students were shown video tutorials on systematic ultrasound of the neck course. Learning outcomes were analyzed using self-assessment questionnaires and external assessment by an experienced ultrasonographer. All participants demonstrated statistically significant learning improvement (p < 0.001) when comparing self-assessment scores before and after training. The mean self-assessment scores increased from 13.8 to 26.6 for the telepresence-guided group, from 16.6 to 27.3 for the web-based group, and from 14.0 to 26.2 for the in-person group. The external observer assessment also showed improvement, with mean scores of 46.7, 48.1, and 46.5, respectively. Overall results did not significantly differ when comparing different instruction modalities. A telepresence-guided video-based ultrasound course is well suited to teaching ultrasound skills similar to in-person courses and allows a more resource-efficient targeting of student needs.
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Affiliation(s)
| | | | | | | | | | - Lukas Pillong
- Department for Otorhinolaryngology and Head- and Neck-Surgery, Saarland University Medical Center, Kirrbergerstraße 100, 66421 Homburg, Germany; (P.K.); (B.S.); (J.H.); (A.B.); (D.J.H.)
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13
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Shanks A, Darwish A, Cook M, Asencio I, Rouse C. Integration of ultrasound simulation to improve medical student knowledge and satisfaction on the obstetrics and gynecology clerkship. AJOG GLOBAL REPORTS 2023; 3:100228. [PMID: 37645647 PMCID: PMC10461243 DOI: 10.1016/j.xagr.2023.100228] [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: 08/31/2023] Open
Abstract
BACKGROUND There has been increased use of ultrasound in contemporary medical education. Students tend to report a higher sense of satisfaction when ultrasound is incorporated into medical education, but little is known about whether its use leads to an improvement in medical knowledge acquisition independent of the ultrasound skill. In addition, there is no consensus among obstetrics and gynecology clerkships on the most effective way to incorporate ultrasound into the clerkship curriculum. OBJECTIVE This project described a method to integrate ultrasound simulation into an obstetrics and gynecology clerkship curriculum. Our hypothesis was that the incorporation of ultrasound simulation in the obstetrics and gynecology clerkship curriculum will lead to an increase in standardized assessments of obstetrics and gynecology knowledge. STUDY DESIGN A prepost study at a single institution with multiple methods design was employed. Of note, 10 high-yield pathology topics commonly tested on the Association of Professors of Gynecology and Obstetrics quizzes and National Board of Medical Examiners examinations were summarized into study sheets and associated with a representative ultrasound simulation module. All students were provided access to the summary sheets. Students with instruction in ultrasound simulation consisted of the postintervention group and were compared with students that did not have ultrasound simulation (preintervention group). Quiz and examination scores were compared between the groups. In addition, students who accessed the ultrasound simulator were given a survey at the end of their rotation to obtain qualitative information regarding satisfaction and the incorporation of ultrasound into the clerkship curriculum. RESULTS There was no significant difference in quiz or examination scores between students who had access to the ultrasound simulation and those who did not. Most students found the integration of ultrasound simulation into the obstetrics and gynecology clerkship to be beneficial, to enhance their learning, to boost their confidence in ultrasound skills, and to be a potential substitute for clinical ultrasounds during the rotation. CONCLUSION Integration of ultrasound simulation into obstetrics and gynecology clerkships and medical school education is understudied but can be a valuable educational tool. The incorporation of ultrasound into the medical education system is a topic of current studies. This study found that integration was viewed favorably by students, although integration was not associated with an improvement in medical knowledge measured via quiz and examination performance. Our research provided students with a standardized ultrasound education experience, which improved student satisfaction with the obstetrics and gynecology clerkship but did not correlate to increased demonstrated medical knowledge and understanding of examinations. Moving forward, student participants provided various suggestions on how we can continue to enrich medical students' education with the implementation of ultrasound.
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Affiliation(s)
- Anthony Shanks
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN (Drs Shanks, Darwish, Asencio, and Rouse); and
| | - Adrianna Darwish
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN (Drs Shanks, Darwish, Asencio, and Rouse); and
| | - Myanna Cook
- Indiana University School of Medicine, Indianapolis, IN (Ms Cook)
| | - Ivana Asencio
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN (Drs Shanks, Darwish, Asencio, and Rouse); and
| | - Carrie Rouse
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN (Drs Shanks, Darwish, Asencio, and Rouse); and
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14
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Weimer JM, Widmer N, Strelow KU, Hopf P, Buggenhagen H, Dirks K, Künzel J, Börner N, Weimer AM, Lorenz LA, Rink M, Bellhäuser H, Schiestl LJ, Kloeckner R, Müller L, Weinmann-Menke J. Long-Term Effectiveness and Sustainability of Integrating Peer-Assisted Ultrasound Courses into Medical School-A Prospective Study. Tomography 2023; 9:1315-1328. [PMID: 37489472 PMCID: PMC10366829 DOI: 10.3390/tomography9040104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Ultrasound diagnostics is an important examination method in everyday clinical practice, but student education is often inadequate for acquiring sufficient basic skills. Individual universities have therefore started integrating (extra)curricular training concepts into medical education. This study aimed to evaluate sustainable skills development through participation in peer-assisted ultrasound courses. METHODS From 2017, students in the clinical part of medical school could opt for extracurricular peer-assisted ultrasound courses. Depending on the format (10-week course/2-day compact course) these comprised 20 teaching units focusing on abdominal and emergency ultrasonography. Students attending compulsory workshops at the start of their practical year were enrolled in this study, allowing for a comparison between the study group (attended ultrasound course) and the control group (did not attend ultrasound course). Competency from two out of four practical exams (subjects: "aorta", "gallbladder", "kidney" and "lung") was measured, and a theory test on the same subject areas ("pathology recognition") was administered. Additional questions concerned biographical data, subjective competency assessment (7-point Likert scale), and "attitude to ultrasound training in the curriculum". RESULTS Analysis included 302 participants in total. Ultrasound courses had been attended on average 2.5 years earlier (10-week course) and 12 months earlier (2-day compact course), respectively. The study group (n = 141) achieved significantly better results than the control group (n = 161) in the long-term follow-up. This applies both to practical exams (p < 0.01) and theory tests (p < 0.01). After course attendance, participants reported a significantly higher subjective assessment of theoretical (p < 0.01) and practical (p < 0.01) ultrasound skills. CONCLUSIONS Peer-assisted ultrasound courses can sustainably increase both theoretical and practical competency of medical students. This highlights the potential and need for standardised implementation of ultrasound courses in the medical education curriculum.
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Affiliation(s)
- Johannes Matthias Weimer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Nina Widmer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Kai-Uwe Strelow
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Paula Hopf
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Klaus Dirks
- Department of General Internal Medicine and Geriatrics, Rems-Murr-Klinikum, 71364 Winnenden, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 95053 Regensburg, Germany
| | - Norbert Börner
- Gastroenterological Medical Group Offices at the MED Specialist Centre Mainz, 55131 Mainz, Germany
| | - Andreas Michael Weimer
- Centre of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, 69118 Heidelberg, Germany
| | - Liv Annebritt Lorenz
- Department of Radiation Oncology and Radiotherapy, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Maximilian Rink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 95053 Regensburg, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, 55112 Mainz, Germany
| | - Lina Judit Schiestl
- Department of Gynaecology and Obstetrics, University Medical Centre of the Johannes-Gutenberg University Mainz, 55131 Mainz, Germany
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein-Campus Lübeck, 23583 Lübeck, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Julia Weinmann-Menke
- I. Department of Medicine, University Medical Centre of the Johannes Gutenberg University-Mainz, 55131 Mainz, Germany
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15
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Draper R, Ellinger D, Trottier M, Armstrong K, Ma W. Ultrasound Education in an Elective Course in the Undergraduate Medical Curriculum Improves Students' Subjective Learning and Clinical Rotation and Residency Preparedness. MEDICAL SCIENCE EDUCATOR 2023; 33:737-746. [PMID: 37501805 PMCID: PMC10368609 DOI: 10.1007/s40670-023-01800-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 07/29/2023]
Abstract
Objectives Studies have demonstrated that students are able to improve their understanding of anatomy, physical exam skills, and clinical knowledge when ultrasound is incorporated into their education. This study investigates whether students enrolled in an elective with significant use of ultrasound (ACS) in their preclinical years subjectively improved their preparedness for clinical rotations, residency, and learning in several subjects. Methods This was a retrospective analysis of an anonymous online needs assessment survey sent to 384 third- and fourth-year medical students. Survey items included Likert scales analyzed with a student's t-test or Chi-Square analysis and yes/no questions analyzed with Chi square, as well as demographic information. Results 201 students responded to the survey (52.3% response rate). ACS participants reported feeling more prepared for their clinical rotations than their non-ACS peers (3.5 vs. 2.33, p < 0.001 ) and felt more prepared for residency (3.12 vs 1.91, p < 0.001). ACS students also found ultrasound significantly more helpful in understanding the physical exam (69.3% vs. 53.2%, p = 0.02) and anatomy (94.7% vs. 81%, p = 0.012). Conclusions Student respondents expressed a desire for more ultrasound education throughout medical school. Students who participated in ACS reported feeling more prepared for their clinical rotations and residency than their non-ACS peers and were more likely to feel that ultrasound improved their understanding of anatomy and the physical exam. This study adds to the literature suggesting that increasing the quantity of ultrasound in preclinical medical education may improve students' satisfaction, learning and clinical preparedness. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01800-4.
