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Passos RDH, Flato UAP, Sanches PR, Pellegrino CM, Cordioli RL, Silva BC, Campos FG, Barros DDS, Coelho FO, Bravim BDA, Corrêa TD. The utility of point-of-care ultrasound in critical care nephrology. FRONTIERS IN NEPHROLOGY 2024; 4:1402641. [PMID: 39421322 PMCID: PMC11484063 DOI: 10.3389/fneph.2024.1402641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 09/06/2024] [Indexed: 10/19/2024]
Abstract
Point-of-care ultrasonography (POCUS) is gaining heightened significance in critical care settings as it allows for quick decision-making at the bedside. While computerized tomography is still considered the standard imaging modality for many diseases, the risks and delays associated with transferring a critically ill patient out of the intensive care unit (ICU) have prompted physicians to explore alternative tools. Ultrasound guidance has increased the safety of invasive procedures in the ICU, such as the placement of vascular catheters and drainage of collections. Ultrasonography is now seen as an extension of the clinical examination, providing quick answers for rapidly deteriorating patients in the ICU. The field of nephrology is increasingly acknowledging the value of diagnostic point-of-care ultrasound (POCUS). By employing multi-organ POCUS, nephrologists can address specific queries that arise during the diagnosis and treatment of patients with acute kidney injury. This approach aids in ruling out hydronephrosis and offers immediate information on hemodynamics, thereby consolidating patient data and facilitating the development of personalized treatment strategies.
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Affiliation(s)
| | - Uri Adrian Prync Flato
- Critical Care Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil
| | | | | | | | - Bruno Caldin Silva
- Critical Care Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | | | | | - Thiago Domingos Corrêa
- Critical Care Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil
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Barth G, Prosch H, Blaivas M, Gschmack AM, Hari R, Hoffmann B, Jenssen C, Möller K, Neubauer R, Nourkami-Tutdibi N, Recker F, Ruppert JP, Von Wangenheim F, Weimer J, Westerway SC, Zervides C, Dietrich CF. Student Ultrasound Education, Current Views and Controversies; Who Should be Teaching? ZEITSCHRIFT FUR GASTROENTEROLOGIE 2024; 62:1718-1723. [PMID: 39074814 DOI: 10.1055/a-2356-7906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
Acquiring diagnostic ultrasound competencies and skills is crucial in modern health care, and achieving the practical experience is vital in developing the necessary anatomy interpretation and scan acquisition skills. However, traditional teaching methods may not be sufficient to provide hands-on practice, which is essential for this skill acquisition. This paper explores various modalities and instructors involved in ultrasound education to identify the most effective approaches. The field of ultrasound instruction is enriched by the diverse roles of physicians, anatomists, peer tutors, and sonographers. All these healthcare professionals can inspire and empower the next generation of ultrasound practitioners with continuous training and support. Physicians bring their clinical expertise to the table, while anatomists enhance the understanding of anatomical knowledge through ultrasound integration. Peer tutors, often medical students, provide a layer of social congruence and motivation to the learning process. Sonographers provide intensive practical experience and structured learning plans to students. By combining different instructors and teaching methods, success can be achieved in ultrasound education. An ultrasound curriculum organized by experts in the field can lead to more efficient use of resources and better learning outcomes. Empowering students through peer-assisted learning can also ease the burden on faculty. Every instructor must receive comprehensive didactic training to ensure high-quality education in diagnostic ultrasound.
