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Graglia S, Huang C, Shokoohi H, Liteplo AS. Faculty opinions concerning ultrasound utilization in the emergency department. Am J Emerg Med 2018; 37:1372-1374. [PMID: 30563715 DOI: 10.1016/j.ajem.2018.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Sally Graglia
- Department of Emergency Medicine, University of California, San Francisco - San Francisco General Hospital, UCSF Medical School, San Francisco CA, United States of America
| | - Calvin Huang
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
| | - Hamid Shokoohi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
| | - Andrew S Liteplo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
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Feilchenfeld Z, Kuper A, Whitehead C. Stethoscope of the 21st century: dominant discourses of ultrasound in medical education. MEDICAL EDUCATION 2018; 52:1271-1287. [PMID: 30334276 DOI: 10.1111/medu.13714] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/11/2018] [Accepted: 07/12/2018] [Indexed: 06/08/2023]
Abstract
CONTEXT In recent years, point-of-care ultrasound (POCUS) has become a widely used clinical tool in a number of clinical specialties. In response, POCUS has been incorporated into medical curricula across the learning continuum, bolstered by enthusiastic appraisals of the technology's benefits for learners, clinicians and patients. In this project, we have sought to identify and understand the effects of dominant discourses influencing the integration of POCUS into medical education. METHODS We conducted a Foucauldian critical discourse analysis (CDA) to identify and analyse discourses that legitimise and privilege the use of POCUS in medical education. We assembled an archive of 473 texts published between 1980 and 2017. Each article in the archive was analysed to identify frequently occurring truth statements (expressing concepts whose truths are unquestioned within particular discourses) that we used to characterise the major discourses that construct representations of POCUS in medical education. RESULTS We identified three dominant discourses: (i) a visuo-centric discourse prioritising the visual information as truth over other clinical data; (ii) a utilitarian discourse emphasising improvements in patient care; and (iii) a modernist discourse highlighting the current and future needs of clinicians in our technological world. These discourses overlap and converge; the core discursive effect makes the further elevation of POCUS in medical education, and the resulting attenuation of other curricular priorities, appear inevitable. CONCLUSIONS The three dominant discourses identified in this paper engender ideal conditions for the proliferation of POCUS in medical education through curricular guidelines, surveys of adherence to these guidelines and authoritative position statements. By identifying and analysing these dominant discourses, we can ask questions that do not take for granted the assumed truths underpinning the discourses, highlight potential pitfalls of proposed curricular changes and ensure these changes truly improve medical education.
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Affiliation(s)
- Zac Feilchenfeld
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Ayelet Kuper
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- The Wilson Centre, Toronto, ON, Canada
| | - Cynthia Whitehead
- The Wilson Centre, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Hospital, Toronto, ON, Canada
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Medical Student Ultrasound Education: A WFUMB Position Paper, Part I. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 45:271-281. [PMID: 30497768 DOI: 10.1016/j.ultrasmedbio.2018.09.017] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 02/06/2023]
Abstract
The introduction of ultrasound into medical student education is well underway in many locations around the world, but is still in its infancy or has yet to begin in others. Proper incorporation of ultrasound education into medical training requires planning and resources, both capital and human. In this article, we discuss the state of the art of ultrasound in medical education throughout the world, as well as various methodologies utilized to improve student education and to incorporate ultrasound into every facet of training. Experiences from various educational systems and available evidence regarding the impact of ultrasound education are summarized. Representing multiple societies and specialties throughout the world, we discuss established modern as well as novel education structures and different successful approaches.
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Knudsen L, Nawrotzki R, Schmiedl A, Mühlfeld C, Kruschinski C, Ochs M. Hands-on or no hands-on training in ultrasound imaging: A randomized trial to evaluate learning outcomes and speed of recall of topographic anatomy. ANATOMICAL SCIENCES EDUCATION 2018; 11:575-591. [PMID: 29683560 DOI: 10.1002/ase.1792] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 05/14/2023]
Abstract
Medical students have difficulties in interpreting two-dimensional (2D) topographic anatomy on sectional images. Hands-on and no hands-on training in ultrasound imaging facilitate learning topographic anatomy. Hands-on training is linked with active search for patterns of anatomical structures and might train pattern recognition for image interpretation better although the added value on learning outcomes is unclear. This study explores first year medical students' knowledge in topographic anatomy of the upper abdomen after attending hands-on or no hands-on training in ultrasound in a randomized trial. While students in the hands-on ultrasound group (N = 21) generated and interpreted standardized planes of ultrasound imaging, students in the no hands-on seminar group (N = 22) interpreted provided ultrasound images by correlation to three-dimensional (3D) anatomical prosections. Afterwards knowledge in topographic anatomy was measured repetitively by text and ultrasound image-based multiple choice (MC) examinations. As surrogate for pattern recognition, students rated whether answers were known after reflection or instantly. While intrinsic motivation was higher in the ultrasound group, no differences in the MC-examination score were found between ultrasound and seminar group instantly (66.5 ±10.9% vs. 64.5% ±11.0%, P = 0.551) or six weeks (62.9% ±12.3% vs. 61.5% ±11.0%, P = 0.718) after training. In both groups scores in text-based questions declined (P < 0.001) while scores in image-based questions remained stable (P = 0.895) with time. After six weeks more image-based questions were instantly known in the hands-on ultrasound compared to seminar-group (28% ±17.3% vs. 16% ±13.5%, P = 0.047). Hands-on ultrasound-training is linked with faster interpreting of ultrasound images without loss in accuracy. The added value of hands-on training might be facilitation of pattern recognition.
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Affiliation(s)
- Lars Knudsen
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hanover, Germany
| | - Ralph Nawrotzki
- Department of Medical Cell Biology, Institute for Anatomy and Cell Biology, University of Heidelberg, Heidelberg, Germany
| | - Andreas Schmiedl
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hanover, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hanover, Germany
| | | | - Matthias Ochs
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hanover, Germany
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Davis JJ, Wessner CE, Potts J, Au AK, Pohl CA, Fields JM. Ultrasonography in Undergraduate Medical Education: A Systematic Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2667-2679. [PMID: 29708268 DOI: 10.1002/jum.14628] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/18/2018] [Indexed: 05/14/2023]
Abstract
OBJECTIVES The purpose of this study was to conduct a systematic review of the evidence of educational outcomes associated with teaching ultrasonography (US) to medical students. METHODS A review of databases through 2016 was conducted for research studies that reported data on teaching US to medical students. Each title and abstract were reviewed by teams of 2 independent abstractors to determine whether the article would be ordered for full-text review and subsequently by 2 independent authors for inclusion. Data were abstracted with a form developed a priori by the authors. RESULTS Ninety-five relevant unique articles were included (of 6936 identified in the databases). Survey data showed that students enjoyed the US courses and desired more US training. Of the studies that assessed US-related knowledge and skill, most of the results were either positive (16 of 25 for knowledge and 24 of 58 for skill) or lacked a control (8 of 25 for knowledge and 27 of 58 for skill). The limited evidence (14 of 95 studies) of the effect of US training on non-US knowledge and skill (eg, anatomy knowledge or physical examination skill) was mixed. CONCLUSIONS There is ample evidence that students can learn US knowledge and skills and that they enjoy and want US training in medical school. The evidence for the effect of US on external outcomes is limited, and there is insufficient evidence to recommend it for this purpose at this time.
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Affiliation(s)
- Joshua J Davis
- Department of Emergency Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Corinne E Wessner
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA
| | - Jacqueline Potts
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Arthur K Au
- Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Charles A Pohl
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - J Matthew Fields
- Department of Emergency Medicine, Kaiser Permanente San Diego, San Diego, California, USA
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Abstract
Limited research exists on PAs and use of point-of-care (POC) ultrasound. This pilot survey sought to determine current views on and use of POC ultrasound in a small group of PAs. METHODS The authors developed an anonymous voluntary survey on PA views and use of POC ultrasound. The survey was entered into Qualtrics and e-mailed three times. RESULTS Nearly 27% of the subjects use ultrasound with 62% feeling confident in their ability to use ultrasound. The top reason for not using ultrasound was lack of access to a machine (50%). Only 35.3% of those without access to a machine were interested in bringing ultrasound into their practices. Sixty-seven percent of respondents felt that PAs should have standardized ultrasound training. CONCLUSIONS Results demonstrate that more research is needed into the applicability of POC ultrasound to all PA practice areas as well as how PAs should be trained in POC ultrasound.