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Affiliation(s)
- Riley Draper
- Michigan State University College of Human Medicine, 15 Michigan St SE, Grand Rapids, MI 49503 USA
| | - Douglas Ellinger
- Michigan State University College of Human Medicine, 15 Michigan St SE, Grand Rapids, MI 49503 USA
| | - Mark Trottier
- Michigan State University College of Human Medicine, 15 Michigan St SE, Grand Rapids, MI 49503 USA
| | - Kelly Armstrong
- Michigan State University College of Human Medicine, 15 Michigan St SE, Grand Rapids, MI 49503 USA
| | - Wenyue Ma
- Michigan State University College of Human Medicine, 15 Michigan St SE, Grand Rapids, MI 49503 USA
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16
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Allen AJ, White AB, Bacon DR, Beck Dallaghan GL, Jordan SG. Commentary on Ultrasound Instruction in Undergraduate Medical Education: Perspective from Two Students. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:1-7. [PMID: 36632196 PMCID: PMC9827631 DOI: 10.2147/amep.s388044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Ultrasound integration in undergraduate medical education (UME) has been a focused endeavor in recent years. According to the American Institute of Ultrasound in Medicine, more than a third of all US medical schools have adopted a focused ultrasound training program for medical students. Medical student perspectives on best practices in ultrasound education are lacking in the literature. CURRICULA EXPERIENCES Two students' reflections are presented regarding two different didactic approaches, flipped classroom and self-study learning models, to teaching ultrasound in the pre-clinical medical education curriculum. Students present reflections on these didactic approaches to facilitate further improvement in ultrasound education curricula. DISCUSSION The self-directed learning model enabled students to learn foundational ultrasound exam techniques efficiently in a low-stress environment and subsequently optimized the efficiency of later faculty-led learning events. However, we noted that in both the flipped classroom and self-study learning models of education, the training on basic physical properties of ultrasound, tissue characteristics, and probe manipulation was limited. CONCLUSION A self-study learning model ultrasound curricula improves perceived learning efficiency and student confidence, especially when followed by faculty-guided didactics and scanning opportunities. We suggest a framework for ultrasound education curricula that includes components of both formats of ultrasound education alongside faculty-led sessions as an ideal model of ultrasound education. Further, we propose the added benefit of inanimate object scanning to optimize students' knowledge of waveform physics (image acquisition and physical properties of materials) early in the ultrasound education process.
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Affiliation(s)
- Austin J Allen
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Alexander B White
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Daniel R Bacon
- Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Gary L Beck Dallaghan
- Department of Medical Education, University of Texas at Tyler School of Medicine, Tyler, TX, USA
| | - Sheryl G Jordan
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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17
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Halata D, Zhoř D, Kulec RS. Implementation of Point‑of‑Care ultrasound examination in general practice. VNITRNI LEKARSTVI 2023; 69:237-241. [PMID: 37468291 DOI: 10.36290/vnl.2023.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Point-of-Care ultrasonography (POCUS) is a method defined as a targeted ultrasound examination of patients with acute symptoms or syndromes that can be diagnosed by a healthcare worker at a site. The aim is to answer a specific diagnostic or therapeutic question or to ease the therapeutic procedure. Recently in Europe, there has been an increase in implementing POCUS in many medical fields including primary health care. The Czech Society of General Practice (SVL ČLS JEP) has for several years been watching the use of POCUS in primary care in many European countries. In August 2020, the committee of the Czech Society of General Practice charged the Working Group for ultrasound in primary care to start a project POCUS iGP - POCUS Implementation in General Practice aiming for the implementation of POCUS into daily practice in general medicine. An ultrasound device is required, as well as setting up the education and training courses with follow up courses and a consensual curriculum of skills, securing quality control mechanisms, proving with scientific evidence the reliability of POCUS when provided by GPs and setting up the final rules of competency and payment for performance. The current international trend of patient centred care in primary health settings and increasing competencies of GPs emphasises a need to implement new point of care diagnostic methods. One of which is point of care ultrasonography. Scientific outcomes and published data from primary care and other fields of medicine show that even doctors who do not work in radiology departments are after a relatively short course able to independently provide POCUS examinations with high reliability. Establishment of the Czech Multidisciplinary Task Force Group for standards, education and research in Pointof- Care ultrasound support development of the POCUS implementation.
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18
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Ross DW, Moses AA, Niyyar VD. Point-of-care ultrasonography in nephrology comes of age. Clin Kidney J 2022; 15:2220-2227. [PMID: 36381376 PMCID: PMC9664573 DOI: 10.1093/ckj/sfac160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Indexed: 03/22/2024] Open
Abstract
The physical exam is changing. Many have argued that the physical exam of the 21st century should include point-of-care ultrasound (POCUS). POCUS is being taught in medical schools and has been endorsed by the major professional societies of internal medicine. In this review we describe the trend toward using POCUS in medicine and describe where the practicing nephrologist fits in. We discuss what a nephrologist's POCUS exam should entail and we give special attention to what nephrologists can gain from learning POCUS. We suggest a 'nephro-centric' approach that includes not only ultrasound of the kidney and bladder, but of the heart, lungs and vascular access. We conclude by reviewing some of the sparse data available to guide training initiatives and give suggested next steps for advancing POCUS in nephrology.
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Affiliation(s)
- Daniel W Ross
- Donald and Barbara Zucker School of Medicine at Hofstra-Northwell, Division of Kidney Diseases and Hypertension, Great Neck, NY, USA
| | - Andrew A Moses
- Donald and Barbara Zucker School of Medicine at Hofstra-Northwell, Lenox Hill Division of Nephrology, New York, NY, USA
| | - Vandana Dua Niyyar
- Emory University, Division of Nephrology, Woodruff Memorial Research Building, Atlanta GA, USA
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19
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Szalai C, Shehada SE, Iancu S, Herbstreit F, Ruhparwar A, Brenner T, Haddad A. Does the clinical experience of a tutor influence how students learn extended focused assessment with sonography for trauma: A randomized controlled trial. MEDICAL TEACHER 2022; 45:1-6. [PMID: 36257290 DOI: 10.1080/0142159x.2022.2133692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Extended focused assessment with sonography for trauma (eFAST) is now an essential part of the primary survey of an emergency patient. The discrepancy between an increasing number of medical students and growing clinical commitments of lecturers is a major challenge in student teaching that needs to be resolved. The practice of using peers in the clinical education of medical students is a well-established tradition and commonly practiced but lacks definition in its implementation. Therefore, we aimed to investigate whether the level of experience of the tutor affects the effectiveness of learning among students using eFAST during a clinical scenario. METHODS A prospective randomized single-blinded controlled trial, where 168 medical students in the eighth semester were randomized into control and intervention groups. The control group received the 4-h standard ultrasound (US) tutorial from various resident doctors. All residents were at least stage-1-certified in ultrasound. The intervention group received the tutorial from trained peer teachers (TPTs). These TPTs were medical students who were qualified to teach the procedure. All students received an initial tutorial on basic ultrasound principles and a final lecture on recognizing pathological images. Students completed basic questionnaires requesting pre-existing US experience, theoretical and clinical application questions based on eFAST one day later and at the end of the semester. Students also completed a 6-min OSCE (Objective-Structured-Clinical-Exam) station involving clinical emergency scenarios. RESULTS Eighty-five percent of participants had no previous eFAST experience. Early and later evaluation of the participants show no significant differences between both groups regarding the theoretical and the clinical application examinations, except the early phase OSCE results, which was not repeated in the late-stage results. CONCLUSIONS Peer-teaching can be utilized to teach practical skills such as eFAST without a loss of clinical application skills. This relieves the burden of removing doctors from patient care situations and maintains teaching standards.
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Affiliation(s)
- Cynthia Szalai
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sharaf-Eldin Shehada
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Canter, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Simona Iancu
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Frank Herbstreit
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Arjang Ruhparwar
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Canter, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Thorsten Brenner
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Ali Haddad
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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20
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Boivin Z, Carpenter S, Lee G, Chimileski B, Harrison J, Choudhary D, Herbst M. Evaluation of a Required Vertical Point-of-Care Ultrasound Curriculum for Undergraduate Medical Students. Cureus 2022; 14:e30002. [PMID: 36348834 PMCID: PMC9637009 DOI: 10.7759/cureus.30002] [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] [Accepted: 10/05/2022] [Indexed: 06/16/2023] Open
Abstract
Introduction Point-of-care ultrasound training beginning in undergraduate medical education reinforces anatomy and physical examination skills and enhances clinical care. Implementation in an overcrowded curriculum requires strategic planning to overcome barriers including lack of faculty and equipment. Using Kern's six-step model as a framework, our study question was whether a longitudinal point-of-care ultrasound curriculum threaded through four years of medical school and using a novel combination of evidence-based strategies was feasible, acceptable, and resulted in students achieving ultrasound competencies by graduation. Materials and methods From 2016 to 2020, a required, vertical point-of-care ultrasound curriculum was created across all four undergraduate medical education class years, spearheaded by a single ultrasound fellowship-trained emergency physician with support from two basic anatomy faculty. We utilized strategies including handheld ultrasound devices, near-peer teaching, flipped classroom with virtual learning modules, staggered station rotations, and gamification to optimize student-instructor ratios and faculty time. Surveys and timed objective structured clinical assessments evaluated the curriculum. Results Students from the class of 2022 (n=99, 100% of class) participated in all curricular elements. Senior students answered more survey knowledge questions correctly when compared to pretest questions answered by first- and second-year students. Among 84 students who completed the survey, 75 (89%) rated their ultrasound curriculum as superior or above average. Objective structured clinical examination scores recorded for 53 students (54% of the class) demonstrated students correctly identified a median of 11-18 structures (interquartile range: 9.5-13) using point-of-care ultrasound. Conclusion Evidence-based strategies allowed faculty to develop a four-year required ultrasound curriculum that was highly acceptable by students and improved their knowledge and skills at graduation. At low cost and with few faculty, this program has been sustained for over six years.
