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Bintaro S, Dietrich CF, Potthoff A. Principles for teaching sonography - current status. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:1628-1634. [PMID: 37142236 DOI: 10.1055/a-2059-4425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Since many young medical residents require sonographic skills early on during training, increased attention has been paid to including sonography classes in undergraduate medical education, among both professional societies and medical educators responsible for medical licensing exams. Medical schools worldwide have developed and implemented a variety of ultrasound teaching formats.This article addresses evidence-based solutions to crucial challenges in planning and implementing undergraduate sonography education. In order to achieve a sustainable increase in practical sonographic competence, we suggest small-group classes with sufficient individual hands-on scanning time for each student. We recommend concentrating on a circumscribed topic and teaching it thoroughly and practically rather than superficially outlining a broad subject area. Provided that peer teachers undergo adequate training, student peer teachers are not inferior to physicians as teachers, as far as student satisfaction, theoretical knowledge and practical skills acquisition are concerned. The assessment of acquired practical skills should consist of practical examinations, such as an objective structured clinical examination (OSCE) or a direct observation of procedural skills (DOPS). In contrast to using healthy volunteers as training models, simulation trainers allow the demonstration of pathological findings in authentic sonographic images, with the disadvantages of unrealistically easy image acquisition, as well as the lack of interaction with the patient.
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Affiliation(s)
- Sabine Bintaro
- Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Christoph F Dietrich
- Allgemeine Innere Medizin (DAIM) Kliniken Beau Site, Salem und Permanence, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Andrej Potthoff
- Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany
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Selman F, Günsoy E, Yürüktümen Ünal A, Şenol Y. Content and Adequacy of Emergency Medicine Point of Care Ultrasound Training: Evaluation of Turkey. EURASIAN JOURNAL OF EMERGENCY MEDICINE 2022. [DOI: 10.4274/eajem.galenos.2022.71224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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3
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Monti JD, Perreault MD. Impact of a 4-hour Introductory eFAST Training Intervention Among Ultrasound-Naïve U.S. Military Medics. Mil Med 2020; 185:e601-e608. [PMID: 32060506 DOI: 10.1093/milmed/usaa014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/23/2019] [Accepted: 05/22/2019] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Advances in the portability of ultrasound have allowed it to be increasingly employed at the point of care in austere settings. Battlefield constraints often limit the availability of medical officers throughout the operational environment, leading to increased interest in whether highly portable ultrasound devices can be employed by military medics to enhance their provision of combat casualty care. Data evaluating optimal training for effective medic employment of ultrasound is limited however. This prospective observational cohort study's primary objective was to assess the impact of a 4-hour introductory training intervention on ultrasound-naïve military medic participants' knowledge/performance of the eFAST application. MATERIALS AND METHODS Conventional U.S. Army Medics, all naïve to ultrasound, were recruited from across JBLM. Volunteer participants underwent baseline eFAST knowledge assessment via a 50-question multiple-choice exam. Participants were then randomized to receive either conventional, expert-led classroom didactic training or didactic training via an online, asynchronously available platform. All participants then underwent expert-led, small group hands-on training and practice. Participants' eFAST performance was then assessed with both live and phantom models, followed by a post-course knowledge exam. Concurrently, emergency medicine (EM) resident physician volunteers, serving as standard criterion for trained personnel, underwent the same OSCE assessments, followed by a written exam to assess their baseline eFAST knowledge. Primary outcome measures included (1) post-course knowledge improvement, (2) eFAST exam technical adequacy, and (3) eFAST exam OSCE score. Secondary outcome measures were time to exam completion and diagnostic accuracy rate for hemoperitoneum and hemopericardium. These outcome measures were then compared across medic cohorts and to those of the EM resident physician cohort. RESULTS A total of 34 medics completed the study. After 4 hours of ultrasound training, overall eFAST knowledge among the 34 medics improved from a baseline mean of 27% on the pretest to 83% post-test. For eFAST exam performance, the medics scored an average of 20.8 out of a maximum of 22 points on the OSCE. There were no statistically significant differences between the medics who received asynchronous learning versus traditional classroom-based learning, and the medics demonstrated comparable performance to previously trained EM resident physicians. CONCLUSIONS A 4-hour introductory eFAST training intervention can effectively train conventional military medics to perform the eFAST exam. Online, asynchronously available platforms may effectively mitigate some of the resource requirement burden associated with point-of-care ultrasound training. Future studies evaluating medic eFAST performance on real-world battlefield trauma patients are needed. Skill and knowledge retention must also be assessed for this degradable skill to determine frequency of refresher training when not regularly performed.