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Hamza A, Radosa J, Meyberg-Solomayer G, Solomayer EF, Takacs Z, Juhasz-Boess I, Krasteva-Christ G, Tschernig T, Maxeiner S. Trial integration of combined ultrasound and laparoscopy tuition in an undergraduate anatomy class with volunteer participation - A pilot study. Ann Anat 2018; 221:101-107. [PMID: 30300688 DOI: 10.1016/j.aanat.2018.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Abstract
Anatomy is a cornerstone of medical undergraduate curricula. Due to increasing changes in various medical fields, a lot of new subjects were introduced in undergraduate curricula, while the teaching areas of basic sciences, i.e. anatomy, were reduced. The introduction of advanced diagnostic and therapeutic devices, i.e. ultrasound and laparoscopy, with outstanding imaging quality will be increasingly introduced in basic sciences. In our project, we examined the effect integrating ultrasound and laparoscopy in an anatomy undergraduate course to illustrate the female pelvis. Anatomy students that completed their practicum and cadaver dissection course were enrolled in our project. They received a theoretical introduction followed by a practical course of ultrasound or laparoscopy in the department of obstetrics and gynaecology. Following the course the students had to answer two questionnaires that evaluated their satisfaction, subjective knowledge-gain, problems and content of the course. At the end, a closing briefing was done to discuss the clinical skills and the course. The answers of the questionnaire were summed up in a Likert scale. 25 students were enrolled in the project. 52% attended laparoscopy operations, while 48% attended ultrasound examinations. After analysing the questionnaires using Likert scales (1=strongly agree, 5=strongly disagree) a general satisfaction of 1.5, a subjective knowledge gain of 2.4 and a thrive to extend these clinical skill programs in gynaecology and other specialities in basic science of 1.5 and 1.2, respectively, was reported. There were no statistically significant differences in the Likert scores between both groups (p>0.05). The introduction of ultrasound and laparoscopy in undergraduate basic science teaching programs is a promising method and should be further evaluated, standardized and expanded.
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Affiliation(s)
- Amr Hamza
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | - Julia Radosa
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | | | - Erich-Franz Solomayer
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | - Zoltan Takacs
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | - Ingolf Juhasz-Boess
- Department of Obstetrics and Gynaecology, University Medical Centre, 66421 Homburg, Germany
| | - Gabriela Krasteva-Christ
- Institute of Anatomy, Cell and Developmental Biology of the University of Saarland, 66421 Homburg, Germany
| | - Thomas Tschernig
- Institute of Anatomy, Cell and Developmental Biology of the University of Saarland, 66421 Homburg, Germany.
| | - Stephan Maxeiner
- Institute of Anatomy, Cell and Developmental Biology of the University of Saarland, 66421 Homburg, Germany
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Galusko V, Bodger O, Rees E, Ionescu A. Hand-held ultrasonography: An opportunity for "hands-on" teaching of medicine. MEDEDPUBLISH 2018; 7:103. [PMID: 38074553 PMCID: PMC10699386 DOI: 10.15694/mep.2018.0000103.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: As ultrasound offers students an opportunity to study anatomy, physiology and pathophysiology actively, we used hand-held ultrasound (HHU) devices to augment current teaching of cardiac murmurs and pathology. Methods: Three types of teaching sessions (of different duration) were explored: 1) compulsory teaching on cardiac murmurs (n=40); 2) extra-curricular teaching of cardiac murmurs (n=8); 3) extra-curricular ultrasound course (n=6). We assessed students' ability to identify valvular lesions on auscultation, and anatomy and pathology on echocardiography, and sought qualitative feedback. Results: Using echocardiography to teach murmurs improved murmur recognition by auscultation alone from 23% pre-test to 93% post-test (p=0.017). Students were able to identify major cardiac anatomical landmarks on echo images (57% vs 98% ( p=0.027) in the voluntary teaching session lasting 90 minutes, and 40% vs 82% ( p=0.027) after the 3 week cardiac ultrasound course. The mean accuracy for diagnosing cardiac pathology on a printed image alone after the 3 week ultrasound course was 71%. Students unanimously found the sessions useful and engaging, and reported they would like further teaching about using ultrasound. Conclusion: Medical students found the sessions engaging, enjoyed this novel way of teaching and would like further teaching using ultrasound. Using hand-held ultrasound scanners to augment the teaching of cardiac murmurs to medical students is feasible and effective.
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Affiliation(s)
| | | | - Emma Rees
- College of Human and Health Sciences
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Di Pietro S, Falaschi F, Bruno A, Perrone T, Musella V, Perlini S. The learning curve of sonographic inferior vena cava evaluation by novice medical students: the Pavia experience. J Ultrasound 2018; 21:137-144. [PMID: 29564661 DOI: 10.1007/s40477-018-0292-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 02/28/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The sonographic evaluation of inferior vena cava diameters and its collapsibility-that is also defined as the caval index-has become a popular way to easily obtain a noninvasive estimate of central venous pressure. This is generally considered an easy sonographic task to perform, and according to the American College of Emergency Physicians (ACEP) Guidelines 25 repetitions of this procedure should be sufficient to reach proficiency. However, little is known about the learning process for this sonographic technique. Therefore, we designed this study to investigate the learning curve of inferior vena cava evaluation. METHODS We enrolled a sample of ten ultrasound-naïve medical students who received a preliminary training provided by two Junior Emergency Medicine Residents. Following training, each student performed the sonographic task on 25 different patients who were hospitalized in the internal medicine ward. The students' performance was compared with the results obtained by a consultant in internal medicine with extensive experience in point-of-care ultrasound, who repeated the procedure on the same patients (gold standard). In detail, we evaluated the time to complete the task, the quality of the obtained images, and the ability to visually estimate and measure the caval index. RESULTS Although most students (9/10) reached the pre-defined level of competence, their overall performance was inferior to the one achieved by the gold standard, with little improvement over time. However, repetition was associated with progressive shortening of the time needed to achieve readable images. CONCLUSIONS Overall, these findings suggest that, although allowing to obtain a pre-defined competence, 25 repetitions are not enough to reach a good level of proficiency for this technique, that needs a longer training to be achieved.
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Affiliation(s)
- Santi Di Pietro
- Clinica Medica 2, Department of Internal Medicine, Emergency Medicine Fellowship Program, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
| | - Francesco Falaschi
- Clinica Medica 2, Department of Internal Medicine, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Alice Bruno
- Clinica Medica 2, Department of Internal Medicine, Emergency Medicine Fellowship Program, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Tiziano Perrone
- Clinica Medica 1, Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Valeria Musella
- Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Stefano Perlini
- Clinica Medica 2, Department of Internal Medicine, Emergency Medicine Fellowship Program, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
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Pinto J, Azevedo R, Pereira E, Caldeira A. Ultrasonography in Gastroenterology: The Need for Training. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2018; 25:308-316. [PMID: 30480048 DOI: 10.1159/000487156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/24/2018] [Indexed: 11/19/2022]
Abstract
The use of ultrasonography (US) as an imaging modality in medicine has spread across almost every clinical specialty. This diffusion is based on the simplicity, accessibility, portability and affordability of the technique producing real-time high-resolution images using non-ionising radiation. On the other hand, this trend also extended the technique to settings other than healthcare, such as public facilities, private houses or remote sites. This tendency can be observed worldwide, from developing countries to prestigious medical schools and tertiary referral hospitals. Furthermore, point-of-care US (POCUS), i.e., US executed at the patient's bedside to obtain real-time objective information with diagnostic and clinical monitoring purposes or to guide invasive procedures, has been incorporated in many specialties. In gastroenterology, despite the essential role of endoscopy, clinical practice is highly dependent on non-endoscopic imaging techniques. However, as in other specialties, the indications of US in gastroenterology have been increasing steadily, covering a broad range of conditions. In response to the generalised employment of US by non-radiologists, institutions such as the European Federation of Societies for Ultrasound in Medicine and Biology and the Royal College of Radiologists issued recommendations to ensure high-quality practice. These theoretical and practical requisites include performing a certain number of examinations and mandatory skills in order to achieve certification to execute unsupervised US. Therefore, there is a need for modern gastroenterology to include US as a basic skill in its clinical practice. To ensure the provision of high-quality US, adequate instruction of future specialists should be guaranteed by the gastroenterology departments and required in the residency training programme.