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Affiliation(s)
- Zachary Boivin
- Emergency Medicine, University of Connecticut Emergency Medicine Residency, Farmington, USA
| | - Sandra Carpenter
- General Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Grace Lee
- Medicine, University of Connecticut School of Medicine, Farmington, USA
| | | | - John Harrison
- Orthodontics, University of Connecticut School of Medicine, Farmington, USA
| | | | - Meghan Herbst
- Emergency Department, University of Connecticut School of Medicine, Farmington, USA
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21
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Kenny EJG, Makwana HN, Thankachan M, Clunie L, Dueñas AN. The Use of Ultrasound in Undergraduate Medical Anatomy Education: a Systematic Review with Narrative Synthesis. MEDICAL SCIENCE EDUCATOR 2022; 32:1195-1208. [PMID: 36276779 PMCID: PMC9583998 DOI: 10.1007/s40670-022-01593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 06/16/2023]
Abstract
This systematic review aimed to synthesize the literature on how ultrasound is currently used in anatomy education within medical schools. A systematic search of Ovid MEDLINE, Scopus, and Educational Resources Information Centre was conducted. Thirty-four relevant unique articles were included from the 1,272 identified from the databases and analyzed via narrative synthesis. Thematic analysis generated two domain summaries: "Successful Aspects of Ultrasound Teaching" and "Barriers to Implementation," each with additional subthemes, aimed to help educators inform best teaching practices from the current evidence base in this field.
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Affiliation(s)
- Edward J. G. Kenny
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Kingston Upon Hull, UK
| | - Haran N. Makwana
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Kingston Upon Hull, UK
| | - Maria Thankachan
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Kingston Upon Hull, UK
| | - Lauren Clunie
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Kingston Upon Hull, UK
| | - Angelique N. Dueñas
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK
- Department of Medical Education, Northwestern University, Feinberg School of Medicine, Chicago, IL USA
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22
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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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Arichai P, Delaney M, Slamowitz A, Rosario R, Gordish-Dressman H, Basu S, Kern J, Maxwell A, Abo A. Pediatric Residency Point-of-Care Ultrasound Training Needs Assessment and Educational Intervention. Cureus 2022; 14:e28696. [PMID: 36204025 PMCID: PMC9527041 DOI: 10.7759/cureus.28696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 11/06/2022] Open
Abstract
Background Prior studies showed that point-of-care ultrasound (POCUS) training is not commonly offered in pediatric residency. We assessed the need for a pediatric POCUS curriculum by evaluating pediatric trainees’ attitudes toward the use of POCUS and identifying barriers to training. We also aimed to evaluate the impact of a POCUS educational intervention on self-efficacy and behavior. Methods We conducted a cross-sectional survey of pediatric residents in a single large freestanding children’s hospital distributed via an institutional listserv and administered online. The survey included opinion-rating of statements regarding POCUS and barriers to training. We also offered a two-week POCUS course with online modules and hands-on scanning. Participating residents completed pre- and post-course knowledge assessments and follow-up surveys up to 12 months following the course to assess POCUS use and self-report confidence on POCUS indications, acquisition, interpretation, and clinical application. Results Forty-nine respondents were included in the survey representing all three pediatric levels with 16 specialty interest areas. Ninety-six percent of trainees reported that POCUS is an important skill in pediatrics. Ninety-two percent of trainees reported that residency programs should teach residents how to use POCUS. The most important perceived barriers to POCUS training were scheduling availability for POCUS rotations and lack of access to an ultrasound machine. Fourteen participants completed the pre- and post-course knowledge tests, with eight and six participants also completing the six- and 12-month follow-up surveys, respectively. Self-ratings of confidence were significantly improved post-intervention in indications (P = 0.007), image acquisition (P = 0.002), interpretation (P = 0.002), and clinical application (P = 0.004). This confidence improvement was sustained up to 6-12 months (P = 0.004-0.032). Participants also reported higher categorical POCUS use after course completion (P = 0.031). Conclusions Pediatric trainees perceive POCUS as an important skill, hold favorable opinions towards the use of POCUS, and support POCUS training within a pediatric residency. A POCUS course can improve resident POCUS knowledge, instill confidence, and motivate higher POCUS use. Further study is needed to evaluate POCUS applications in pediatric medicine to develop a standardized POCUS curriculum and establish a training guideline for pediatric residency.
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Russell FM, Herbert A, Peterson D, Wallach PM, Ferre RM. Assessment of Medical Students' Ability to Integrate Point-of-Care Cardiac Ultrasound Into a Case-Based Simulation After a Short Intervention. Cureus 2022; 14:e27513. [PMID: 36060409 PMCID: PMC9424786 DOI: 10.7759/cureus.27513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2022] [Indexed: 11/05/2022] Open
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Höhne E, Recker F, Dietrich CF, Schäfer VS. Assessment Methods in Medical Ultrasound Education. Front Med (Lausanne) 2022; 9:871957. [PMID: 35755059 PMCID: PMC9218354 DOI: 10.3389/fmed.2022.871957] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Medical schools are increasingly incorporating ultrasound into undergraduate medical education. The global integration of ultrasound into teaching curricula and physical examination necessitates a strict evaluation of the technology's benefit and the reporting of results. Course structures and assessment instruments vary and there are no national or worldwide standards yet. This systematic literature review aims to provide an up-to-date overview of the various formats for assessing ultrasound skills. The key questions were framed in the PICO format (Population, Intervention, Comparator, and Outcome). A review of literature using Embase, PubMed, Medline, Cochrane and Google Scholar was performed up to May 2021, while keywords were predetermined by the authors. Inclusion criteria were as follows: prospective as well as retrospective studies, observational or intervention studies, and studies outlining how medical students learn ultrasound. In this study, 101 articles from the literature search matched the inclusion criteria and were investigated. The most frequently used methods were objective structured clinical examinations (OSCE), multiple choice questions, and self-assessments via questionnaires while frequently more than one assessment method was applied. Determining which assessment method or combination is ideal to measure ultrasound competency remains a difficult task for the future, as does the development of an equitable education approach leading to reduced heterogeneity in curriculum design and students attaining equivalent skills.
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Affiliation(s)
- Elena Höhne
- Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology and Clinical Immunology, University Hospital Bonn, Bonn, Germany
| | - 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
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FAST exam for the anesthesiologist. Int Anesthesiol Clin 2022; 60:55-64. [PMID: 35536999 DOI: 10.1097/aia.0000000000000363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Olivares-Perez ME, Graglia S, Harmon DJ, Klein BA. Virtual anatomy and point-of-care ultrasonography integration pilot for medical students. ANATOMICAL SCIENCES EDUCATION 2022; 15:464-475. [PMID: 34748279 DOI: 10.1002/ase.2151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/12/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
Despite its significant clinical use, there is no standardized point-of-care ultrasonography (POCUS) curriculum in undergraduate medical education. As Covid-19 abruptly mandated the use of virtual education, instructors were challenged to incorporate and improve POCUS education within these new constraints. It was hypothesized that integrating POCUS into anatomy via brief video lessons and a subsequent interactive virtual lesson would lead to an objective understanding of POCUS concepts, improved understanding of the corresponding anatomy, and subjective improvement of student confidence with POCUS. A cross-sectional descriptive study assessed first-year medical students' perspectives and performance before and after the interventions (n = 161). The intervention was split into two parts: (1) three optional 10-minute POCUS videos that reinforced anatomy concepts taught in the laboratory sessions, and (2) a subsequent two-hour interactive virtual session reviewing POCUS and anatomy concepts. Students completed a knowledge and confidence assessment tool before and after the interactive session. Survey responses (n = 51) indicated that 94% of students felt the optional videos improved their understanding of POCUS and were educationally valuable. One half of medical students (50%) indicated that the demonstrations improved their anatomy understanding. Initial self-reported confidence was low after the optional video lessons, despite an average score of 58% on the knowledge assessment (n = 130). However, confidence increased significantly along with an increase in score performance to 80% after the interactive session (n = 39, P < 0.01). Results suggest that the virtual integration pilot enhanced student learning of both anatomy and POCUS.