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Affiliation(s)
- Gregor Barth
- Department of Hematology, Oncology and Palliative Care, Brandenburg an der Havel University Hospital, Brandenburg an der Havel, Germany
- Brandenburg Institute for Clinical Ultrasound (BICUS), Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Helmut Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Wien, Austria
| | - Michael Blaivas
- Department of Medicine, University of South Carolina School of Medicine, Columbia, United States
| | | | - Roman Hari
- Dean's office, Medical Faculty, University of Bern, Bern, Switzerland
| | - Beatrice Hoffmann
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, United States
- Harvard Medical School, Boston, United States
| | - Christian Jenssen
- Department for Internal Medicine, Krankenhaus Märkisch Oderland GmbH, Strausberg, Germany
- Department for Internal Medicine, Krankenhaus Märkisch Oderland GmbH, Wriezen, Germany
- Brandenburg Institute for Clinical Ultrasound (BICUS), Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Kathleen Möller
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | | | - Nasenien Nourkami-Tutdibi
- Department of General Pediatrics and Neonatology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Johannes Weimer
- Rudolf Frey Teaching Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | - Christoph F Dietrich
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Farooq M, Cevik AA, Alao DO, Pedo VG, Abu-Zidan F. Medical Students' Competency in EFAST (Extended Focused Assessment Sonography for Trauma) Components: A Prospective Observational Study. Cureus 2024; 16:e69338. [PMID: 39398650 PMCID: PMC11471152 DOI: 10.7759/cureus.69338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2024] [Indexed: 10/15/2024] Open
Abstract
OBJECTIVE Ultrasound training in undergraduate medical education is developing, and its incorporation into the curriculum requires careful planning. Extended Focused Assessment Sonography for Trauma (EFAST) is commonly taught to medical students as one of the primary applications of ultrasound. Because false-negative EFAST scans can affect patients' clinical outcomes, it is essential to evaluate the individual components of this skill. We aim to determine which EFAST components students perform sub-optimally after initial training. METHODS In this prospective observational study, 90 medical students from two final-year cohorts were assessed in EFAST components after uniform training during the emergency medicine clerkship. All validated components of the standard EFAST exam were assessed, and a descriptive analysis of individual components of EFAST was performed. RESULTS The hepatorenal space, splenorenal space, and pelvic space fluid investigations had the lowest completion rates. Pericardial fluid, pelvic free fluid, and right thoracic pleural fluid investigations were often incorrectly applied. Fanning was most commonly missed in hepatorenal, splenorenal, and pelvic free fluid investigations, and between 12% and 50% of EFAST components had omitted reporting. CONCLUSIONS There were significant incomplete assessments for free intraperitoneal fluid, primarily due to a lack of fanning in the hepatorenal, splenorenal, and pelvic areas. Trainers can effectively enhance student performance and outcomes by targeting these challenging areas. Further research might reveal whether residents and physicians show similar trends in EFAST completion.
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Affiliation(s)
- Munawar Farooq
- Department of Internal Medicine, Emergency Medicine Section, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
- Department of Emergency Medicine, Tawam Hospital, Al Ain, ARE
| | - Arif Alper Cevik
- Department of Internal Medicine, Emergency Medicine Section, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
- Department of Emergency Medicine, Tawam Hospital, Al Ain, ARE
| | - David O Alao
- Department of Internal Medicine, Emergency Medicine Section, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
- Department of Emergency Medicine, Tawam Hospital, Al Ain, ARE
| | - Virgie Guy Pedo
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
| | - Fikri Abu-Zidan
- Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
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Moran CM, McLeod C, Inglis S, Pye SD. An Assessment of the Imaging Performance of Hand-Held Ultrasound Scanners Using the Edinburgh Pipe Phantom. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1178-1182. [PMID: 38705784 DOI: 10.1016/j.ultrasmedbio.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Although hand-held ultrasound devices (HHUSDs) are currently used for a diverse range of diagnostic and interventional applications the imaging performance of such scanners is rarely considered. The aim of this study was to assess the imaging performance of a wide-range of HHUSDs and compare their imaging performance to cart-based systems utilized for the same clinical applications. METHODS The grayscale imaging performances of 19 HHUSDs from eight different manufacturers, manufactured between 2016 and 2021, were measured using a figure-of-merit known as the resolution integral. The imaging performance of the HHUSDs were compared to 142 cart-based ultrasound scanners. RESULTS The HHUSD with the overall highest resolution integral (66) was a Butterfly (Burlington, MA, USA) wired phased array for small parts applications, followed by a Philips (Bothell, WA, USA) Lumify wired curvilinear transducer (57) for abdominal applications, a Butterfly wired phased array (56) for abdominal applications, a GE (Freiburg, Baden-Wurttemberg, Germany) VScan Air wireless linear array (56) for small parts applications, and a Healcerion (Seoul, Korea) Sonon 300L wireless linear array (56) for small parts applications. A GE VScan Extend wired phased array had the highest resolution integral (44) for cardiac applications. CONCLUSIONS The Butterfly phased array had the highest resolution integral of all the 19 HHUSDs, although this value is still less than the majority of cart-based cardiac and abdominal ultrasound scanners manufactured from 2010 to 2017. Clinical users of HHUSDs should be mindful of the limitations in imaging performance of hand-held ultrasound devices.