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Affiliation(s)
- Jonathan D Monti
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Madigan Army Medical Center, 9040 Jackson Avenue, Joint Base Lewis-McChord, Washington 98431
| | - Michael D Perreault
- Department of Emergency Medicine, Madigan Army Medical Center, 9040 Jackson Avenue, Joint Base Lewis-McChord, Washington 98431
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Kumar A, Kugler J, Jensen T. Evaluation of Trainee Competency with Point-of-Care Ultrasonography (POCUS): a Conceptual Framework and Review of Existing Assessments. J Gen Intern Med 2019; 34:1025-1031. [PMID: 30924088 PMCID: PMC6544692 DOI: 10.1007/s11606-019-04945-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Point-of-care ultrasonography (POCUS) has the potential to transform healthcare delivery through its diagnostic expediency. Trainee competency with POCUS is now mandated for emergency medicine through the Accreditation Council for Graduate Medical Education (ACGME), and its use is expanding into other medical specialties, including internal medicine. However, a key question remains: how does one define "competency" with this emerging technology? As our trainees become more acquainted with POCUS, it is vital to develop validated methodology for defining and measuring competency amongst inexperienced users. As a framework, the assessment of competency should include evaluations that assess the acquisition and application of POCUS-related knowledge, demonstration of technical skill (e.g., proper probe selection, positioning, and image optimization), and effective integration into routine clinical practice. These assessments can be performed across a variety of settings, including web-based applications, simulators, standardized patients, and real clinical encounters. Several validated assessments regarding POCUS competency have recently been developed, including the Rapid Assessment of Competency in Echocardiography (RACE) or the Assessment of Competency in Thoracic Sonography (ACTS). However, these assessments focus mainly on technical skill and do not expand upon other areas of this framework, which represents a growing need. In this review, we explore the different methodologies for evaluating competency with POCUS as well as discuss current progress in the field of measuring trainee knowledge and technical skill.
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Affiliation(s)
- Andre Kumar
- Department of Medicine, Stanford University School of Medicine, Pasteur Drive, Stanford, CA, USA.
| | - John Kugler
- Department of Medicine, Stanford University School of Medicine, Pasteur Drive, Stanford, CA, USA
| | - Trevor Jensen
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Damewood SC, Lewiss RE, Huang JV. Ultrasound simulation utilization among point of care ultrasound users: Results of a survey. JOURNAL OF CLINICAL ULTRASOUND : JCU 2018; 46:571-574. [PMID: 30393889 DOI: 10.1002/jcu.22610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/28/2018] [Accepted: 05/18/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE While ultrasound simulation devices have long been available as adjuncts to ultrasound education, it is unclear how they are used. We conducted a survey to determine the current utilization of emergency point-of-care ultrasound simulation and describe the current trends in the use of ultrasound simulation. METHODS A survey was sent to 1270 members of the American College of Emergency Physicians Ultrasound Section via email. The survey listed 23 questions that queried how survey participants used ultrasound simulation devices. RESULTS One hundred and fifty-one survey responses were collected. The majority of survey respondents (83%) indicated that ultrasound simulation devices are available at their institution, with nearly half (45%) survey participants reporting both high- and low-fidelity ultrasound simulators available, and fewer describing low-fidelity simulators only (33%) or high-fidelity simulators only (5%). Most respondents (84%) with ultrasound simulators use them for training residents, students, fellows, and faculty. Only 20% of survey participants use ultrasound simulators for credentialing purposes. CONCLUSIONS Ultrasound simulation devices are widespread amongst our survey respondents, who represent a small percentage of the ACEP ultrasound section. Ultrasound simulators are used to help ultrasound learners at various levels of training.