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Affiliation(s)
- Marcus E Olivares-Perez
- Department of Emergency Medicine, University of California, San Francisco-Fresno, Fresno, California, USA
| | - Sally Graglia
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA
- Department of Emergency Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Derek J Harmon
- Department of Anatomy, University of California, San Francisco, School of Medicine, San Francisco, California, USA
| | - Barbie A Klein
- Department of Anatomy, University of California, San Francisco, School of Medicine, San Francisco, California, USA
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DePhilip RM, Quinn MM. Adaptation of an anatomy graduate course in ultrasound imaging from in-person to live, remote instruction during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:493-507. [PMID: 35271761 PMCID: PMC9082486 DOI: 10.1002/ase.2177] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/26/2022] [Accepted: 03/07/2022] [Indexed: 05/28/2023]
Abstract
Health concerns during the Covid-19 pandemic required the adaptation of a lecture-laboratory course in ultrasound imaging for graduate students from an in-person to a live, remote learning format. The adaptation of in-person lectures to live, remote delivery was achieved by using videoconferencing. The adaptation of in-person laboratory sessions to live, remote instruction was achieved in the first half of the course by providing a hand-held ultrasound instrument to each student who performed self-scanning at their remote locations, while the instructor provided live instruction using videoconferencing. In the second half of the course, the students transitioned to using cart-based, hospital-type instruments and self-scanning in the ultrasound laboratory on campus. The aim of this study was to measure the success of this adaptation to the course by comparing assessment scores of students in the live, remote course with assessment scores of students in the in-person course offered in the previous year. There were no statistically significant differences in the assessment scores of students in the two courses. The adaptation of a course in ultrasound imaging from an in-person to a live, remote learning format during the Covid-19 pandemic described here suggests that contrary to the prevailing view, ultrasound imaging can be taught to students without in-person instruction. The adapted course can serve as a model for teaching ultrasound where instructors and learners are physically separated by constraints other than health concerns during a pandemic.
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Affiliation(s)
- Robert M. DePhilip
- Division of AnatomyDepartment of Biomedical Education and AnatomyThe Ohio State University College of MedicineColumbusOhioUSA
| | - Melissa M. Quinn
- Division of AnatomyDepartment of Biomedical Education and AnatomyThe Ohio State University College of MedicineColumbusOhioUSA
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29
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Rodrigues DM, Kundra A, Hookey L, Montague S. Does Point-of-Care Ultrasound Change the Needle Insertion Location During Routine Bedside Paracentesis? J Gen Intern Med 2022; 37:1598-1602. [PMID: 34346007 PMCID: PMC9130424 DOI: 10.1007/s11606-021-07042-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Paracentesis is a bedside procedure to obtain ascitic fluid from the peritoneum. Point-of-care ultrasound (POCUS) improves the safety of some medical procedures. However, the evidence supporting its utility in paracentesis is limited. OBJECTIVE We aimed to assess if POCUS would yield a user-preferred site for needle insertion compared to conventional landmarking, defined as a ≥ 5 cm change in location. DESIGN This was a prospective non-randomized trial comparing a POCUS-guided site to the conventional anatomic site in the same patient. PARTICIPANTS Adult patients at Kingston Health Sciences Centre undergoing paracentesis were included. INTERVENTIONS Physicians landmarked using conventional technique and compared this to a POCUS-guided site. The paracentesis was performed at whatever site was deemed optimal, if safe to do so. MAIN MEASURES Data collected included the distance from the two sites, depth of fluid pockets, and anatomic considerations. KEY RESULTS Forty-five procedures were performed among 30 patients and by 24 physicians, who were primarily in their PGY 1 and 2 years of training (33% and 31% respectively). Patients' ascites was mostly due to cirrhosis (84%) predominantly due to alcohol (47%) and NAFLD (34%). Users preferred the POCUS-guided site which resulted in a change in needle insertion ≥ 5 cm from the conventional anatomic site in 69% of cases. The average depth of fluid was greater at the POCUS site vs. the anatomic site (5.4±2.8 cm vs. 3.0±2.5 cm, p < 0.005). POCUS deflected the needle insertion site superiorly and laterally to the anatomic site. The POCUS site was chosen (1) to avoid adjacent organs, (2) to optimize the fluid pocket, and (3) due to abdominal wall considerations, such as pannus. Six cases landmarked anatomically were aborted when POCUS revealed inadequate ascites. CONCLUSIONS POCUS changes the needle insertion site from the conventional anatomic site for most procedures, due to optimizing the fluid pocket and safety concerns, and helped avoid cases where an unsafe volume of ascites was present.
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Affiliation(s)
| | - Arjun Kundra
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Lawrence Hookey
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Steven Montague
- Department of Medicine, Queen's University, Kingston, ON, Canada.
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Breunig M, Huckabee M, Rieck KM. An Integrated Point-of-Care Ultrasound Curriculum: An Evidence-Based Approach. J Physician Assist Educ 2022; 33:41-46. [PMID: 35067591 DOI: 10.1097/jpa.0000000000000402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Point-of-care ultrasound (POCUS) has been demonstrated to improve students' medical knowledge and clinical exam skills and advances patient care through numerous diagnostic and therapeutic applications. Despite the growing use of ultrasound in medical education and clinical practice, few physician assistant (PA) programs have successfully integrated POCUS education into their curricula. This manuscript describes an evidence-based approach for integrating POCUS education throughout a 2-year PA curriculum, with the goal of serving as a useful guidepost for other PA programs as they strive to incorporate this valuable skill into their curricula.
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Affiliation(s)
- Michael Breunig
- Michael Breunig, MPAS, PA-C, is the clinical skills co-director of the Mayo Clinic Physician Assistant Program and a hospitalist at the Mayo Clinic, Division of Hospital Internal Medicine, in Rochester, Minnesota
- Michael Huckabee, PhD, PA-C, is director of the Mayo Clinic Physician Assistant Program, Mayo Clinic School of Health Sciences, in Rochester, Minnesota
- Katie M. Rieck, MD, MHA, is medical director of the Mayo Physician Assistant Program and a hospitalist at the Mayo Clinic, Division of Hospital Internal Medicine, in Rochester, Minnesota
| | - Michael Huckabee
- Michael Breunig, MPAS, PA-C, is the clinical skills co-director of the Mayo Clinic Physician Assistant Program and a hospitalist at the Mayo Clinic, Division of Hospital Internal Medicine, in Rochester, Minnesota
- Michael Huckabee, PhD, PA-C, is director of the Mayo Clinic Physician Assistant Program, Mayo Clinic School of Health Sciences, in Rochester, Minnesota
- Katie M. Rieck, MD, MHA, is medical director of the Mayo Physician Assistant Program and a hospitalist at the Mayo Clinic, Division of Hospital Internal Medicine, in Rochester, Minnesota
| | - Katie M Rieck
- Michael Breunig, MPAS, PA-C, is the clinical skills co-director of the Mayo Clinic Physician Assistant Program and a hospitalist at the Mayo Clinic, Division of Hospital Internal Medicine, in Rochester, Minnesota
- Michael Huckabee, PhD, PA-C, is director of the Mayo Clinic Physician Assistant Program, Mayo Clinic School of Health Sciences, in Rochester, Minnesota
- Katie M. Rieck, MD, MHA, is medical director of the Mayo Physician Assistant Program and a hospitalist at the Mayo Clinic, Division of Hospital Internal Medicine, in Rochester, Minnesota
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Santos VA, Barreira MP, Saad KR. Technological resources for teaching and learning about human anatomy in the medical course: Systematic review of literature. ANATOMICAL SCIENCES EDUCATION 2022; 15:403-419. [PMID: 34664384 DOI: 10.1002/ase.2142] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
The consolidation of technology as an alternative strategy to cadaveric dissection for teaching anatomy in medical courses was accelerated by the recent Covid-19 pandemic, which caused the need for social distance policies and the closure of laboratories and classrooms. Consequently, new technologies were created, and those already been developed started to be better explored. However, information about many of these instruments and resources is not available to anatomy teachers. This systematic review presents the technological means for teaching and learning about human anatomy developed and applied in medical courses in the last ten years, besides the infrastructure necessary to use them. Studies in English, Portuguese, and Spanish were searched in MEDLINE, Scopus, ERIC, LILACS, and SciELO databases, initially resulting in a total of 875 identified articles, from which 102 were included in the analysis. They were classified according to the type of technology used: three-dimensional (3D) printing (n = 22), extended reality (n = 49), digital tools (n = 23), and other technological resources (n = 8). It was made a detailed description of technologies, including the stage of the medical curriculum in which it was applied, the infrastructure utilized, and which contents were covered. The analysis shows that between all technologies, those related to the internet and 3D printing are the most applicable, both in student learning and the financial cost necessary for its structural implementation.
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Affiliation(s)
- Vinícius A Santos
- School of Medicine, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
| | - Matheus P Barreira
- School of Medicine, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
| | - Karen R Saad
- Department of Morphology, School of Medicine, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
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Haidar DA, Kessler R, Khanna NK, Cover MT, Burkhardt JC, Theyyunni N, Tucker RV, Huang RD, Holman E, Bridge PD, Klein KA, Fung CM. Association of a longitudinal, preclinical ultrasound curriculum with medical student performance. BMC MEDICAL EDUCATION 2022; 22:50. [PMID: 35062942 PMCID: PMC8780388 DOI: 10.1186/s12909-022-03108-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Point-of-care ultrasound (US) is used in clinical practice across many specialties. Ultrasound (US) curricula for medical students are increasingly common. Optimal timing, structure, and effect of ultrasound education during medical school remains poorly understood. This study aims to retrospectively determine the association between participation in a preclinical, longitudinal US curriculum and medical student academic performance. METHODS All first-year medical students at a medical school in the Midwest region of the United States were offered a voluntary longitudinal US curriculum. Participants were selected by random lottery. The curriculum consisted of five three-hour hands on-sessions with matching asynchronous content covering anatomy and pathologic findings. Content was paired with organ system blocks in the standard first year curriculum at our medical school. Exam scores between the participating and non-participating students were compared to evaluate the objective impact of US education on performance in an existing curriculum. We hypothesized that there would be an association between participation in the curriculum and improved medical student performance. Secondary outcomes included shelf exam scores for the surgery, internal medicine, neurology clerkships and USMLE Step 1. A multivariable linear regression model was used to evaluate the association of US curriculum participation with student performance. Scores were adjusted for age, gender, MCAT percentile, and science or engineering degree. RESULTS 76 of 178 students applied to participate in the curriculum, of which 51 were accepted. US curriculum students were compared to non-participating students (n = 127) from the same class. The US curriculum students performed better in cardiovascular anatomy (mean score 92.1 vs. 88.7, p = 0.048 after adjustment for multiple comparisons). There were no significant differences in cumulative cardiovascular exam scores, or in anatomy and cumulative exam scores for the gastroenterology and neurology blocks. The effect of US curriculum participation on cardiovascular anatomy scores was estimated to be an improvement of 3.48 points (95% CI 0.78-6.18). No significant differences were observed for USMLE Step 1 or clerkship shelf exams. There were no significant differences in either preclinical, clerkship or Step 1 score for the 25 students who applied and were not accepted and the 102 who did not apply. CONCLUSIONS Participation in a preclinical longitudinal US curriculum was associated with improved exam performance in cardiovascular anatomy but not examination of other cardiovascular system concepts. Neither anatomy or comprehensive exam scores for neurology and gastrointestinal organ system blocks were improved.