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Affiliation(s)
- João Pinto
- Gastroenterology Department, Amato Lusitano Hospital, Castelo Branco, Portugal
| | - Richard Azevedo
- Gastroenterology Department, Amato Lusitano Hospital, Castelo Branco, Portugal
| | - Eduardo Pereira
- Gastroenterology Department, Amato Lusitano Hospital, Castelo Branco, Portugal
| | - Ana Caldeira
- Gastroenterology Department, Amato Lusitano Hospital, Castelo Branco, Portugal
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Tarique U, Tang B, Singh M, Kulasegaram KM, Ailon J. Ultrasound Curricula in Undergraduate Medical Education: A Scoping Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:69-82. [PMID: 28748549 DOI: 10.1002/jum.14333] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/20/2017] [Indexed: 05/20/2023]
Abstract
The clinical applications of point-of-care ultrasound (US) have expanded rapidly over the past decade. To promote early exposure to point-of-care US, there is widespread support for the integration of US curricula within undergraduate medical education. However, despite growing evidence and enthusiasm for point-of-care US education in undergraduate medical education, the curricular design and delivery across undergraduate medical education programs remain variable without widely adopted national standards and guidelines. This article highlights the educational and teaching applications of point-of-care US with a focus on outcomes. We then review the evidence on curricular design, delivery, and integration and the assessment of competency for point-of-care US in undergraduate medical education.
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Affiliation(s)
- Usman Tarique
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Brandon Tang
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Manni Singh
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Kulamakan Mahan Kulasegaram
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Wilson Center and Undergraduate Medical Education, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan Ailon
- Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of General Internal Medicine and Palliative Care, Saint Michael's Hospital, Toronto, Ontario, Canada
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Krause C, Krause R, Krause R, Gomez N, Jafry Z, Dinh VA. Effectiveness of a 1-Hour Extended Focused Assessment With Sonography in Trauma Session in the Medical Student Surgery Clerkship. JOURNAL OF SURGICAL EDUCATION 2017; 74:968-974. [PMID: 28479071 DOI: 10.1016/j.jsurg.2017.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/15/2017] [Accepted: 03/24/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To demonstrate the effectiveness of incorporating 1 hour of ultrasound training on the extended focused assessment with sonography in trauma (eFAST) into the year-3 medical student surgical clerkship. DESIGN A prospective cohort study where participants served as self-controls. One hour of instruction in the eFAST examination, along with 3 required observed examinations, was incorporated into the year-3 surgery clerkship. Effectiveness of the training was evaluated by a preliminary and posttraining assessment. An online survey was used assessing comfort based on a 5-point Likert scale. An online quiz was used assessing knowledge, and a 2-part objective structured clinical examination (OSCE) was used assessing skill and speed. Participants also logged 3 eFAST examinations during the 10-week clerkship where they reported their comfort in performing and interpreting the eFAST on a 5-point Likert scale. Postassessment was held during the last week of the clerkship and included the same online quiz, survey, and 2-part OSCE. SETTING The study was performed at Loma Linda University and affiliated hospitals where surgical clerkship students rotate. PARTICIPANTS A total of 148 year-3 medical students completed the study. RESULTS All testing modalities showed improvement. The mean average of the OSCE improved from 46% ± 27% to 81% ± 18%. The percentage of participants able to perform the examination in less than 6 minutes increased from 18% ± 27% to 84% ± 36%. Participants' comfort level in recognizing eFAST pathology increased from a mean of 2.40 ± 0.94 to 3.55 ± 0.87 out of 5. Comfort in performing the eFAST examination improved from 2.81 ± 0.79 to 3.77 ± 0.68. Comfort in interpreting the eFAST examination improved from 2.88 ± 0.87 to 3.65 ± 0.72. CONCLUSIONS This study demonstrates that incorporating 1 hour of eFAST training into the general surgery clerkship is feasible and may lead to improved competency in performing and interpreting the eFAST examination.
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Affiliation(s)
- Cassandra Krause
- Department of Surgery, Loma Linda University, Loma Linda School of Medicine, Loma Linda, California.
| | - Reed Krause
- Department of Surgery, Loma Linda University, Loma Linda School of Medicine, Loma Linda, California
| | - Raymond Krause
- Department of Surgery, Loma Linda University, Loma Linda School of Medicine, Loma Linda, California
| | - Nephtali Gomez
- Department of Surgery, Loma Linda University, Loma Linda, California
| | - Zan Jafry
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California
| | - Vi Am Dinh
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California; Department of Medicine, Loma Linda University, Loma Linda, California
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Galusko V, Khanji MY, Bodger O, Weston C, Chambers J, Ionescu A. Hand-held Ultrasound Scanners in Medical Education: A Systematic Review. J Cardiovasc Ultrasound 2017; 25:75-83. [PMID: 29093769 PMCID: PMC5658292 DOI: 10.4250/jcu.2017.25.3.75] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 01/16/2023] Open
Abstract
Background Ultrasound imaging devices are becoming popular in clinical and teaching settings, but there is no systematic information on their use in medical education. We conducted a systematic review of hand-held ultrasound (HHU) devices in undergraduate medical education to delineate their role, significance, and limitations. Methods We searched Cochrane, PubMed, Embase, and Medline using the strategy: [(Hand-held OR Portable OR Pocket OR "Point of Care Systems") AND Ultrasound] AND (Education OR Training OR Undergraduate OR "Medical Students" OR "Medical School"). We retained 12 articles focusing on undergraduate medical education. We summarised the patterns of HHU use, pooled and estimated sensitivity, and specificity of HHU for detection of left ventricular dysfunction. Results Features reported were heterogeneous: training time (1-25 hours), number of students involved (1-an entire cohort), number of subjects scanned (27-211), and type of learning (self-directed vs. traditional lectures + hands-on sessions). Most studies reported cardiac HHU examinations, but other anatomical areas were examined, e.g. abdomen and thyroid. Pooled sensitivity 0.88 [95% confidence interval (CI) 0.83-0.92] and specificity 0.86 (95% CI 0.81-0.90) were high for the detection of left ventricular systolic dysfunction by students. Conclusion Data on HHU devices in medical education are scarce and incomplete, but following training students can achieve high diagnostic accuracy, albeit in a limited number of (mainly cardiac) pathologies. There is no consensus on protocols best-suited to the educational needs of medical students, nor data on long-term impact, decay in proficiency or on the financial implications of deploying HHU in this setting.
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Affiliation(s)
- Victor Galusko
- Swansea University Medical School, Singleton Park, Swansea, UK
| | | | - Owen Bodger
- Swansea University Medical School, Singleton Park, Swansea, UK
| | - Clive Weston
- Swansea University Medical School, Singleton Park, Swansea, UK
| | | | - Adrian Ionescu
- Morriston Cardiac Regional Centre, ABMU LHB, Swansea, UK
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Flaum TB, Rusnack FM, Mirza A, Apoznanski TE, Munarova A, Mazzie JP, Terzella MJ, Yao SC. An observational study of ultrasound to confirm cervical spine segmental positional rotation. INT J OSTEOPATH MED 2017. [DOI: 10.1016/j.ijosm.2017.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ma IWY, Arishenkoff S, Wiseman J, Desy J, Ailon J, Martin L, Otremba M, Halman S, Willemot P, Blouw M. Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group. J Gen Intern Med 2017; 32:1052-1057. [PMID: 28497416 PMCID: PMC5570740 DOI: 10.1007/s11606-017-4071-5] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/05/2017] [Accepted: 04/13/2017] [Indexed: 11/29/2022]
Abstract
Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs. We recommend four POCUS applications for the core PGY 1-3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4-5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.
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Affiliation(s)
- Irene W Y Ma
- Department of Medicine, University of Calgary, Calgary, AB, Canada.