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Affiliation(s)
- Sara C Damewood
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin, Wisconsin
| | - Resa E Lewiss
- Department of Emergency Medicine, Thomas Jefferson University School of Medicine, Pennsylvania
| | - Jennifer V Huang
- Department of Emergency Medicine, University of Southern California, Los Angelos, California
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Liteplo AS, Carmody K, Fields MJ, Liu RB, Lewiss RE. SonoGames: Effect of an Innovative Competitive Game on the Education, Perception, and Use of Point-of-Care Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2491-2496. [PMID: 29676524 DOI: 10.1002/jum.14606] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 01/10/2018] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Gamification is a powerful tool in medical education. SonoGames is a competitive games-based event designed to educate and inspire emergency medicine (EM) residents about point-of-care ultrasound. We sought to describe: (1) the perceived effectiveness of a competitive event on both immediate learning and long-term education; and (2) the resultant attitudes of participants and program directors regarding ultrasound training. METHODS The SonoGames Organizational Committee designed 2 surveys: 1 for SonoGames V EM resident participants and a second for EM program directors. Survey questions used a 5-point Likert scale to assess overall perceptions and attitudes about ultrasound, changes in self-reported content knowledge and competency, effects on clinical use, and perceived impacts of a competitive game format on education. RESULTS Seventy-three resident participants and 42 program directors responded to the survey. Ninety-four percent of participants thought that the competitive gaming format of SonoGames was effective in making the event an educational experience. Participants reported that their ultrasound knowledge increased (81%), their enthusiasm for ultrasound increased (87%), and their clinical use of ultrasound increased (61%). Residency program directors reported similar increases to a lesser degree. Greater advancement through the event was associated with more positive responses. Residencies that participated in the event saw greater increases in the use of ultrasound by residents than those that did not. CONCLUSIONS A competitive games-based educational event focused on point-of-care ultrasound is an effective educational tool. SonoGames increases EM residents' knowledge, enthusiasm, and clinical use of ultrasound both during and after the event.
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Affiliation(s)
- Andrew S Liteplo
- Center for Ultrasound Research and Education, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kristin Carmody
- New York University School of Medicine, New York, New York, USA
| | - Matt J Fields
- Kaiser Permanente, San Diego Medical Center, San Diego, California, USA
| | - Rachel B Liu
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Resa E Lewiss
- Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Davy RB, Hamel PE, Su Y, Berry CR, Conner BJ. Evaluation of Two Training Methods for Teaching the Abdominal Focused Assessment with Sonography for Trauma Technique (A-FAST) to First- and Second-Year Veterinary Students. JOURNAL OF VETERINARY MEDICAL EDUCATION 2018; 46:258-263. [PMID: 30285594 DOI: 10.3138/jvme.0517-059r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ultrasound techniques, including focused assessment with sonography for trauma (FAST) examinations, are commonly used in veterinary practice, making inclusion of ultrasound in veterinary curricula increasingly important. The best approach for teaching ultrasound techniques in veterinary medicine has not been evaluated. This study compared the results of two training techniques, live-animal training and online video instruction, on students' performance during abdominal FAST (A-FAST) examinations. Thirty-eight first- and second-year veterinary students were randomly assigned to learn A-FAST via a live-animal laboratory or an instructional video. The live-animal group received one-on-one instruction in A-FAST techniques during a single laboratory. The video group received a link to an instructional video demonstrating A-FAST techniques, allowing unlimited viewing opportunities over a two-week period. Both groups were also provided written instructional information. All participants were assessed on their ability to find and correctly name the four A-FAST quadrants on a live animal. We found a significant difference between the two groups in the students' ability to identify the diaphragmatic-hepatic (DH) view, but for the other three views (hepatorenal, splenorenal, and cystocolic), training method did not affect performance. Results suggest the potential for using a multi-modal instructional approach to teach ultrasound techniques to veterinary students.