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Affiliation(s)
- David A Haidar
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Ross Kessler
- Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Neil K Khanna
- Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan, USA
| | - Michael T Cover
- Department of Emergency Medicine, University Hospitals, Cleveland, Ohio, USA
| | - John C Burkhardt
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Nik Theyyunni
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryan V Tucker
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Rob D Huang
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Holman
- Office of Evaluation and Assessment, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Patrick D Bridge
- Office of Evaluation and Assessment, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Katherine A Klein
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Christopher M Fung
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA.
- Taubman Center, B1-380A 1500 E. Medical Center Dr., SPC 5305, 48109, Ann Arbor, USA, MI.
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Camilo GB, Abu-Zidan F, Koratala A. Editorial: Experiences and advances in endocrinology point-of-care ultrasound (POCUS). Front Endocrinol (Lausanne) 2022; 13:1094024. [PMID: 36755579 PMCID: PMC9901292 DOI: 10.3389/fendo.2022.1094024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/28/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- Gustavo Bittenourt Camilo
- Department of Anatomy, Juiz de Fora Federal University, Juiz de Fora, Brazil
- *Correspondence: Gustavo Bittenourt Camilo,
| | - Fikri Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Abhilash Koratala
- College of Health Sciences, University of Wisconsin–Milwaukee, Milwaukee, WI, United States
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Raja AE, Shustorovich A, Robinson DM, Alfonso K, Meyer R, Roemmich RT, Eng C, Wisniewski SJ, Cabahug P. Musculoskeletal Ultrasound as a Motivator for Selecting a Physical Medicine and Rehabilitation Residency Program in the United States: A Multicenter Survey Study. Am J Phys Med Rehabil 2022; 101:97-103. [PMID: 33605576 PMCID: PMC8371081 DOI: 10.1097/phm.0000000000001719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACT This study aimed to determine the influence of musculoskeletal ultrasound (MSKUS) curriculum on applicants during the residency-selection process. A survey of 666 applicants for the Johns Hopkins University, Mayo Clinic, and Harvard/Spaulding Rehabilitation Physical Medicine and Rehabilitation programs was conducted in June 2020. A total of 180 respondents scored the influence of a MSKUS curriculum on their decision making for residency selection. In addition, applicants were asked to rank specific areas of physical medicine and rehabilitation that influenced their decision making. Participants most commonly included MSKUS in their top three areas of interest when constructing their rank order list. When asked whether MSKUS presence within a program had an effect during the interview-selection process, 71% responded with "very important" or "absolutely essential" (P < 0.001). For 74% of applicants, exposure to MSKUS in residency was an important factor when creating their rank order list (P < 0.001). More than 92% of applicants stated that they are "likely" or "very likely" to use MSKUS in their future practice and 83% would recommend a program with MSKUS to future candidates (P < 0.001). Based on these results, a large percentage of physical medicine and rehabilitation applicants intend on using MSKUS in their future practice. Therefore, MSKUS may be an important factor for residency selection.
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Affiliation(s)
- Altamash E Raja
- From the Department of Physical Medicine & Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland (AER, AS, RM, RTR, PC); Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, Massachusetts (DMR, CE); Department of Physical Medicine & Rehabilitation, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota (KA, SJW); and Center for Movement Studies (RTR) and International Center for Spinal Cord Injury (PC), Kennedy Krieger Institute, Baltimore, Maryland
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Hendi A. Effectiveness of a short course on undergraduate medical students' acquisition of basic ultrasound skills: Findings from a Saudi University. SAUDI JOURNAL OF MEDICINE AND MEDICAL SCIENCES 2022; 10:253-258. [PMID: 36247054 PMCID: PMC9555041 DOI: 10.4103/sjmms.sjmms_560_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/20/2022] [Accepted: 08/17/2022] [Indexed: 11/04/2022] Open
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Oberoi MK, Perera NC, Reynaga J, Yoo BR, Miller CC, Lockhart W, Entezampour M, Friedman L. Students Teaching Students: Student-Led Ultrasound Curriculum in Medical School Education. Cureus 2021; 13:e19332. [PMID: 34909295 PMCID: PMC8653858 DOI: 10.7759/cureus.19332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction With the expanding use of point-of-care ultrasound throughout medical specialties for the rapid bedside assessment integral to patient care, medical schools have sought to incorporate ultrasound education into their curriculum. Second-year medical students (MS2s) at our institution met this demand by forming the Ultrasound Student Instructor Cadre (USSIC), a longitudinal ultrasound curriculum where MS2s teach first-year medical students (MS1s). The objectives of this study were to assess the ultrasound knowledge of medical students and their perceptions of ultrasound incorporation into their medical education. Methods Our flipped classroom curriculum consisted of four lessons (cardiopulmonary, gastrointestinal, genitourinary, and musculoskeletal) composed of videos, didactic lessons, and hands-on probe-time, with 15-minute pre- and post-assessments. Paired Wilcoxon signed-rank tests were performed to evaluate the differences in the pre- and post-assessment scores for each teaching session. Additionally, an end-of-the-year survey assessed the perceived preparedness and overall satisfaction of the MS1s with the course. Results The differences between the pre- and post-assessments for each teaching session were statistically significant: cardiopulmonary (45.6 ± 16.9% vs. 82.9 ± 9.4%, p < 0.0001, n = 55), gastrointestinal (53.9 ± 18.0% vs. 84.1 ± 13.5%, p < 0.0001, n = 54), genitourinary (68.9 ± 19.1% vs. 91.4 ± 14.4%, p < 0.0001, n = 64), and musculoskeletal (33.6 ± 14.7% vs. 78.2 ± 18.2%, p < 0.0001, n = 55). Conclusion Our study suggests that MS1s met the learning objective for each teaching session. Furthermore, MS1s who became USSIC instructors as MS2s felt more prepared and were more satisfied with the course. This study demonstrates the efficacy of student-led instruction in ultrasound, and we offer our model for adoption into other medical schools.
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Affiliation(s)
- Michelle K Oberoi
- Emergency Medicine, University of California, Riverside School of Medicine, Riverside, USA
| | - Niresh C Perera
- Emergency Medicine, Harbor-University of California Los Angeles Medical Center, Los Angeles, USA
| | - Josue Reynaga
- Family Medicine, Scripps Mercy Hospital Chula Vista, Chula Vista, USA
| | - Bo Ram Yoo
- Psychiatry, University of California Riverside, Riverside University Health System, Riverside, USA
| | - Christopher C Miller
- Medical Simulation and Research, University of California, Riverside School of Medicine, Riverside, USA
| | - Wesley Lockhart
- Medical Simulation and Research, University of California, Riverside School of Medicine, Riverside, USA
| | - Mo Entezampour
- Medical Simulation and Research, University of California, Riverside School of Medicine, Riverside, USA
| | - Lucas Friedman
- Emergency Medicine, University of California, Riverside School of Medicine, Riverside, USA
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Kefala-Karli P, Sassis L, Sassi M, Zervides C. Introduction of ultrasound-based living anatomy into the medical curriculum: a survey on medical students' perceptions. Ultrasound J 2021; 13:47. [PMID: 34862937 PMCID: PMC8643372 DOI: 10.1186/s13089-021-00247-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/09/2021] [Indexed: 11/24/2022] Open
Abstract
Background Traditional anatomy teaching methods are based on the models and cadaveric dissections, providing fixed views of the anatomical structures. However, in the last few years, the emerging concept of ultrasound-based teaching in anatomy has started to gain ground among medical curricula. This study aims to evaluate the integration of ultrasound as an adjunct tool to traditional anatomy teaching methods and explore students’ perceptions of whether ultrasound-based teaching enhances their interest and knowledge of anatomy. A cross-sectional study was carried out among the students of the 6-year undergraduate entry (MD) and 4-year graduate entry (MBBS) program of the University of Nicosia. A questionnaire was distributed to them after the delivery of several twenty minutes ultrasound sessions by an expert in the field during anatomy practicals. The data were analyzed utilizing SPSS software, and the statistical significance was determined as p value < 0.05. Results 107 MD and 42 MBBS students completed the questionnaire. Both groups agreed that their ultrasound-based learning experience was good or excellent (79.4% MD students; 92.9% MBBS students), that it enhanced their knowledge of anatomy (68.2% MD students; 90.5% MBBS students) and boosted their confidence regarding their examination skills practice (69.2% MD students; 85.7% MBBS students). Although most students desired more time allocated to the ultrasound station (72% MD students; 85.7% MBBS students), they believed that ultrasound-based teaching is a necessary adjunct to the traditional teaching methods of anatomy (89.7% MD students; 92.9% MBBS students). Conclusions Overall, MBBS students were more confident about the benefits of ultrasound-based teaching. Most of the students agreed that cross-sectional sessions of traditional teaching and ultrasound-based teaching strengthened their knowledge of anatomy and enhanced their confidence concerning their clinical examination skills. Medical schools should embrace the advantages that ultrasound-based teaching offers in order future doctors to be qualified to utilize ultrasound for procedural and diagnostical purposes. Supplementary Information The online version contains supplementary material available at 10.1186/s13089-021-00247-1.