- W21C, University of Calgary, Calgary, AB, Canada.
| | | | | | - Janeve Desy
- Department of Medicine, University of Calgary, Calgary, AB, Canada
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Arora S, Cheung AC, Tarique U, Agarwal A, Firdouse M, Ailon J. First-year medical students use of ultrasound or physical examination to diagnose hepatomegaly and ascites: a randomized controlled trial. J Ultrasound 2017; 20:199-204. [PMID: 28900520 DOI: 10.1007/s40477-017-0261-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 07/05/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To compare point-of-care ultrasound and physical examination (PEx), each performed by first-year medical students after brief teaching, for assessing ascites and hepatomegaly. Ultrasound and PEx were compared on: (1) reliability, validity and performance, (2) diagnostic confidence, ease of use, utility, and applicability. METHODS A single-center, randomized controlled trial was performed at a tertiary centre. First-year medical students were randomized to use ultrasound or PEx to assess for ascites and hepatomegaly. Cohen's kappa and interclass coefficient (ICC) were used to measure interrater reliability between trainee assessments and the reference standard (a same day ultrasound by a radiologist). Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were compared. A ten-point Likert scale was used to assess trainee diagnostic confidence and perceptions of utility. RESULTS There were no significant differences in interobserver reliability, sensitivity, specificity, accuracy, PPV, or NPV between the ultrasound and PEx groups. However, students in the ultrasound group provided higher scores for perceived utility (ascites 8.38 ± 1.35 vs 7.08 ± 1.86, p = 0.008; hepatomegaly 7.68 ± 1.52 vs 5.36 ± 2.48, p < 0.001) and likelihood of adoption (ascites 8.67 ± 1.61 vs 7.46 ± 1.79, p = 0.02; hepatomegaly 8.12 ± 1.90 vs 5.92 ± 2.32, p = 0.001). CONCLUSIONS When performed by first-year medical students, the validity and reliability of ultrasound is comparable to PEx, but with greater perceived utility and likelihood of adoption. With similarly brief instruction, point-of-care ultrasonography can be as effectively learned and performed as PEx, with a high degree of interest from trainees.
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Affiliation(s)
- Samantha Arora
- Department of Medicine, McMaster University, Hamilton, ON Canada
| | - Angela C Cheung
- Division of Gastroenterology, Department of Medicine, Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, ON Canada
| | - Usman Tarique
- Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Arnav Agarwal
- Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | | | - Jonathan Ailon
- Faculty of Medicine, University of Toronto, Toronto, ON Canada.,Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON Canada.,Saint Michael's Hospital, 30 Bond Street, 4-146 Cardinal Carter Wing, Toronto, ON M5B1W8 Canada
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Influence of case-based e-learning on students' performance in point-of-care ultrasound courses: a randomized trial. Eur J Emerg Med 2017; 23:298-304. [PMID: 25851331 DOI: 10.1097/mej.0000000000000270] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Theoretical knowledge, visual perception, and sensorimotor skills are key elements in ultrasound education. Classroom-based presentations are used routinely to teach theoretical knowledge, whereas visual perception and sensorimotor skills typically require hands-on training (HT). We aimed to compare the effect of classroom-based lectures versus a case-based e-learning (based on clinical cases only) on the hands-on performance of trainees during an emergency ultrasound course. PARTICIPANTS AND METHODS This is a randomized, controlled, parallel-group study. Sixty-two medical students were randomized into two groups [group 1 (G1) and group 2 (G2)]. G1 (n=29) was subjected to a precourse e-learning, based on 14 short screencasts (each 5 min), an on-site discussion (60 min), and a standardized HT session on the day of the course. G2 (n=31) received classroom-based presentations on the day of the course before an identical HT session. Both groups completed a multiple-choice (MC) pretest (test A), a practical postcourse test (objective structured clinical exam), and MC tests directly after the HT (test B) and 1 day after the course (test C). The Mann-Whitney U-test was used for statistical analysis. RESULTS G1 performed markedly better in test A (median 84.2, 25%; 75% percentile: 68.5; 92.2) compared with G2 (65.8; 53.8; 80.4), who had not participated in case-based e-learning (P=0.0009). No differences were found in the objective structured clinical exam, test B, and test C. CONCLUSION e-learning exclusively based on clinical cases is an effective method of education in preparation for HT sessions and can reduce attendance time in ultrasound courses.
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Royer DF, Kessler R, Stowell JR. Evaluation of an innovative hands-on anatomy-centered ultrasound curriculum to supplement graduate gross anatomy education. ANATOMICAL SCIENCES EDUCATION 2017; 10:348-362. [PMID: 27870531 DOI: 10.1002/ase.1670] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/17/2016] [Accepted: 11/02/2016] [Indexed: 06/06/2023]
Abstract
Ultrasound (US) can enhance anatomy education, yet is incorporated into few non-medical anatomy programs. This study is the first to evaluate the impact of US training in gross anatomy for non-medical students in the United States. All 32 master's students enrolled in gross anatomy with the anatomy-centered ultrasound (ACUS) curriculum were recruited. Mean Likert ratings on pre- and post-course surveys (100% response rates) were compared to evaluate the effectiveness of the ACUS curriculum in developing US confidence, and gauge its impact on views of US. Post-course, students reported significantly higher (P < 0.001) mean confidence ratings in five US skills (pre-course versus post-course mean): obtaining scans (3.13 ±1.04 versus 4.03 ±0.78), optimizing images (2.78 ±1.07 versus 3.75 ±0.92), recognizing artifacts (2.94 ±0.95 versus 3.97 ±0.69), distinguishing tissue types (2.88 ±0.98 versus 4.09 ±0.69), and identifying structures (2.97 ±0.86 versus 4.03 ±0.59), demonstrating the success of the ACUS curriculum in students with limited prior experience. Views on the value of US to anatomy education and to students' future careers remained positive after the course. End-of-semester quiz performance (91% response rate) provided data on educational outcomes. The average score was 79%, with a 90% average on questions about distinguishing tissues/artifacts, demonstrating positive learning outcomes and retention. The anatomy-centered ultrasound curriculum significantly increased confidence with and knowledge of US among non-medical anatomy students with limited prior training. Non-medical students greatly value the contributions that US makes to anatomy education and to their future careers. It is feasible to enhance anatomy education outside of medical training by incorporating US. Anat Sci Educ 10: 348-362. © 2016 American Association of Anatomists.
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Affiliation(s)
- Danielle F Royer
- Department of Cell and Developmental Biology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ross Kessler
- Department of Emergency Medicine, University of Michigan Health System, Ann Arbor, Michigan
| | - Jeffrey R Stowell
- Department of Emergency Medicine, Maricopa Integrated Health System, Phoenix, Arizona
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DesJardin JT, Ricceri SK, Brown SD, Webb EM, Naeger DM, Teismann NA. A Near-peer Point-of-care Ultrasound Elective for Medical Students: Impact on Anatomy Knowledge, Perceptions About Ultrasound, and Self-reported Skill Level. Acad Radiol 2017. [DOI: 10.1016/j.acra.2016.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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70
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Jamniczky HA, Cotton D, Paget M, Ramji Q, Lenz R, McLaughlin K, Coderre S, Ma IWY. Cognitive load imposed by ultrasound-facilitated teaching does not adversely affect gross anatomy learning outcomes. ANATOMICAL SCIENCES EDUCATION 2017; 10:144-151. [PMID: 27533319 DOI: 10.1002/ase.1642] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 05/14/2023]
Abstract
Ultrasonography is increasingly used in medical education, but its impact on learning outcomes is unclear. Adding ultrasound may facilitate learning, but may also potentially overwhelm novice learners. Based upon the framework of cognitive load theory, this study seeks to evaluate the relationship between cognitive load associated with using ultrasound and learning outcomes. The use of ultrasound was hypothesized to facilitate learning in anatomy for 161 novice first-year medical students. Using linear regression analyses, the relationship between reported cognitive load on using ultrasound and learning outcomes as measured by anatomy laboratory examination scores four weeks after ultrasound-guided anatomy training was evaluated in consenting students. Second anatomy examination scores of students who were taught anatomy with ultrasound were compared with historical controls (those not taught with ultrasound). Ultrasound's perceived utility for learning was measured on a five-point scale. Cognitive load on using ultrasound was measured on a nine-point scale. Primary outcome was the laboratory examination score (60 questions). Learners found ultrasound useful for learning. Weighted factor score on "image interpretation" was negatively, but insignificantly, associated with examination scores [F (1,135) = 0.28, beta = -0.22; P = 0.61]. Weighted factor score on "basic knobology" was positively and insignificantly associated with scores; [F (1,138) = 0.27, beta = 0.42; P = 0.60]. Cohorts exposed to ultrasound had significantly higher scores than historical controls (82.4% ± SD 8.6% vs. 78.8% ± 8.5%, Cohen's d = 0.41, P < 0.001). Using ultrasound to teach anatomy does not negatively impact learning and may improve learning outcomes. Anat Sci Educ 10: 144-151. © 2016 American Association of Anatomists.