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Mackay FD, Zhou F, Lewis D, Fraser J, Atkinson PR. Can You Teach Yourself Point-of-care Ultrasound to a Level of Clinical Competency? Evaluation of a Self-directed Simulation-based Training Program. Cureus 2018; 10:e3320. [PMID: 30473953 PMCID: PMC6248742 DOI: 10.7759/cureus.3320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction Self-directed learning in medical professions is established as an effective method of training in certain modalities. Furthermore, simulation technology is becoming widely used and accepted as a valid method of training for various medical skills, with ultrasound being one of the best studied. The use of point-of-care ultrasound (PoCUS) in the practice of emergency medicine is well established, and PoCUS is a core competency of the Royal College of Physicians and Surgeons of Canada emergency medicine standards. The primary goal of our study was to assess the effectiveness of a self-directed simulation-based training program for medical students, in terms of achieving competency in basic PoCUS scans. Methods Fourteen second-year medical students with no prior ultrasound experience were provided access to online study modules created by SonoSim ultrasound training solutions (SonoSim, Santa Monica, CA, US), covering ultrasound theory and methodology, and attended a two-hour introductory session where they were introduced to the study protocol, simulation equipment, and software. Participants then undertook self-directed ultrasound simulation training throughout the year, using the CAE Vimedix PoCUS simulator (CAE Healthcare, Sarasota, FL, US) and the SonoSim ultrasound training solution system. Upon reaching 10 (and 25) scans in each of the four categories (cardiac, abdomen, aorta, and pelvic), a triggered assessment was arranged in which participants scanned a live volunteer under the direct supervision of PoCUS-certified physicians. The physicians scored the participant attempts in terms of image acquisition, interpretation, and clinical understanding. No feedback was provided to the participants. Following the study, participants submitted feedback regarding the design of the study and were asked to rank their preferred training program protocols out of a provided list of five different options. Results At the first triggered assessment (after completing only 10 scans in each category), four out of 14 participants were scored as competent in the aorta scan, two out of 14 participants were competent in the pelvic scan, and none of the participants were competent in both the cardiac and abdominal scans. Only nine out of 14 participants completed the second triggered assessment (after completing 25 scans in each category). At the second assessment, only three participants were scored as competent in the aorta scan, two participants were competent in the cardiac scan, and one participant was competent in the pelvic scan. None of the 14 learners completed the final phase of the training and assessment protocol. Feedback following the termination of the study showed that none of the participants supported continuing the study protocol as designed originally, and the preferred study design consisted of a full-day introductory course with live models and simulation, followed by self-directed learning with simulation and live models until 50 scans in each category were achieved. Conclusion We were unable to demonstrate the achievement of competence in PoCUS in medical learners engaged in our combined self-directed simulation-based training program. This is in contrast to the considerable literature supporting self-directed learning and simulation-based learning for other skills. Feedback from faculty, curriculum integration, and alignment with clinical experience may be beneficial.
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Affiliation(s)
| | - Felix Zhou
- Medical Education, Memorial University of Newfoundland, Saint John, CAN
| | - David Lewis
- Emergency Medicine, Dalhousie University, Saint John, CAN
| | | | - Paul R Atkinson
- Emergency Medicine, Saint John Regional Hospital, Saint John, CAN
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9
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Orr KE, Hamilton SC, Clarke R, Adi MY, Gutteridge C, Suresh P, Freeman SJ. The integration of transabdominal ultrasound simulators into an ultrasound curriculum. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2018; 27:20-30. [PMID: 30774695 DOI: 10.1177/1742271x18762251] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 02/07/2018] [Indexed: 11/16/2022]
Abstract
Introduction Simulation is increasingly used throughout medicine. Within ultrasound, simulators are more established for learning transvaginal and interventional procedures. The use of modern high-fidelity transabdominal simulators is increasing, particularly in centres with large trainee numbers. There is no current literature on the value of these simulators in gaining competence in abdominal ultrasound. The aim was to investigate the impact of a new ultrasound curriculum, incorporating transabdominal simulators into the first year of training in a UK radiology academy. Methods The simulator group included 13 trainees. The preceding cohort of 15 trainees was the control group. After 10 months, a clinical assessment was performed to assess whether the new curriculum resulted in improved ultrasound skills. Questionnaires were designed to explore the acceptability of simulation training and whether it had any impact on confidence levels. Results Trainees who had received simulator-enriched training scored higher in an objective clinical ultrasound assessment, which was statistically significant (p = 0.0463). End confidence scores for obtaining diagnostic images and demonstrating pathology were also higher in the simulation group. All trainees stated that transabdominal simulator training was useful in early training. Conclusions This initial study shows that embedded into a curriculum, transabdominal ultrasound simulators are an acceptable training method that can result in improved ultrasound skills and higher confidence levels. Using simulators early in training could allow trainees to master the basics, improve their confidence, enabling them to get more educational value from clinical ultrasound experience while reducing the impact of training on service provision.