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Affiliation(s)
- Pelagia Kefala-Karli
- School of Medicine, University of Nicosia, 21 Ilia Papakyriakou Street, 2414, Engomi, Nicosia, Cyprus
| | - Leandros Sassis
- School of Medicine, University of Nicosia, 21 Ilia Papakyriakou Street, 2414, Engomi, Nicosia, Cyprus
| | - Marina Sassi
- Children's Hospital "Agia Sofia", Thivon Ave. and Papadiamantopoulou Street, 11527, Athens, Greece
| | - Constantinos Zervides
- School of Medicine, University of Nicosia, 21 Ilia Papakyriakou Street, 2414, Engomi, Nicosia, Cyprus. .,Department of Medical Physics and Clinical Engineering, Mediterranean Hospital of Cyprus, 9 Stygos Str., 3117, Limassol, Cyprus.
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Nicholas E, Ly AA, Prince AM, Klawitter PF, Gaskin K, Prince LA. The Current Status of Ultrasound Education in United States Medical Schools. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:2459-2465. [PMID: 33448471 DOI: 10.1002/jum.15633] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/18/2020] [Accepted: 01/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Ultrasound is used by nearly every medical specialty. Medical schools are integrating ultrasound education into their curriculum but studies show this to be inconsistent. The purpose of this study was to provide an updated description of ultrasound in the curricula of United States Accredited Medical Schools (USAMS). METHODS In 2019, USAMS curricular offices were contacted. Institutions were asked about the presence of ultrasound curriculum and for contact information for faculty involved with education. Schools reporting ultrasound curriculum were surveyed regarding details of their curriculum. RESULTS Two hundred USAMS were contacted with a response rate of 84%. Of 168 schools, 72.6% indicated they have an ultrasound curriculum. For schools with a curriculum, 79 (64.8%) completed our survey. The majority of survey respondents, 66 (83.5%), indicated having mandatory ultrasound. Ultrasound is primarily integrated into courses (73.8% in basic science courses, 66.2% in clinical skills courses, and 35.4% in clinical rotations). Emergency medicine physicians accounted for 54.7% of course directors. Ten or fewer faculty participate in education in 68.4% of schools and mostly as volunteers. Dedicated machines for education were reported by 78.5% of schools. CONCLUSIONS Compared to prior studies, this study had a higher response rate at 84%, and more schools reported ultrasound in their curricula. Emergency medicine represents the majority of leadership in ultrasound education. Despite increased integration of ultrasound into American medical school curricula, its instruction is still inconsistent.
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Affiliation(s)
- Elizabeth Nicholas
- Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
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Zavitz J, Sarwal A, Schoeneck J, Glass C, Hays B, Shen E, Bryant C, Gupta K. Virtual multispecialty point-of-care ultrasound rotation for fourth-year medical students during COVID-19: Innovative teaching techniques improve ultrasound knowledge and image interpretation. AEM EDUCATION AND TRAINING 2021; 5:e10632. [PMID: 34179677 PMCID: PMC8209882 DOI: 10.1002/aet2.10632] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/18/2021] [Accepted: 06/02/2021] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Point-of-care ultrasound (PoCUS) has been integrated into undergraduate medical education. The COVID-19 pandemic forced medical schools to evolve clinical rotations to minimize interruption through implementation of novel remote learning courses. To address the students' need for remote clinical education, we created a virtual PoCUS course for our fourth-year class. We present details of the course's development, implementation, quality improvement processes, achievements, and limitations. METHODS A virtual PoCUS course was created for 141 fourth-year medical students. The learning objectives included ultrasound physics, performing and interpreting ultrasound applications, and incorporating PoCUS into clinical decisions and procedural guidance. Students completed a 30-question pre- and posttest focused on ultrasound and knowledge of clinical concepts. PoCUS educators from 10 different specialties delivered the course over 10 days using video-conferencing software. Students watched live scanning demonstrations and practiced ultrasound probe maneuvers using a cellular telephone to simulate ultrasound probe. Students completed daily course evaluations that were used as a continuous needs assessment to make improvements. RESULTS A total of 141 students participated in the course; all received a passing grade. The mean pre- and posttest scores improved from 58% to 88% (p < 0.001) through the course duration. Daily evaluations revealed the percentage of students who rated the course's live scanning sessions and didactic components as "very well" increased from 32.7% on day 1 to 69.7% on day 10. The end-of-course evaluation revealed that 91% of students agreed they received effective teaching. CONCLUSIONS In response to the COVID-19 pandemic, our multispecialty faculty expeditiously developed a virtual PoCUS curriculum for the entire fourth-year class. This innovative course improved students' ultrasound knowledge, image interpretation, and clinical application while utilizing novel techniques to teach a hands-on skill virtually. As the demand for PoCUS instruction continues to increase, the accessibility of virtual training and blended learning will be beneficial.
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Affiliation(s)
- Joshua Zavitz
- Department of Emergency MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Aarti Sarwal
- Department of NeurologyWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Jacob Schoeneck
- Department of Emergency MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Casey Glass
- Department of Emergency MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Brandon Hays
- Department of Pediatric CardiologyWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - E. Shen
- Medical EducationWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Casey Bryant
- Department of Critical CareWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Karisma Gupta
- Wake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
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Kaganovskaya M, Wuerz L. Development of an educational program using ultrasonography in vascular access for nurse practitioner students. ACTA ACUST UNITED AC 2021; 30:S34-S42. [PMID: 33529109 DOI: 10.12968/bjon.2021.30.2.s34] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
HIGHLIGHTS Ultrasonography is an important tool for vascular access practice. Ultrasound should be used for vascular access assessment and insertion. Ultrasonography should be incorporated into formal nursing education curriculum and simulation training. BACKGROUND This study analyzed nurse practitioner students' knowledge of ultrasound-guided vascular access after the implementation of an educational and simulation course. METHODS Nurses' knowledge of ultrasound-guided peripheral intravenous catheter placement was analyzed using a ten-item questionnaire both before and after course. A sample of bachelor's degree-prepared nurses voluntarily participated in this study. Ultrasonography simulation was carried out with two handheld ultrasound devices and two ultrasound blocks. RESULTS The findings demonstrated that there is a statistically significant increased comprehension of ultrasoundguided vascular access after simulation courses. CONCLUSION This study illuminates the need for formal education both in academic curriculum and through simulation to improve ultrasound-guided vascular access knowledge for patient care.
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Affiliation(s)
- Marcel Kaganovskaya
- Department of Surgery, Bronx, NY, and Wagner College-Evelyn Spiro School of Nursing, Staten Island, NY
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Glass C, Sarwal A, Zavitz J, Nitsche J, Joyner J, Johnson LL, Garcia-Vargas J, O'Brien MC. Scoping review of implementing a longitudinal curriculum in undergraduate medical education: The wake forest experience. Ultrasound J 2021; 13:23. [PMID: 33871741 PMCID: PMC8055803 DOI: 10.1186/s13089-021-00206-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hands-on ultrasound experience has become a desirable component for undergraduate medical education (UGME) curricula throughout medical schools in the United States (US) to enhance readiness for future training. Ultrasound integration can be a useful assistive educational method in undergraduate medical education to improve anatomy and physiology skills. Relatively few medical schools have integrated ultrasound experiences formally into their 4-year medical school curriculum due to limitations of a resource intensive set up. METHODS We undertook a scoping review of published UGME ultrasound curricula integrated into all four years in peer-reviewed as well online literature. In addition, we provide a narrative review of our institutional experience in conceptualization, design and implementation of UGME ultrasound curriculum driven by need to address the fading knowledge in anatomy and physiology concepts beyond pre-clinical years. RESULTS Integrated ultrasound curriculum at WFSOM utilizes focused ultrasonography as a teaching aid for students to gain a more thorough understanding of basic and clinical science concepts taught in the medical school curriculum. We found 18 medical schools with ultrasound curricula published in peer-reviewed literature with a total of 33 ultrasound programs discovered by adding Google search and personal communication CONCLUSIONS: The results of the review and our institutional experience can help inform future educators interested in developing similar curricula in their undergraduate programs. Common standards, milestones and standardized competency-based assessments would be helpful in more widespread application of ultrasound in UGME curricula.