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Affiliation(s)
- Heather A Jamniczky
- Department of Cell Biology and Anatomy, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darrel Cotton
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael Paget
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Qahir Ramji
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ryan Lenz
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kevin McLaughlin
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sylvain Coderre
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Irene W Y Ma
- Undergraduate Medical Education Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Ward of the 21st Century (W21C), University of Calgary/Calgary Zone of Alberta Health Services, Calgary, Alberta, Canada
- Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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So S, Patel RM, Orebaugh SL. Ultrasound imaging in medical student education: Impact on learning anatomy and physical diagnosis. ANATOMICAL SCIENCES EDUCATION 2017; 10:176-189. [PMID: 27286419 DOI: 10.1002/ase.1630] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 05/18/2016] [Accepted: 05/18/2016] [Indexed: 05/28/2023]
Abstract
Ultrasound use has expanded dramatically among the medical specialties for diagnostic and interventional purposes, due to its affordability, portability, and practicality. This imaging modality, which permits real-time visualization of anatomic structures and relationships in vivo, holds potential for pre-clinical instruction of students in anatomy and physical diagnosis, as well as providing a bridge to the eventual use of bedside ultrasound by clinicians to assess patients and guide invasive procedures. In many studies, but not all, improved understanding of anatomy has been demonstrated, and in others, improved accuracy in selected aspects of physical diagnosis is evident. Most students have expressed a highly favorable impression of this technology for anatomy education when surveyed. Logistic issues or obstacles to the integration of ultrasound imaging into anatomy teaching appear to be readily overcome. The enthusiasm of students and anatomists for teaching with ultrasound has led to widespread implementation of ultrasound-based teaching initiatives in medical schools the world over, including some with integration throughout the entire curriculum; a trend that likely will continue to grow. Anat Sci Educ 10: 176-189. © 2016 American Association of Anatomists.
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Affiliation(s)
- Sokpoleak So
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rita M Patel
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven L Orebaugh
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Nelson BP, Hojsak J, Dei Rossi E, Karani R, Narula J. Seeing Is Believing: Evaluating a Point-of-Care Ultrasound Curriculum for 1st-Year Medical Students. TEACHING AND LEARNING IN MEDICINE 2017; 29:85-92. [PMID: 27191830 DOI: 10.1080/10401334.2016.1172012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PROBLEM Point-of-care ultrasound has been a novel addition to undergraduate medical education at a few medical schools. The impact is not fully understood, and few rigorous assessments of educational outcomes exist. This study assessed the impact of a point-of-care ultrasound curriculum on image acquisition, interpretation, and student and faculty perceptions of the course. INTERVENTION All 142 first-year medical students completed a curriculum on ultrasound physics and instrumentation, cardiac, thoracic, and abdominal imaging. A flipped classroom model of preclass tutorials and tests augmenting live, hands-on scanning sessions was incorporated into the physical examination course. Students and faculty completed surveys on impressions of the curriculum, and all students under-went competency assessments with standardized patients. CONTEXT The curriculum was a mandatory part of the physical examination course and was taught by experienced clinician-sonographers as well as faculty who do not routinely perform sonography in their clinical practice. OUTCOME Students and faculty agreed that the physical examination course was the right time to introduce ultrasound (87% and 80%). Students demonstrated proper use of the ultrasound machine functions (M score = 91.55), and cardiac, thoracic, and abdominal system assessments (M score = 80.35, 79.58, and 71.57, respectively). Students and faculty valued the curriculum, and students demonstrated basic competency in performance and interpretation of ultrasound. Further study is needed to determine how to best incorporate this emerging technology into a robust learning experience for medical students.
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Affiliation(s)
- Bret P Nelson
- a Department of Emergency Medicine , Icahn School of Medicine at Mount Sinai , New York , New York , USA
| | - Joanne Hojsak
- b Department of Pediatrics , Icahn School of Medicine at Mount Sinai , New York , New York , USA
| | - Elizabeth Dei Rossi
- a Department of Emergency Medicine , Icahn School of Medicine at Mount Sinai , New York , New York , USA
| | - Reena Karani
- c Department of Medicine , Icahn School of Medicine at Mount Sinai , New York , New York , USA
| | - Jagat Narula
- c Department of Medicine , Icahn School of Medicine at Mount Sinai , New York , New York , USA
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Wortsman X, Alfageme F, Roustan G, Arias-Santiago S, Martorell A, Catalano O, di Santolo MS, Zarchi K, Bouer M, Gonzalez C, Bard R, Mandava A, Crisan M, Crisan D, Gaitini D. Proposal for an Assessment Training Program in Dermatologic Ultrasound by the DERMUS Group. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2305-2309. [PMID: 27629760 DOI: 10.7863/ultra.15.10068] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Ximena Wortsman
- Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Fernando Alfageme
- Department of Dermatology, University Hospital Puerta del Hierro, EFSUMB Dermatologic Ultrasound Learning Center, Majahonda, Madrid, Spain
| | - Gaston Roustan
- Department of Dermatology, University Hospital Puerta del Hierro, EFSUMB Dermatologic Ultrasound Learning Center, Majahonda, Madrid, Spain
| | | | | | - Orlando Catalano
- Department of Radiology, National Cancer Institute Fondazione Pascale, Naples, Italy
| | | | - Kian Zarchi
- Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
| | - Marcio Bouer
- Department of Radiology, Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil
| | - Claudia Gonzalez
- Department of Radiology, Instituto Diagnóstico Médico, Instituto de Imágenes Diagnósticas, Bogota, Colombia
| | | | - Anitha Mandava
- Department of Radiodiagnosis, Central Hospital, Telangana, India
| | - Maria Crisan
- Departments of Dermatology and Histology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Crisan
- Department of Dermatology and Allergic Diseases, University Clinic Ulm, Ulm, Germany
| | - Diana Gaitini
- Department of Medical Imaging, Rambam Health Care Center, Haifa, Israel
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Perioperative Ultrasound: The challenge of applying an old technology in new clinical settings. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2016. [DOI: 10.1016/j.rcae.2016.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Rojas-Gómez MF, Bonilla-R AJ. Ultrasonido perioperatorio: el reto de aplicar una vieja tecnología en nuevos escenarios clínicos. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2016. [DOI: 10.1016/j.rca.2016.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Royer DF. The role of ultrasound in graduate anatomy education: Current state of integration in the United States and faculty perceptions. ANATOMICAL SCIENCES EDUCATION 2016; 9:453-467. [PMID: 26821269 DOI: 10.1002/ase.1598] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 12/29/2015] [Accepted: 12/29/2015] [Indexed: 06/05/2023]
Abstract
Ultrasound (US) is increasingly taught in medical schools, where it has been shown to be a valuable adjunct to anatomy training. To determine the extent of US training in nonmedical anatomy programs, and evaluate anatomists' perceptions on the role of US in anatomy education, an online survey was distributed to faculty in anatomy Master's and Doctoral programs. Survey results sampled 71% of anatomy graduate degree programs nationally. Of the faculty surveyed, 65% report little to no experience with US. Thirty-six percent of programs surveyed incorporate exposure to US, while only 15% provide hands-on US training. Opportunities for anatomy trainees to teach with US were found in 12% of programs. Likert responses indicated that anatomists hold overwhelmingly positive views on the contributions of US to anatomy education: 91% agreed US reinforces anatomical concepts (average 4.33 ± 0.68), 95% agreed it reinforces clinical correlates (average 4.43 ± 0.65). Anatomists hold moderately positive views on the value of US to the future careers of anatomy graduates: 69% agreed US increases competitiveness on the job market (average 3.91 ± 0.90), 85% agreed US is a useful skill for a medical school teaching career (average 4.24 ± 0.75), and 41% agreed that US should be required for a medical education career (average 3.34 ± 1.09). With continued improvements in technology and the widespread adoption of US into diverse areas of clinical practice, medical education is on the cusp of a paradigm shift with regards to US. Anatomists must decide whether US is an essential skills for the modern anatomist. Anat Sci Educ 9: 453-467. © 2016 American Association of Anatomists.