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Affiliation(s)
- K E Orr
- Peninsula Radiology Academy, UK.,Derriford Hospital, Plymouth, UK
| | - S C Hamilton
- Peninsula Radiology Academy, UK.,Derriford Hospital, Plymouth, UK
| | | | - M Y Adi
- Peninsula Radiology Academy, UK
| | | | - P Suresh
- Peninsula Radiology Academy, UK.,Derriford Hospital, Plymouth, UK
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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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Ultrasound Guidelines: Emergency, Point-of-Care and Clinical Ultrasound Guidelines in Medicine. Ann Emerg Med 2017; 69:e27-e54. [PMID: 28442101 DOI: 10.1016/j.annemergmed.2016.08.457] [Citation(s) in RCA: 393] [Impact Index Per Article: 56.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Indexed: 02/06/2023]
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Savatmongkorngul S, Wongwaisayawan S, Kaewlai R. Focused assessment with sonography for trauma: current perspectives. Open Access Emerg Med 2017; 9:57-62. [PMID: 28794661 PMCID: PMC5536884 DOI: 10.2147/oaem.s120145] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Focused assessment with sonography for trauma (FAST) is a part of resuscitation of trauma patients recommended by international panel consensus. The purpose of FAST is to identify free fluid, which necessarily means blood in acute trauma patients. In this article, the authors focused on various aspects of FAST in the emergency department, prehospital care, pediatric setting, training and general pearls/pitfalls. Detailed techniques and interpretation of FAST are beyond the scope of this article.
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Affiliation(s)
| | - Sirote Wongwaisayawan
- Division of Emergency Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Rathachai Kaewlai
- Division of Emergency Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Shaffer M, Brown HA, McCoy C, Bashaka P. Evaluation of a Short-term Training Program in Bedside Emergency Ultrasound in Southwestern Tanzania. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:515-521. [PMID: 28088840 DOI: 10.7863/ultra.16.04006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/13/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To evaluate the effect of a short-term training program in emergency ultrasound on physician skills and attitudes in southwestern Tanzania. METHODS Eight registrar physicians at Mbeya Zonal Referral Hospital (Mbeya, Tanzania) underwent a 5-day course in bedside emergency ultrasound, focusing primarily on the focused assessment with sonography for trauma examination, including didactic sessions, practical sessions, and on-job training. The impact on ultrasound knowledge was assessed by pretest and posttest evaluations. Provider skill was evaluated by a standardized observed simulated patient encounter. Attitudes toward ultrasound training, utility, and self-confidence were assessed by a post-training questionnaire. RESULTS All 8 physicians who began the training completed the course and successfully passed their objective structured clinical examination. There was a statistically significant improvement in written ultrasound test scores from 31% to 66% (P < .01) after the course. Most trainees felt confident performing and interpreting a basic focused assessment with sonography for trauma examination at the end of the course, and 7 of 8 stated that they would consider paying tuition for similar courses in the future. Main concerns with the course revolved around insufficient time dedicated to practicing under supervision. CONCLUSIONS Registrar physicians in Tanzania can effectively learn basic emergency ultrasound skills in a short-term training program. Similar future programs may consider heavier emphasis on practical hands-on training with experts. Ongoing data collection is required to understand the true impact of such training on long-term ultrasound use and patient outcomes.
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Affiliation(s)
- Mark Shaffer
- Departments of Family and Preventive Medicine, University of South Carolina/Palmetto Health Richland, Columbia, South Carolina, USA
| | - Heather A Brown
- Department of Emergency Medicine, Palmetto Health Richland, Columbia, South Carolina, USA
- Department of Surgery, University of South Carolina, Columbia, South Carolina, USA
| | - Chloé McCoy
- Emergency Medicine, University of South Carolina/Palmetto Health Richland, Columbia, South Carolina, USA
| | - Prosper Bashaka
- Department of Emergency Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Smalley CM, Browne V, Kaplan B, Russ B, Wilson J, Lewiss RE. Early Innovative Immersion: A Course for Pre-Medical Professions Students Using Point-of-Care Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2681-2686. [PMID: 27821654 DOI: 10.7863/ultra.16.01050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/15/2016] [Accepted: 03/09/2016] [Indexed: 06/06/2023]
Abstract
In preparing for medical school admissions, premedical students seek opportunities to expand their medical knowledge. Knowing what students seek and what point-of-care ultrasound offers, we created a novel educational experience using point-of-care ultrasound. The innovation has 3 goals: (1) to use point-of-care ultrasound to highlight educational concepts such as the flipped classroom, simulation, hands-on interaction, and medical exposure; (2) to work collaboratively with peers; and (3) to expose premedical students to mentoring for the medical school application process. We believe that this course could be used to encourage immersive innovation with point-of-care ultrasound, progressive education concepts, and preparation for medical admissions.