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Affiliation(s)
- Casey Glass
- Department of Emergency Medicine, Medical Center, Wake Forest School of Medicine, 1 Winston-Salem, Boulevard, NC, 27157, USA
| | - Aarti Sarwal
- Department of Neurology, Medical Center, Wake Forest School of Medicine, 1 Winston-Salem, Boulevard, NC, 27157, USA
| | - Joshua Zavitz
- Department of Emergency Medicine, Medical Center, Wake Forest School of Medicine, 1 Winston-Salem, Boulevard, NC, 27157, USA
| | - Joshua Nitsche
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Medical Center, 1 Winston-Salem, Boulevard, NC, 27157, USA
| | - JaNae Joyner
- Department of Medical Education, Wake Forest School of Medicine, Medical Center , 1 Winston-Salem, Boulevard, NC, 27157, USA
| | - Leilani L Johnson
- Department of Neurology, Medical Center, Wake Forest School of Medicine, 1 Winston-Salem, Boulevard, NC, 27157, USA.
| | - Julia Garcia-Vargas
- Department of Neurology, Medical Center, Wake Forest School of Medicine, 1 Winston-Salem, Boulevard, NC, 27157, USA
| | - Mary Claire O'Brien
- Department of Emergency Medicine, Medical Center, Wake Forest School of Medicine, 1 Winston-Salem, Boulevard, NC, 27157, USA
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Yinh J, Torralba KD, Choi KS, Fairchild RM, Cannella A, Salto L, Kissin EY, Thiele R, Oberle EJ, Marston B, Nishio MJ. North American musculoskeletal ultrasound scanning protocol of the hip, knee, ankle, and foot: update of a Delphi consensus study. Clin Rheumatol 2021; 40:4233-4242. [PMID: 33821367 DOI: 10.1007/s10067-021-05716-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE A North American rheumatology consensus on tiered-mastery designation for anatomic views was developed in 2011 for course and fellowship teaching. This study updates the lower extremity joint scanning protocols aiming to inform musculoskeletal ultrasound curriculum development for the American College of Rheumatology affiliated Fellowship Programs. METHODS Three Delphi rounds were conducted to reach consensus for tiered-level mastery designation for hip, knee, ankle, and foot scanning views. The survey was disseminated (Qualtrics™) to 101 potential participants with ultrasound teaching experience. High agreement was defined as ≥ 85% consensus and final tier designation as having >50% agreement for the preferred tier. Response changes were evaluated by McNemar's chi-square test. RESULTS Consensus regarding tier designations was reached for 80% of the views. Three knee views (anterior transverse suprapatellar, medial, and lateral longitudinal) and 2 ankle views (anterior and posterior transverse) achieved upgrades to tier 1 from 2. The transverse sacroiliac hip joint was downgraded from tier 2 to 3. The lateral longitudinal hip view was added with a tier 1 designation. CONCLUSION Updated scanning protocols support modifications reflecting current scanning methods delivered by North American rheumatologists performing point of care ultrasound that may inform educators involved in rheumatology ultrasound. Key Points • The anterior transverse suprapatellar, medial, and lateral longitudinal knee views; the anterior and posterior transverse ankle views; and the lateral longitudinal view hip view were perceived as important to master and perform routinely. • The transverse sacroiliac joint view was suggested to be performed based on practice focus.
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Affiliation(s)
- Janeth Yinh
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Yawkey 2C, Boston, MA, 02144, USA.
| | - Karina D Torralba
- Division of Rheumatology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Kristal S Choi
- Division of Rheumatology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Robert M Fairchild
- Division of Immunology and Rheumatology, Stanford University, Stanford, CA, USA
| | - Amy Cannella
- Division of Rheumatology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Lorena Salto
- Department of Basic Sciences, Loma Linda University, Loma Linda, CA, USA
| | - Eugene Y Kissin
- Division of Rheumatology, Boston University, Boston, MA, USA
| | - Ralf Thiele
- Division of Rheumatology, University of Rochester, Rochester, NY, USA
| | - Edward J Oberle
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Division of Rheumatology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Bethany Marston
- Division of Pediatric Rheumatology and Division of Allergy/Immunology and Rheumatology, University of Rochester, Rochester, NY, USA
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Situ-LaCasse E, Acuña J, Huynh D, Amini R, Irving S, Samsel K, Patanwala AE, Biffar DE, Adhikari S. Can ultrasound novices develop image acquisition skills after reviewing online ultrasound modules? BMC MEDICAL EDUCATION 2021; 21:175. [PMID: 33743680 PMCID: PMC7980807 DOI: 10.1186/s12909-021-02612-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/11/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Point-of-care ultrasound is becoming a ubiquitous diagnostic tool, and there has been increasing interest to teach novice practitioners. One of the challenges is the scarcity of qualified instructors, and with COVID-19, another challenge is the difficulty with social distancing between learners and educators. The purpose of our study was to determine if ultrasound-naïve operators can learn ultrasound techniques and develop the psychomotor skills to acquire ultrasound images after reviewing SonoSim® online modules. METHODS This was a prospective study evaluating first-year medical students. Medical students were asked to complete four SonoSim® online modules (aorta/IVC, cardiac, renal, and superficial). They were subsequently asked to perform ultrasound examinations on standardized patients utilizing the learned techniques/skills in the online modules. Emergency Ultrasound-trained physicians evaluated medical students' sonographic skills in image acquisition quality, image acquisition difficulty, and overall performance. Data are presented as means and percentages with standard deviation. All P values are based on 2-tailed tests of significance. RESULTS Total of 44 medical students participated in the study. All (100%) students completed the hands-on skills evaluation with a median score of 83.7% (IQR 76.7-88.4%). Thirty-three medical students completed all the online modules and quizzes with median score of 87.5% (IQR 83.8-91.3%). There was a positive association between module quiz performance and the hands-on skills performance (R-squared = 0.45; p < 0.001). There was no statistically significant association between module performance and hands-on performance for any of the four categories individually. In all four categories, the evaluators' observation of the medical students' difficulty obtaining views correlated with hands-on performance scores. CONCLUSIONS Our study findings suggest that ultrasound-naïve medical students can develop basic hands-on skills in image acquisition after reviewing online modules.
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Affiliation(s)
- Elaine Situ-LaCasse
- University of Arizona, College of Medicine & Banner University Medical Center - Tucson, Department of Emergency Medicine, PO Box 245057, Tucson, AZ 85724 USA
| | - Josie Acuña
- University of Arizona, College of Medicine & Banner University Medical Center - Tucson, Department of Emergency Medicine, PO Box 245057, Tucson, AZ 85724 USA
| | - Dang Huynh
- Tucson Medical Center, Department of Emergency Medicine, Tucson, AZ USA
| | - Richard Amini
- College of Medicine, Department of Emergency Medicine, University of Arizona, Tucson, AZ USA
| | | | - Kara Samsel
- Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, TX USA
| | | | - David E. Biffar
- Arizona Simulation Technology and Education Center – University of Arizona Health Sciences, Tucson, AZ USA
| | - Srikar Adhikari
- College of Medicine, Department of Emergency Medicine, University of Arizona, Tucson, AZ USA
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Russell FM, Herbert A, Ferre RM, Zakeri B, Echeverria V, Peterson D, Wallach P. Development and implementation of a point of care ultrasound curriculum at a multi-site institution. Ultrasound J 2021; 13:9. [PMID: 33615390 PMCID: PMC7897586 DOI: 10.1186/s13089-021-00214-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/13/2021] [Indexed: 12/23/2022] Open
Abstract
In 2014, over 60% of medical schools were incorporating point of care ultrasound (POCUS) into their curriculum. Today, over 6 years later, many more schools are teaching POCUS or are in the planning stages of implementing a POCUS curriculum. In 2019, the AAMC reported that 53 schools or over one-third of US medical schools have multi-site campuses for undergraduate medical education. Implementation of a POCUS educational initiative at a multi-site campus presents unique challenges for teaching a uniform curriculum statewide. This article will discuss the POCUS curriculum and implementation process at a large multi-site institution.
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Affiliation(s)
- Frances M Russell
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA.
| | - Audrey Herbert
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
| | - Robinson M Ferre
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
| | - Bita Zakeri
- Education and Continuing Medical Education, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Dina Peterson
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Paul Wallach
- Department of Internal Medicine, Office of the Dean, Indiana University School of Medicine, Indianapolis, IN, USA
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Valenciaga A, Ivancic RJ, Khawaja R, Way DP, Bahner DP. Efficacy of an Integrated Hands-On Thyroid Ultrasound Session for Medical Student Education. Cureus 2021; 13:e12421. [PMID: 33542869 PMCID: PMC7847777 DOI: 10.7759/cureus.12421] [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] [Indexed: 11/16/2022] Open
Abstract
As ultrasound has gained popularity with improving technology and ease-of-use, a push has been made to integrate ultrasound into the medical school curriculum. Many institutions are reporting one- to four-year integrated ultrasound curricula to augment anatomy and pathophysiology teaching. Our goal was to integrate a thyroid ultrasound scanning session into the endocrinology block of our institution’s medical school curriculum to enhance medical student understanding of thyroid anatomy and pathophysiology. We conducted a prospective, single-center cohort (pre-experimental) study to evaluate student performance and knowledge acquisition using a pretest-posttest design. These multimodal sessions, consisting of a didactic, hands-on scanning sessions, and knowledge integration tests, covered ultrasound technique and thyroid evaluation and advanced to diagnosing an abnormal thyroid and working up a thyroid nodule. There were 26 to 27 second-year medical students per session who rotated between three stations proctored by credentialled physicians. Students participated in hands-on scanning of patients with or without thyroid pathology at each station. Out of the 209 students who participated in the ultrasound sessions, 114 (54.5%) consented to participate in the research project and completed both the pretest and posttest. Test data from the 114 students showed a mean pretest score of 57.5% ± 14.6% and the mean posttest score of 73.9% ± 17.4%. They had a 16.5% ± 19.6% (p < 0.001) increase in score between the two tests. Our study demonstrates that a multimodal thyroid ultrasound scanning session is an effective tool to augment the medical school endocrinology curriculum and to improve students’ knowledge of thyroid anatomy, pathophysiology, and diagnostic workup of thyroid nodules.