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Affiliation(s)
- Carmel M Moran
- University-BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK.
| | | | | | - Stephen D Pye
- University-BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK
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Weimer JM, Rink M, Vieth T, Lauff J, Weimer A, Müller L, Stäuber M, Reder SR, Buggenhagen H, Bellhäuser H, Kloeckner R, Künzel J, Hoffmann EM, Würde A. Development and evaluation of a point-of-care ocular ultrasound curriculum for medical students - a proof-of-concept study. BMC MEDICAL EDUCATION 2023; 23:723. [PMID: 37789302 PMCID: PMC10548604 DOI: 10.1186/s12909-023-04723-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Point-of-care Ocular Ultrasound (POCOUS) has gained importance in emergency medicine and intensive care in recent years. This work aimed to establish and evaluate a dedicated ultrasound education program for learning POCOUS-specific skills during medical studies at a university hospital. METHODS The blended learning-based program (6 teaching units) based on recent scientific publications and recommendations was developed for students in the clinical part of their medical studies. Experts and trainers consisted of physicians from the Ear-Nose-Throat, radiology, ophthalmology and neurology specialties as well as university educational specialists. Lecture notes containing digital video links for preparation was produced as teaching material. In total, 33 students participated in the study. The education program, including the teaching materials, motivation and subjective gain in competency, was evaluated with the aid of a questionnaire (7-point Likert response format). Objective learning success was assessed on the basis of pre- and post-tests. These covered the skill areas: "anatomical basics", "ultrasound basics", "understanding of cross-sectional images", "normal findings" and "pathology recognition". RESULTS In the objective assessment of image interpretation, the participants improved significantly (p < 0.001) from pre- to post-test with a large effect size (Cohen's d = 1.78, effect size r = 0.66). The evaluations revealed a high level of satisfaction with the course concept, teaching materials and the tutors. In addition, a high level of motivation was recorded in relation to continuing to study "ultrasound diagnostics" and "ophthalmologic diseases". A significant (p < 0.01) positive gain was also achieved in terms of the subjective assessment of competency. This covers areas such as expertise, sonographic anatomy and performing a POCOUS examination as well as recognizing retinal detachment, globe perforation and increased optic nerve sheath diameter. CONCLUSION The results of this feasibility study show that medical students accept and support a POCOUS-specific education program and are able to develop a higher objective and subjective level of competency. Future transfer to other sites and larger groups of participants seems feasible.
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Affiliation(s)
- Johannes Matthias Weimer
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Maximilian Rink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Thomas Vieth
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jonas Lauff
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Weimer
- Center of Orthopedics, Trauma Surgery, and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, Heidelberg, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marie Stäuber
- Department of Anesthesia, Intensive Care Medicine, Emergency medicine, Pain medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sebastian R Reder
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein - Campus Lübeck, Lübeck, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Esther M Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Anna Würde
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
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Kameda T, Taniguchi N, Konno K, Koibuchi H, Omoto K, Itoh K. Reply to comments on "Ultrasonography in undergraduate medical education: a comprehensive review and the education program implemented at Jichi Medical University". J Med Ultrason (2001) 2023; 50:587. [PMID: 37548876 DOI: 10.1007/s10396-023-01349-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Toru Kameda
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
- Department of Ultrasound Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashicho, Utsunomiya-shi, Tochigi, 321-0974, Japan.