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Affiliation(s)
- Danielle F Royer
- Department of Cell and Developmental Biology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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77
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Tshibwabwa ET, Cannon J, Rice J, Kawooya MG, Sanii R, Mallin R. Integrating Ultrasound Teaching into Preclinical Problem-based Learning. J Clin Imaging Sci 2016; 6:38. [PMID: 27833780 PMCID: PMC5041377 DOI: 10.4103/2156-7514.190897] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/01/2016] [Indexed: 11/04/2022] Open
Abstract
Objectives: The aim is to provide students in the preclinical with ultrasound image interpretation skills. Research question: Are students in smaller groups with access to a combination of lectures and hands-on patient contact most likely to have better ultrasound image interpretation skills, than students in larger groups with only interactive didactic lectures? Methodology: First-year students at the preclinical Program of the College of Medicine, participated in two 2-h introductory interactive ultrasound sessions. The study comprised two cohorts: 2012/2013 students, who were offered large group teaching (LGT) sessions (control group), and 2013/2014 students, who received the intervention in small group learning problem-based learning (PBL) sessions (experimental group). The overall learning objectives were identical for both groups. The success of the module was evaluated using pre- and post-tests as well as students’ feedback. Results: The students in the experimental group showed significantly higher scores in interpretations of images than those in the control group. The experimental group showed achievement of learning outcomes along with higher levels of satisfaction with the module compared to the latter. Conclusion: Posttest knowledge of the basics of ultrasound improved significantly over the pretest in the experimental group. In addition, students’ overall satisfaction of the ultrasound module was shown to be higher for the PBL compared to the LGT groups. Small groups in an interactive and PBL setting along with opportunities for hands-on practice and simultaneous visualization of findings on a high definition screen should enhance preclinical student learning of the basics of ultrasound. Despite the potential of ultrasound as a clinical, teaching and learning tool for students in the preclinical years, standardized recommendations have yet to be created regarding its integration into the curricula within academic institutions and clinical medicine. The interactive and PBL is here to stay at the college of medicine. Further research would be carried out to see if this trend persists in the upcoming vertical system-based curriculum of the college of medicine.
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Affiliation(s)
- Eli Tumba Tshibwabwa
- Department of Clinical Medicine, College of Medicine, American University of Antigua, Antigua and Barbuda; Department of Radiology, McMaster University Faculty of Health Sciences, HSC Building, Hamilton, Ontario, Canada
| | - Jenifer Cannon
- Department of Clinical Medicine, College of Medicine, American University of Antigua, Antigua and Barbuda
| | - James Rice
- Department of Behavioral Science and Neuroscience, College of Medicine, American University of Antigua, Antigua And Barbuda
| | - Michael G Kawooya
- Department of Radiology, Ernest Cook Ultrasound Research and Education Institute, Mengo Hospital, Kampala, Uganda
| | - Reza Sanii
- Department of Physiology, College of Medicine, American University of Antigua, Antigua And Barbuda
| | - Robert Mallin
- Department of Clinical Medicine, College of Medicine, American University of Antigua, Antigua and Barbuda
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Blackstock U, Carmody K. Transforming Learning Anatomy: Basics of Ultrasound Lecture and Abdominal Ultrasound Anatomy Hands-on Session. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2016; 12:10446. [PMID: 31008224 PMCID: PMC6464447 DOI: 10.15766/mep_2374-8265.10446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 07/24/2016] [Indexed: 05/30/2023]
Abstract
INTRODUCTION As point-of-care ultrasound units become more compact and portable, clinicians in over 20 different medical and surgical specialties have begun using the technology in diverse clinical applications. However, a knowledge gap still exists between what medical students are learning in their undergraduate medical education curriculum and the clinical skills required for practice. Over the last 10 years, point-of-care ultrasound content has been slowly incorporated into undergraduate medical education, yet only a handful of medical schools have developed ultrasound curricula. This module was developed at our institution in response to survey feedback from medical students overwhelmingly requesting preclerkship ultrasound education. The target audience for this module is first-year medical students with no prior ultrasound exposure. METHODS The module consists of a 1-hour introductory lecture and a 1-hour hands-on session during the abdominal anatomy course. Associated materials include the introductory lecture, presenter notes for the introductory lecture, instructor guidelines for the hands-on session, hands-on session setup instructions, a student handout for the hands-on session, and a module evaluation form. RESULTS We have successfully implemented this module for the past 3-years and learner feedback has been overwhelmingly positive. Learner comments on a postmodule survey included, "Great job of explaining the science behind ultrasounds as well as how to interpret the images." DISCUSSION As a result of our first-year students' evaluation responses, this module has been incorporated into our medical school's anatomy course.
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Affiliation(s)
- Uche Blackstock
- Assistant Professor, Department of Emergency Medicine, New York University School of Medicine
| | - Kristin Carmody
- Assistant Professor, Department of Emergency Medicine, New York University School of Medicine
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Incorporation of Ultrasound Education Into Medical School Curricula: Survey of Directors of Medical Student Education in Radiology. Acad Radiol 2016; 23:830-5. [PMID: 27311803 DOI: 10.1016/j.acra.2016.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 02/10/2016] [Accepted: 02/14/2016] [Indexed: 11/21/2022]
Abstract
RATIONALE AND OBJECTIVES This study aimed to determine the degree of involvement of radiologists in ultrasound education in medical schools in the United States. MATERIALS AND METHODS An online survey was sent to 129 directors of medical student education in radiology, identified by the Alliance of Medical Student Educators in Radiology. Each survey recipient represented a unique medical school. RESULTS There was a 31% survey completion rate. Radiology education was incorporated into the majority of respondents' medical school curricula (95%). Ultrasound images were used in preclinical education in the majority of schools (76%). Students were trained to perform hands-on ultrasound examinations in half of schools (49%), and a minority of schools offered a dedicated point-of-care ultrasound elective (14%). Radiology and emergency medicine were the most involved departments in teaching ultrasound to medical students (88% and 75% of medical schools, respectively). CONCLUSIONS Ultrasound imaging was incorporated into the curricula of most of the responding medical schools, although actual hands-on training was less widespread.
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Shokoohi H, Boniface K, Kaviany P, Armstrong P, Calabrese K, Pourmand A. An Experiential Learning Model Facilitates Learning of Bedside Ultrasound by Preclinical Medical Students. JOURNAL OF SURGICAL EDUCATION 2016; 73:208-214. [PMID: 26868311 DOI: 10.1016/j.jsurg.2015.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/08/2015] [Accepted: 10/12/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To examine the effects of an experiential learning model of ultrasound training on preclinical medical students' knowledge and practice of Focused Assessment with Sonography for Trauma (FAST) examination. METHODS The study was conducted in 2 phases. In phase 1, first- and second-year medical students participated in a 45-minute didactic presentation and subsequent 1-hour hands-on practice followed by 3-5 precepted FAST examinations in the emergency department. A pretest or posttest design was used to examine the participants' knowledge interpreting ultrasound images of the FAST examination. In phase 2, students performed FAST scans on patients with abdominal complaints under the supervision of emergency ultrasound faculty over a 1-year period. The participants were scored based on window acquisition, quality of images, accuracy of FAST scan interpretation, confidence level rated by participant, and supervising attending physician. RESULTS In phase 1, 68 novice medical students participated in 11 training sessions offered over a 1-year period. Students showed significant improvement in basic ultrasound and abdominal anatomy knowledge. The mean score improved from a pretest score of 5.8 of 10 (95% CI: 5.3-6.2) to a posttest score of 7.3 of 10 (95% CI: 7-7.6). The students also demonstrated a significant improvement in FAST image interpretation (pretest of 6.2 [95% CI: 5.9-6.6] and posttest of 7.6 [95% CI: 7.1-7.9]). In phase 2, 22 students performed 304 FAST examinations on patients. At the beginning of their training when they performed less than 10 FAST scans, students were able to complete the right upper quadrant view in 88.9%, left upper quadrant view in 69.7%, subxiphoid in 64.7%, and pelvic view in 70% of scans. Across all views of the FAST examination, increasing level of practice was associated with improvement in successfully completing the examination. The absolute increase in the proportion experiencing success in the right upper quadrant view was 1.6%, 3.6%, and 6.2% for the 10-19, 20-29, and >30 groups, respectively, of which none were statistically significant. However, the improvements in the left upper quadrant view was 12.7%, 11.6%, 15.7% for the 10-19, 20-29, and >30 groups, respectively. In all views, performing >30 examinations more than doubled the odds of successfully completing the examination. CONCLUSION An experiential learning model of ultrasound training consisting of brief didactic presentation, practice FAST examinations on normal models, and proctored examinations on patients is an effective way to teach preclinical medical students basic ultrasound skills.