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Affiliation(s)
- Anisley Valenciaga
- Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Ryan J Ivancic
- Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Raheela Khawaja
- Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, USA
| | - David P Way
- Emergency Medicine, The Ohio State University, Columbus, USA
| | - David P Bahner
- Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, USA
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van Rijn RR, Stafrace S, Arthurs OJ, Rosendahl K. Non-radiologist-performed point-of-care ultrasonography in paediatrics - European Society of Paediatric Radiology position paper. Pediatr Radiol 2021; 51:161-167. [PMID: 33211186 PMCID: PMC7796864 DOI: 10.1007/s00247-020-04843-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/07/2020] [Accepted: 09/07/2020] [Indexed: 12/22/2022]
Abstract
Non-radiologist point-of-care ultrasonography (US) is increasingly implemented in paediatric care because it is believed to facilitate a timely diagnosis, such as in ascites or dilated renal pelvicalyceal systems, and can be used to guide interventional procedures. To date, all policy statements have been published by non-radiologic societies. The European Society of Paediatric Radiology hereby issues a position statement on paediatric non-radiologist point-of-care US from the point of view of those leading on children's imaging, i.e. paediatric radiologists. In this position statement, we will address the boundaries, education, credentialing, quality control, reporting and storage of images in paediatric practice.
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Affiliation(s)
- Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital-Amsterdam UMC, University of Amsterdamn, Meibergdreef 9, 1105 AZ, Amsterdam Zuid-Oost, the Netherlands.
| | - Samuel Stafrace
- Department of Diagnostic Imaging, Sidra Medicine, Doha, Qatar
- Weill Cornell Medicine, Doha, Qatar
| | - Owen J Arthurs
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
- UCL GOS Institute of Child Health, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Karen Rosendahl
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
- The Arctic University of Norway, Tromsø, Norway
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Bowers R, Neuberger D, Williams C, Kneer L, Sussman W. The Impact of an Ultrasound Curriculum on the Accuracy of Resident Joint Line Palpation. PM R 2020; 13:1261-1265. [PMID: 33340274 DOI: 10.1002/pmrj.12538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Ultrasound education has been used as a tool to help improve physical examination skills. However, its utility in increasing accuracy of joint line palpation has yet to be investigated. OBJECTIVE To evaluate the accuracy of resident palpation and identification of the lateral knee joint line before and after introducing a musculoskeletal ultrasound (MSUS) curriculum. DESIGN Cohort study. SETTING A physical medicine and rehabilitation (PM&R) residency program at an academic institution. PARTICIPANTS Seventeen PM&R residents. INTERVENTIONS Residents underwent a knee-focused MSUS workshop. MAIN OUTCOME MEASURES Distance from needle placement to joint line confirmed with ultrasound. RESULTS All residents demonstrated improved accuracy in lateral knee joint line palpation after completing a knee-focused MSUS workshop, with statistically significant (P < .05) improvement in postgraduate year (PGY) 2 (P = .02), PGY-3 (P = .04), and across all residents (P = .001). CONCLUSIONS MSUS education significantly improved lateral knee joint line palpation accuracy in resident physicians.
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Affiliation(s)
- Robert Bowers
- Department of Physical Medicine & Rehabilitation, Emory University School of Medicine, Atlanta, GA.,Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
| | - David Neuberger
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA
| | | | - Lee Kneer
- Department of Physical Medicine & Rehabilitation, Emory University School of Medicine, Atlanta, GA.,Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
| | - Walter Sussman
- Department of Physical Medicine & Rehabilitation, Tufts University School of Medicine, Boston, MA
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Alerhand S, Choi A, Ostrovsky I, Chen S, Ramdin C, Laboy M, Lamba S. Integrating Basic and Clinical Sciences Using Point-of-Care Renal Ultrasound for Preclerkship Education. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2020; 16:11037. [PMID: 33324747 PMCID: PMC7732135 DOI: 10.15766/mep_2374-8265.11037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/03/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Point-of-care ultrasound (POCUS) is a valuable asset in bedside clinical care. Undergraduate medical education is increasingly using POCUS as an adjunct tool for teaching anatomy, pathophysiology, and physical exam in an integrated manner. Many medical schools teach content in an organ systems-based format in the preclerkship years. POCUS teaching can be very effectively tailored to specific organ systems. Though pilot curricula for generalized ultrasound education exist, few teach organ systems-based content using POCUS. To address this gap, we designed and implemented an integrated POCUS module to supplement anatomy, pathophysiology, and physical exam teaching in the renal course. METHODS The module consisted of (1) a 30-minute didactic lecture introducing students to renal ultrasound technique and image interpretation and (2) a practical hands-on skills session. Pre- and postmodule surveys assessed the efficacy and impact of the curriculum. RESULTS A total of 31 first-year medical students completed the POCUS renal curriculum. A majority reported that the module positively affected their understanding of renal pathophysiology and the physical exam. They also reported increased confidence in using POCUS to detect renal pathology and make clinical decisions. DISCUSSION It was feasible to implement a POCUS curriculum to supplement integrated teaching of renal system concepts in the first year of medical school, and students found POCUS teaching valuable. POCUS provides educators with another tool to integrate basic and clinical sciences with hands-on relevant clinical skills practice in early medical school years.
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Affiliation(s)
- Stephen Alerhand
- Assistant Professor, Department of Emergency Medicine, Rutgers New Jersey Medical School
| | - April Choi
- Resident Physician, Department of Emergency Medicine, Rutgers New Jersey Medical School
| | - Ilya Ostrovsky
- Assistant Professor, Department of Emergency Medicine, Rutgers New Jersey Medical School
| | - Sophia Chen
- Assistant Professor, Department of Pediatrics, Rutgers New Jersey Medical School
| | - Christine Ramdin
- Research Associate, Department of Emergency Medicine, Rutgers New Jersey Medical School
| | - Maria Laboy
- Administrative Director, Clinical Skills Center, Rutgers New Jersey Medical School
| | - Sangeeta Lamba
- Professor, Department of Emergency Medicine, Rutgers New Jersey Medical School
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Importance of Ultrasound Education in Undergraduate Medical Curriculum: A Survey Study Based on First-Year Medical Students' Perception of the 6-Year Doctor of Medicine Program of the University of Nicosia Medical School in Cyprus. Ultrasound Q 2020; 36:328-332. [PMID: 33136934 DOI: 10.1097/ruq.0000000000000540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ultrasound imaging modality is a tool used in clinical practice and is being introduced gradually in the undergraduate curriculum of several medical schools worldwide. This study aims to assess medical students' perception regarding the integration of ultrasound training as part of undergraduate education. A questionnaire was given to first-year medical students after a 2-hour-long session, which was developed to introduce them in the fundamental physics theory and function of ultrasound equipment in the clinical practice. Analysis of the results indicated that students acknowledged that ultrasound training would improve their knowledge of internal medicine (P = 0.027) and of different diagnostic modalities (P = 0.019), and enhance their medical decision making (P = 0.0004). Moreover, students found beneficial the ultrasound education regarding correlating clinical knowledge with basic sciences (P = 0.0004). The study pointed out that the majority of first-year students have the opinion that the integration of ultrasound training in the medical program is valuable in medical education and patient care. However, work is needed to determine how to provide an optimal learning environment and to assess the competency of the training sessions.
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Hammadah M, Ponce C, Sorajja P, Cavalcante JL, Garcia S, Gössl M. Point-of-care ultrasound: Closing guideline gaps in screening for valvular heart disease. Clin Cardiol 2020; 43:1368-1375. [PMID: 33174635 PMCID: PMC7724242 DOI: 10.1002/clc.23499] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/14/2020] [Accepted: 10/19/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND A linear increase in the number of valvular heart disease is expected due to the aging population, yet most patients with severe valvular heart disease remain undiagnosed. HYPOTHESIS POCUS can serve as a screening tool for valvular heart disease. METHODS We reviewed the literature to assess the strengths and limitations of POCUS in screening and diagnosing valvular heart disease. RESULTS POCUS is an accurate, affordable, accessible, and comprehensive tool. It has a fast learning curve and can prevent unnecessary and more expensive imaging. Challenges include training availability, lack of simplified screening protocols, and reimbursement. Large scale valvular screening data utilizing POCUS is not available. CONCLUSION POCUS can serve as a screening tool and guide the management of patients with valvular heart disease. More data is needed about its efficacy and cost-effectiveness in the screening of patients with valvular heart disease.
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Affiliation(s)
- Muhammad Hammadah
- Interventional Cardiology DepartmentMinneapolis Heart instituteMinneapolisMinnesotaUSA
| | - Christopher Ponce
- Interventional Cardiology DepartmentMinneapolis Heart instituteMinneapolisMinnesotaUSA
| | - Paul Sorajja
- Interventional Cardiology DepartmentMinneapolis Heart instituteMinneapolisMinnesotaUSA
| | - João L. Cavalcante
- Interventional Cardiology DepartmentMinneapolis Heart instituteMinneapolisMinnesotaUSA
| | - Santiago Garcia
- Interventional Cardiology DepartmentMinneapolis Heart instituteMinneapolisMinnesotaUSA
| | - Mario Gössl
- Interventional Cardiology DepartmentMinneapolis Heart instituteMinneapolisMinnesotaUSA
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