| | - Nobuyuki Taniguchi
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
- Department of Ultrasound Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashicho, Utsunomiya-shi, Tochigi, 321-0974, Japan
| | - Kei Konno
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Harumi Koibuchi
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Kiyoka Omoto
- Department of Laboratory Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya-ku, Saitama-shi, Saitama, 330-8503, Japan
| | - Kouichi Itoh
- Saiseikai Rikuzentakada Clinic, 194 Azanakai, Kesencho, Rikuzentakada-shi, Iwate, Japan
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McCormick E, Flanagan B, Johnson CD, Sweeney EM. Ultrasound skills teaching in UK medical education: A systematic review. CLINICAL TEACHER 2023; 20:e13635. [PMID: 37655446 DOI: 10.1111/tct.13635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 08/01/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Sonography is increasingly integrated into medical curricula to prepare students for clinical practice. In 2022, we conducted a systematic review to explore the degree to which ultrasound skill acquisition is incorporated into undergraduate medial education in the United Kingdom. METHODS A search of Medline and Embase databases from 2003 to 2022 identified 15 relevant articles. Studies were included if they described ultrasound skills training in UK undergraduate medical education. FINDINGS A range of teaching methods were reported including didactic demonstrations, hands-on experience and combinations thereof. Portable machines were more common than cart-based machines, and most demonstrators were ultrasound-trained clinicians. Ultrasound teaching is well received, with improvements in confidence using ultrasound, motivation to learn anatomy and retention of knowledge. DISCUSSION Obstacles to integration were noted including training, cost, curriculum time constraints and the issue of incidental pathology. One study demonstrated that anatomists with appropriate training could provide ultrasound teaching, reducing the need for clinicians or sonographers. Costs may be reduced by renting machines or purchasing portable/hand-held devices. Allowing access to machines during student's free time may address scheduling difficulties. A final recommendation is to pre-scan volunteers prior to the teaching session. CONCLUSION We have outlined approaches to ultrasound skills teaching and the inherent hurdles to this, as well as potential solutions. This may aid educators wishing to augment their curricula. Although there are relatively few studies from the United Kingdom, there is consensus that students enjoy the incorporation of ultrasound practice and believe it complements existing teaching, especially in a small group setting.
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Affiliation(s)
- Emer McCormick
- Centre for Biomedical Sciences Education, Queen's University Belfast, Belfast, UK
| | - Brendan Flanagan
- Centre for Biomedical Sciences Education, Queen's University Belfast, Belfast, UK
| | | | - Eva M Sweeney
- Centre for Biomedical Sciences Education, Queen's University Belfast, Belfast, UK
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8
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Megafu MN. Comments on "Ultrasonography in undergraduate medical education: a comprehensive review and the education program implemented at Jichi Medical University". J Med Ultrason (2001) 2023; 50:585-586. [PMID: 37247175 DOI: 10.1007/s10396-023-01318-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/30/2023]
Affiliation(s)
- Michael N Megafu
- A.T. Still University, Kirksville College of Osteopathic Medicine, 800 W Jefferson St, Kirksville, MO, 63501, USA.
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9
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Barger JB, Resuehr D, Edwards DN. Radiology for anatomy educators: Success of an online, 2-day course for radiology training. ANATOMICAL SCIENCES EDUCATION 2023; 16:958-968. [PMID: 37183970 DOI: 10.1002/ase.2284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023]
Abstract
Incorporation of radiology training into anatomy education from community college to health professional schools is becoming increasingly popular. However, anatomy educators generally lack training in common radiology modalities, including X-ray, CT, MRI, and ultrasound. Professional development or continuing education courses provide current and new educators the chance to gain new skills within a short timeframe. Here, a 2-day, online course for anatomy educators was created. The goals of which were for the participants: to gain basic knowledge of different radiology modalities, recognize normal radiographic images, and apply that information to common diseases or injuries in interactive case studies. Each day focused on different modalities, where Day 1 studied X-ray, CT, and MRI; and Day 2 studied Ultrasound. A 10-question pre- and post-test was taken by attendees for each day of instruction on a voluntary basis. Following the completion of the course, attendees were provided a survey to determine their perceptions on course content and knowledge acquired. Most attendees instructed undergraduates at 4-year universities, though several attendees came from community colleges and high schools. All attendees showed a significant improvement in knowledge from their pre- to post-test scores in X-ray, CT, MRI, and ultrasound following training. This was also reflected in their survey responses, where attendees felt the course was effective in increasing their knowledge and confidence in radiology. Overall, this study demonstrates the effectiveness of online continuing education courses and the need for more introductory radiology courses for anatomy educators.