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Affiliation(s)
- Hamid Shokoohi
- Department of Emergency Medicine, The George Washington University, Washington DC.
| | - Keith Boniface
- Department of Emergency Medicine, The George Washington University, Washington DC
| | - Parisa Kaviany
- School of Medicine and Health Sciences, The George Washington University Medical Center, Washington, DC
| | - Paige Armstrong
- Department of Emergency Medicine, The George Washington University, Washington DC
| | - Kathleen Calabrese
- Department of Emergency Medicine, The George Washington University, Washington DC
| | - Ali Pourmand
- Department of Emergency Medicine, The George Washington University, Washington DC
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Cantisani V, Dietrich CF, Badea R, Dudea S, Prosch H, Cerezo E, Nuernberg D, Serra AL, Sidhu PS, Radzina M, Piscaglia F, Bachmann Nielsen M, Ewertsen C, Săftoiu A, Calliada F, Gilja OH. EFSUMB Statement on Medical Student Education in Ultrasound [long version]. Ultrasound Int Open 2016; 2:E2-7. [PMID: 27689163 PMCID: PMC5023223 DOI: 10.1055/s-0035-1569413] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 01/15/2016] [Indexed: 12/19/2022] Open
Abstract
The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) recommends that ultrasound should be used systematically as an easy accessible and instructive educational tool in the curriculum of modern medical schools. Medical students should acquire theoretical knowledge of the modality and hands-on training should be implemented and adhere to evidence-based principles. In this paper we report EFSUMB policy statements on medical student education in ultrasound that in a short version is already published in Ultraschall in der Medizin 1.
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Affiliation(s)
- V. Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy
| | - C. F. Dietrich
- Medizinische Klinik 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim
| | - R. Badea
- Department of Ultrasonography, 3rd Medical Clinic, Institute of Gastroenterology and Hepatology Octavian Fodor; Imaging Department, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj Napoca, Romania
| | - S. Dudea
- Radiology Department "Iuliu Hatieganu" Univ. Med. Pharm. Cluj-Napoca, Romania
| | - H. Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General Hospital, Austria
| | - E. Cerezo
- Calle Francisco Silvela #124, lo 3 Madrid, Spain
| | - D. Nuernberg
- Department of Gastroenterology, Brandenburg University of Medicine Theodor Fontane, Neuruppin
| | - A. L. Serra
- Department of Internal Medicine and Nephrology, Ultrasound Learning Center, Hirslanden Clinic, Zürich, Switzerland
| | - P. S. Sidhu
- Department of Radiology, King’s College Hospital, London, UK
| | - M. Radzina
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - F. Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - M. Bachmann Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C. Ewertsen
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - A. Săftoiu
- Gastroenterology Department, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania
| | | | - O. H. Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Norway
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Dinh VA, Lakoff D, Hess J, Bahner DP, Hoppmann R, Blaivas M, Pellerito JS, Abuhamad A, Khandelwal S. Medical Student Core Clinical Ultrasound Milestones: A Consensus Among Directors in the United States. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:421-434. [PMID: 26782162 DOI: 10.7863/ultra.15.07080] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/20/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Many medical schools are implementing point-of-care ultrasound in their curricula to help augment teaching of the physical examination, anatomy, and ultimately clinical management. However, point-of-care ultrasound milestones for medical students remain unknown. The purpose of this study was to formulate a consensus on core medical student clinical point-of-care ultrasound milestones across allopathic and osteopathic medical schools in the United States. Directors who are leading the integration of ultrasound in medical education (USMED) at their respective institutions were surveyed. METHODS An initial list of 205 potential clinical ultrasound milestones was developed through a literature review. An expert panel consisting of 34 USMED directors across the United States was used to produce consensus on clinical ultrasound milestones through 2 rounds of a modified Delphi technique, an established anonymous process to obtain consensus through multiple rounds of quantitative questionnaires. RESULTS There was a 100% response rate from the 34 USMED directors in both rounds 1 and 2 of the modified Delphi protocol. After the first round, 2 milestones were revised to improve clarity, and 9 were added on the basis of comments from the USMED directors, resulting in 214 milestones forwarded to round 2. After the second round, only 90 milestones were found to have a high level of agreement and were included in the final medical student core clinical ultrasound milestones. CONCLUSIONS This study established 90 core clinical milestones that all graduating medical students should obtain before graduation, based on consensus from 34 USMED directors. These core milestones can serve as a guide for curriculum deans who are initiating ultrasound curricula at their institutions. The exact method of implementation and competency assessment needs further investigation.
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Affiliation(s)
- Vi Am Dinh
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.).
| | - Daniel Lakoff
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.)
| | - Jamie Hess
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.)
| | - David P Bahner
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.)
| | - Richard Hoppmann
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.)
| | - Michael Blaivas
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.)
| | - John S Pellerito
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.)
| | - Alfred Abuhamad
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.)
| | - Sorabh Khandelwal
- Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); Icahn School of Medicine at Mount Sinai, New York, New York USA (D.L.); University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin USA (J.H.); The Ohio State University College of Medicine, Columbus, Ohio USA (D.P.B., S.K.); University of South Carolina School of Medicine, Columbia, South Carolina USA (R.H., M.B.); Hofstra University North Shore-LIJ School of Medicine, Hempstead, New York USA (J.S.P.); and Eastern Virginia Medical School, Norfolk, Virginia USA (A.A.)
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Chiem AT, Soucy Z, Dinh VA, Chilstrom M, Gharahbaghian L, Shah V, Medak A, Nagdev A, Jang T, Stark E, Hussain A, Lobo V, Pera A, Fox JC. Integration of Ultrasound in Undergraduate Medical Education at the California Medical Schools: A Discussion of Common Challenges and Strategies From the UMeCali Experience. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:221-233. [PMID: 26764278 DOI: 10.7863/ultra.15.05006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 05/26/2015] [Indexed: 06/05/2023]
Abstract
Since the first medical student ultrasound electives became available more than a decade ago, ultrasound in undergraduate medical education has gained increasing popularity. More than a dozen medical schools have fully integrated ultrasound education in their curricula, with several dozen more institutions planning to follow suit. Starting in June 2012, a working group of emergency ultrasound faculty at the California medical schools began to meet to discuss barriers as well as innovative approaches to implementing ultrasound education in undergraduate medical education. It became clear that an ongoing collaborative could be formed to discuss barriers, exchange ideas, and lend support for this initiative. The group, termed Ultrasound in Medical Education, California (UMeCali), was formed with 2 main goals: to exchange ideas and resources in facilitating ultrasound education and to develop a white paper to discuss our experiences. Five common themes integral to successful ultrasound education in undergraduate medical education are discussed in this article: (1) initiating an ultrasound education program; (2) the role of medical student involvement; (3) integration of ultrasound in the preclinical years; (4) developing longitudinal ultrasound education; and (5) addressing competency.
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Affiliation(s)
- Alan T Chiem
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.).
| | - Zachary Soucy
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Vi Am Dinh
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Mikaela Chilstrom
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Laleh Gharahbaghian
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Virag Shah
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Anthony Medak
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Arun Nagdev
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Timothy Jang
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Elena Stark
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Aliasgher Hussain
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Viveta Lobo
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - Abraham Pera
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
| | - J Christian Fox
- Olive View-UCLA Medical Center, UCLA Geffen School of Medicine, Sylmar, California USA (A.T.C.); Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire USA (Z.S.); Loma Linda University School of Medicine, Loma Linda, California USA (V.A.D.); University of Southern California Keck School of Medicine, Los Angeles, California USA (M.C.); Stanford University School of Medicine, Stanford, California USA (L.G., V.L.); University of California San Diego School of Medicine, San Diego, California USA (V.S., A.M.); Highland General Hospital, University of California San Francisco School of Medicine, Oakland, California USA (A.N.); Harbor-UCLA Medical Center, UCLA Geffen School of Medicine, Los Angeles, California USA (T.J., A.H.); UCLA Geffen School of Medicine, Los Angeles, California USA (E.S.); Touro University College of Medicine, San Francisco, California USA (A.P.); and University of California Irvine School of Medicine, Irvine, California USA (J.C.F.)