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Affiliation(s)
- J Bradley Barger
- Department of Cell, Developmental, and Integrative Biology, Birmingham Heersink School of Medicine, University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
| | - David Resuehr
- Department of Cell, Developmental, and Integrative Biology, Birmingham Heersink School of Medicine, University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
| | - Danielle N Edwards
- Department of Cell, Developmental, and Integrative Biology, Birmingham Heersink School of Medicine, University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
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Weimer J, Dionysopoulou A, Strelow KU, Buggenhagen H, Weinmann-Menke J, Dirks K, Weimer A, Künzel J, Börner N, Ludwig M, Yang Y, Lorenz L, Ille C, Müller L. Undergraduate ultrasound training: prospective comparison of two different peer assisted course models on national standards. BMC MEDICAL EDUCATION 2023; 23:513. [PMID: 37461025 DOI: 10.1186/s12909-023-04511-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND A thorough knowledge of sonography is essential in clinical practice. Therefore, sonography training is increasingly incorporated into the medical school curriculum, entailing different course models. The question arises which model is most effective to convey sustained sonographic skills. METHODS Two different peer-assisted learning (PAL) sonography course models were developed as part of a clinical prospective study. The course content was based on the national resident curriculum of the German Society for Ultrasound in Medicine (DEGUM). Model A consists of a 10-week course and model B of a two-day compact course. Each model entailed 20 teaching units (TU). A script was used to prepare for each unit. Two modified OSCE exams of the ultrasound skills (max = 50 points per exam) were performed during the last teaching unit to assess the competence level. For subjective self-assessment and model evaluation, a questionnaire with a 7-point Likert scale was employed. RESULTS A total of 888 students of the 3rd year participated as part of a voluntary elective in the study (744 in model A and 144 in model B). In the exams, participants in model A (median 43 points) scored significantly higher than those in model B (median 39; p < 0.01). Participants in model A (mean 1.71 points) obtained significantly higher mean competency gain scores in subject knowledge than model B (mean 1.43 points; p < 0.01) participants. All participants were satisfied with the course concept (A: mean 1.68 vs. B: mean 1.78 points; p = 0.05), the teaching materials (A: mean 1.81 vs. B: mean 1.69 points; p = 0.52), and the tutor's didactic skills (A: mean 1.24 vs. B: mean 1.15 points; p < 0.05). CONCLUSION These results suggest that sonography-specific competency may be obtained through different course models, with a model stretching over several weeks leading to a higher competence level. Further research should assess the long-term retention of the skills obtained in different models.
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Affiliation(s)
- Johannes Weimer
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Anna Dionysopoulou
- Department of obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kai-Uwe Strelow
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Julia Weinmann-Menke
- Department of Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Dirks
- Department of General Internal Medicine and Geriatrics, Rems-Murr-Klinikum, Winnenden, Germany
| | - Andreas Weimer
- Center of Orthopedics, Trauma Surgery, and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, Heidelberg, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Norbert Börner
- Gastroenterological Medical Group Offices, MED Specialist Center Mainz, Mainz, Germany
| | - Michael Ludwig
- Department of Internal Medicine I, Hospital of the German Armed Forces Berlin, Berlin, Germany
| | - Yang Yang
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Liv Lorenz
- Department of Radiation Oncology and Radiotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Carlotta Ille
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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11
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Weimer JM, Widmer N, Strelow KU, Hopf P, Buggenhagen H, Dirks K, Künzel J, Börner N, Weimer AM, Lorenz LA, Rink M, Bellhäuser H, Schiestl LJ, Kloeckner R, Müller L, Weinmann-Menke J. Long-Term Effectiveness and Sustainability of Integrating Peer-Assisted Ultrasound Courses into Medical School-A Prospective Study. Tomography 2023; 9:1315-1328. [PMID: 37489472 PMCID: PMC10366829 DOI: 10.3390/tomography9040104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Ultrasound diagnostics is an important examination method in everyday clinical practice, but student education is often inadequate for acquiring sufficient basic skills. Individual universities have therefore started integrating (extra)curricular training concepts into medical education. This study aimed to evaluate sustainable skills development through participation in peer-assisted ultrasound courses. METHODS From 2017, students in the clinical part of medical school could opt for extracurricular peer-assisted ultrasound courses. Depending on the format (10-week course/2-day compact course) these comprised 20 teaching units focusing on abdominal and emergency ultrasonography. Students attending compulsory workshops at the start of their practical year were enrolled in this study, allowing for a comparison between the study group (attended ultrasound course) and the control group (did not attend ultrasound course). Competency from two out of four practical exams (subjects: "aorta", "gallbladder", "kidney" and "lung") was measured, and a theory test on the same subject areas ("pathology recognition") was administered. Additional questions concerned biographical data, subjective competency assessment (7-point Likert scale), and "attitude to ultrasound training in the curriculum". RESULTS Analysis included 302 participants in total. Ultrasound courses had been attended on average 2.5 years earlier (10-week course) and 12 months earlier (2-day compact course), respectively. The study group (n = 141) achieved significantly better results than the control group (n = 161) in the long-term follow-up. This applies both to practical exams (p < 0.01) and theory tests (p < 0.01). After course attendance, participants reported a significantly higher subjective assessment of theoretical (p < 0.01) and practical (p < 0.01) ultrasound skills. CONCLUSIONS Peer-assisted ultrasound courses can sustainably increase both theoretical and practical competency of medical students. This highlights the potential and need for standardised implementation of ultrasound courses in the medical education curriculum.
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Affiliation(s)
- Johannes Matthias Weimer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Nina Widmer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Kai-Uwe Strelow
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Paula Hopf
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Klaus Dirks
- Department of General Internal Medicine and Geriatrics, Rems-Murr-Klinikum, 71364 Winnenden, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 95053 Regensburg, Germany
| | - Norbert Börner
- Gastroenterological Medical Group Offices at the MED Specialist Centre Mainz, 55131 Mainz, Germany
| | - Andreas Michael Weimer
- Centre of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, 69118 Heidelberg, Germany
| | - Liv Annebritt Lorenz
- Department of Radiation Oncology and Radiotherapy, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Maximilian Rink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 95053 Regensburg, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, 55112 Mainz, Germany
| | - Lina Judit Schiestl
- Department of Gynaecology and Obstetrics, University Medical Centre of the Johannes-Gutenberg University Mainz, 55131 Mainz, Germany
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein-Campus Lübeck, 23583 Lübeck, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Julia Weinmann-Menke
- I. Department of Medicine, University Medical Centre of the Johannes Gutenberg University-Mainz, 55131 Mainz, Germany
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Kameda T. The combination of physical examination and point-of-care ultrasonography in undergraduate medical education. J Med Ultrason (2001) 2023; 50:273-274. [PMID: 37464174 DOI: 10.1007/s10396-023-01328-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 07/20/2023]
Affiliation(s)
- Toru Kameda
- Department of Ultrasound Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
- Department of Emergency Medicine, Red Cross Society Azumino Hospital, Nagano, Japan.
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Kameda T, Koibuchi H, Konno K, Taniguchi N. Self-learning followed by telepresence instruction of focused cardiac ultrasound with a handheld device for medical students: a preliminary study. J Med Ultrason (2001) 2022; 49:415-423. [PMID: 35739371 PMCID: PMC9223254 DOI: 10.1007/s10396-022-01233-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/26/2022] [Indexed: 11/25/2022]
Abstract
Purpose This study aimed to assess the feasibility and efficiency of self-learning with or without self-training (subjects performed scans on themselves) and telepresence instruction in focused cardiac ultrasound (FOCUS) education for medical students. Methods This study included 24 medical students. The participants initially completed a written pre-test and were randomized into a video lecture (participants watched a video lecture) or self-training (participants watched a video lecture and self-performed FOCUS) group. After finishing self-learning, they completed a written post-test. Then they undertook a skill pre-test and a first perception survey. Telepresence instruction was then provided. Finally, they undertook a skill post-test and a second perception survey. Results The written post-test total scores were significantly higher than the pre-test total scores (P < 0.001). In the skill pre-test, the scores for the video lecture and self-training groups were not significantly different (P = 0.542). The skill post-test total scores were significantly higher than the skill pre-test total scores (P = 0.008). Forty-two percent of the video lecture group participants agreed that the video lecture was effective preparation for the skill pre-test, while all participants in the same group agreed that the combination of the video lecture and telepresence instruction was effective preparation for the skill post-test. Conclusion This study demonstrated the feasibility and efficiency of self-learning followed by telepresence instruction on FOCUS for medical students.
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Affiliation(s)
- Toru Kameda
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
| | - Harumi Koibuchi
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Kei Konno
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Nobuyuki Taniguchi
- Department of Clinical Laboratory Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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