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Perioperative Ultrasound: The challenge of applying an old technology in new clinical settings☆. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2016. [DOI: 10.1097/01819236-201644040-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hoppmann RA, Rao VV, Bell F, Poston MB, Howe DB, Riffle S, Harris S, Riley R, McMahon C, Wilson LB, Blanck E, Richeson NA, Thomas LK, Hartman C, Neuffer FH, Keisler BD, Sims KM, Garber MD, Shuler CO, Blaivas M, Chillag SA, Wagner M, Barron K, Davis D, Wells JR, Kenney DJ, Hall JW, Bornemann PH, Schrift D, Hunt PS, Owens WB, Smith RS, Jackson AG, Hagon K, Wilson SP, Fowler SD, Catroppo JF, Rizvi AA, Powell CK, Cook T, Brown E, Navarro FA, Thornhill J, Burgis J, Jennings WR, McCallum JB, Nottingham JM, Kreiner J, Haddad R, Augustine JR, Pedigo NW, Catalana PV. The evolution of an integrated ultrasound curriculum (iUSC) for medical students: 9-year experience. Crit Ultrasound J 2015; 7:18. [PMID: 26589313 PMCID: PMC4654731 DOI: 10.1186/s13089-015-0035-3] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 11/03/2015] [Indexed: 01/08/2023] Open
Abstract
Interest in ultrasound education in medical schools has increased dramatically in recent years as reflected in a marked increase in publications on the topic and growing attendance at international meetings on ultrasound education. In 2006, the University of South Carolina School of Medicine introduced an integrated ultrasound curriculum (iUSC) across all years of medical school. That curriculum has evolved significantly over the 9 years. A review of the curriculum is presented, including curricular content, methods of delivery of the content, student assessment, and program assessment. Lessons learned in implementing and expanding an integrated ultrasound curriculum are also presented as are thoughts on future directions of undergraduate ultrasound education. Ultrasound has proven to be a valuable active learning tool that can serve as a platform for integrating the medical student curriculum across many disciplines and clinical settings. It is also well-suited for a competency-based model of medical education. Students learn ultrasound well and have embraced it as an important component of their education and future practice of medicine. An international consensus conference on ultrasound education is recommended to help define the essential elements of ultrasound education globally to ensure ultrasound is taught and ultimately practiced to its full potential. Ultrasound has the potential to fundamentally change how we teach and practice medicine to the benefit of learners and patients across the globe.
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Affiliation(s)
- Richard A Hoppmann
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Victor V Rao
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Floyd Bell
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Mary Beth Poston
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Duncan B Howe
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Shaun Riffle
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Stephen Harris
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Ruth Riley
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Carol McMahon
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - L Britt Wilson
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Erika Blanck
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Nancy A Richeson
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Lynn K Thomas
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Celia Hartman
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Francis H Neuffer
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Brian D Keisler
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Kerry M Sims
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Matthew D Garber
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - C Osborne Shuler
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Michael Blaivas
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Shawn A Chillag
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Michael Wagner
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Keith Barron
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Danielle Davis
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - James R Wells
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Donald J Kenney
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Jeffrey W Hall
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Paul H Bornemann
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - David Schrift
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Patrick S Hunt
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - William B Owens
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - R Stephen Smith
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Allison G Jackson
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Kelsey Hagon
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Steven P Wilson
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Stanley D Fowler
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - James F Catroppo
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Ali A Rizvi
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Caroline K Powell
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Thomas Cook
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Eric Brown
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Fernando A Navarro
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Joshua Thornhill
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Judith Burgis
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - William R Jennings
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - James B McCallum
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - James M Nottingham
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - James Kreiner
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Robert Haddad
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - James R Augustine
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Norman W Pedigo
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
| | - Paul V Catalana
- Dorothea H. Krebs Endowed Chair of Ultrasound Education, University of South Carolina, School of Medicine, Columbia, SC, 29208, USA.
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Torralba KD, Villaseñor-Ovies P, Evelyn CM, Koolaee RM, Kalish RA. Teaching of clinical anatomy in rheumatology: a review of methodologies. Clin Rheumatol 2015; 34:1157-63. [PMID: 26037454 DOI: 10.1007/s10067-015-2984-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 05/23/2015] [Indexed: 11/29/2022]
Abstract
Clinical anatomy may be defined as anatomy that is applied to the care of the patient. It is the foundation of a well-informed physical examination that is so important in rheumatologic practice. Unfortunately, there is both documented and observed evidence of a significant deficiency in the teaching and performance of a competent musculoskeletal examination at multiple levels of medical education including in rheumatology trainees. At the Annual Meeting of the American College of Rheumatology in Boston, MA, that took place in November 2014, a Clinical Anatomy Study Group met to share techniques of teaching clinical anatomy to rheumatology fellows, residents, and students. Techniques that were reviewed included traditional anatomic diagrams, hands-on cross-examination, cadaver study, and musculoskeletal ultrasound. The proceedings of the Study Group section are described in this review.
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Affiliation(s)
- Karina D Torralba
- Division of Rheumatology, Department of Medicine, Loma Linda University, Loma Linda, USA
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Jamniczky HA, McLaughlin K, Kaminska ME, Raman M, Somayaji R, Wright B, Ma IWY. Cognitive load imposed by knobology may adversely affect learners' perception of utility in using ultrasonography to learn physical examination skills, but not anatomy. ANATOMICAL SCIENCES EDUCATION 2015; 8:197-204. [PMID: 24903679 DOI: 10.1002/ase.1467] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/24/2014] [Accepted: 05/18/2014] [Indexed: 06/03/2023]
Abstract
Ultrasonography is increasingly used for teaching anatomy and physical examination skills but its effect on cognitive load is unknown. This study aimed to determine ultrasound's perceived utility for learning, and to investigate the effect of cognitive load on its perceived utility. Consenting first-year medical students (n = 137) completed ultrasound training that includes a didactic component and four ultrasound-guided anatomy and physical examination teaching sessions. Learners then completed a survey on comfort with physical examination techniques (three items; alpha = 0.77), perceived utility of ultrasound in learning (two items; alpha = 0.89), and cognitive load on ultrasound use [measured with a validated nine-point scale (10 items; alpha = 0.88)]. Learners found ultrasound useful for learning for both anatomy and physical examination (mean 4.2 ± 0.9 and 4.4 ± 0.8, respectively; where 1 = very useless and 5 = very useful). Principal components analysis on the cognitive load survey revealed two factors, "image interpretation" and "basic knobology," which accounted for 60.3% of total variance. Weighted factor scores were not associated with perceived utility in learning anatomy (beta = 0.01, P = 0.62 for "image interpretation" and beta = -0.04, P = 0.33 for "basic knobology"). However, factor score on "knobology" was inversely associated with perceived utility for learning physical examination (beta = -0.06; P = 0.03). While a basic introduction to ultrasound may suffice for teaching anatomy, more training may be required for teaching physical examination. Prior to teaching physical examination skills with ultrasonography, we recommend ensuring that learners have sufficient knobology skills.
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Affiliation(s)
- Heather A Jamniczky
- Department of Cell Biology and Anatomy, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Undergraduate Medical Education, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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Webb EM, Cotton JB, Kane K, Straus CM, Topp KS, Naeger DM. Teaching point of care ultrasound skills in medical school: keeping radiology in the driver's seat. Acad Radiol 2014; 21:893-901. [PMID: 24928158 DOI: 10.1016/j.acra.2014.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 02/28/2014] [Accepted: 03/03/2014] [Indexed: 12/26/2022]
Abstract
RATIONALE AND OBJECTIVES Ultrasound is used increasingly in medical practice as a tool for focused bedside diagnosis and technical assistance during procedures. Widespread availability of small portable units has put this technology into the hands of many physicians and medical students who lack dedicated training, leaving the education and introduction of this key modality increasingly to physicians from other specialties. We developed a radiology-led program to teach ultrasound skills to preclinical medical students. MATERIALS AND METHODS To develop this new ultrasound program we 1) established a program leader, 2) developed teaching materials, 3) created a hands-on interactive program, and 4) recruited the necessary instructors. The program was piloted with the first-year medical student class of 154 students. The introductory session was assessed by pre- and post-activity Likert scale-based surveys. RESULTS Of 154 (68.8%) students, 106 completed a voluntary online survey before starting the program and 145 students (94.2%) completed a voluntary survey after the session. Students found the program educationally valuable (4.64 of 5) and reported that it improved their understanding of ultrasound imaging (4.7 of 5). Students' reported confidence in identifying abdominal organs, intra-abdominal fluid, and Morison pouch that was significantly higher on the postactivity survey compared to the presurvey (P < .001 for all). CONCLUSIONS We piloted a radiology-led program to teach ultrasound skills to preclinical medical students. Students found the experience enjoyable and educationally valuable.
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Affiliation(s)
- Emily M Webb
- Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628.
| | | | - Kevin Kane
- University of California, San Francisco, California
| | | | - Kimberly S Topp
- Department of Anatomy and Physical Therapy, University of California, San Francisco, California; Department of Rehabilitation Science, University of California, San Francisco, California
| | - David M Naeger
- Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628
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