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Affiliation(s)
| | - Vaughn Browne
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado USA
| | - Bonnie Kaplan
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado USA
| | - Brian Russ
- Department of Emergency Medicine, The University of Arkansas for Medical Sciences, Little Rock, Arkansas USA
| | - Juliana Wilson
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado USA
| | - Resa E Lewiss
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado USA
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Oh KH, Do HH, Kim HY, Seo JS. The Effectiveness of Extended Focused Assessment with Sonography for Trauma Education Conducted on the Medical College Students. JOURNAL OF TRAUMA AND INJURY 2016. [DOI: 10.20408/jti.2016.29.3.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Kyu Ho Oh
- Department of Emergency Medicine, Dongguk University Ilsan Medical Center, Gyeonggi-do, Korea
| | - Han Ho Do
- Department of Emergency Medicine, Dongguk University Ilsan Medical Center, Gyeonggi-do, Korea
| | - Hee Young Kim
- Department of Emergency Medicine, Dongguk University Ilsan Medical Center, Gyeonggi-do, Korea
| | - Jun Seok Seo
- Department of Emergency Medicine, Dongguk University Ilsan Medical Center, Gyeonggi-do, Korea
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Thoirs K, Osborne B, Childs JT, Parange N, Maranna S. Skill development of beginner sonography students using high-fidelity simulators: Initial experiences. SONOGRAPHY 2015. [DOI: 10.1002/sono.12043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Kerry Thoirs
- International Centre for Allied Health Evidence ( i CAHE); City East Campus, North Tce, Adelaide, University of South Australia; GPO Box 2471 Adelaide SA 5001 Australia
- School of Health Sciences; University of South Australia; GPO Box 2471 Adelaide SA 5001 Australia
| | - Brooke Osborne
- School of Health Sciences; University of South Australia; GPO Box 2471 Adelaide SA 5001 Australia
| | - Jessie T. Childs
- School of Health Sciences; University of South Australia; GPO Box 2471 Adelaide SA 5001 Australia
| | - Nayana Parange
- School of Health Sciences; University of South Australia; GPO Box 2471 Adelaide SA 5001 Australia
| | - Sandy Maranna
- School of Health Sciences; University of South Australia; GPO Box 2471 Adelaide SA 5001 Australia
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Bentley S, Mudan G, Strother C, Wong N. Are Live Ultrasound Models Replaceable? Traditional versus Simulated Education Module for FAST Exam. West J Emerg Med 2015; 16:818-22. [PMID: 26594272 PMCID: PMC4651576 DOI: 10.5811/westjem.2015.9.27276] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/31/2015] [Accepted: 09/26/2015] [Indexed: 11/28/2022] Open
Abstract
Introduction The focused assessment with sonography for trauma (FAST) is a commonly used and life-saving tool in the initial assessment of trauma patients. The recommended emergency medicine (EM) curriculum includes ultrasound and studies show the additional utility of ultrasound training for medical students. EM clerkships vary and often do not contain formal ultrasound instruction. Time constraints for facilitating lectures and hands-on learning of ultrasound are challenging. Limitations on didactics call for development and inclusion of novel educational strategies, such as simulation. The objective of this study was to compare the test, survey, and performance of ultrasound between medical students trained on an ultrasound simulator versus those trained via traditional, hands-on patient format. Methods This was a prospective, blinded, controlled educational study focused on EM clerkship medical students. After all received a standardized lecture with pictorial demonstration of image acquisition, students were randomized into two groups: control group receiving traditional training method via practice on a human model and intervention group training via practice on an ultrasound simulator. Participants were tested and surveyed on indications and interpretation of FAST and training and confidence with image interpretation and acquisition before and after this educational activity. Evaluation of FAST skills was performed on a human model to emulate patient care and practical skills were scored via objective structured clinical examination (OSCE) with critical action checklist. Results There was no significant difference between control group (N=54) and intervention group (N=39) on pretest scores, prior ultrasound training/education, or ultrasound comfort level in general or on FAST. All students (N=93) showed significant improvement from pre- to post-test scores and significant improvement in comfort level using ultrasound in general and on FAST (p<0.001). There was no significant difference between groups on OSCE scores of FAST on a live model. Overall, no differences were demonstrated between groups trained on human models versus simulator. Discussion There was no difference between groups in knowledge based ultrasound test scores, survey of comfort levels with ultrasound, and students’ abilities to perform and interpret FAST on human models. Conclusion These findings suggest that an ultrasound simulator is a suitable alternative method for ultrasound education. Additional uses of ultrasound simulation should be explored in the future.
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Affiliation(s)
- Suzanne Bentley
- Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York City, New York ; Elmhurst Hospital Center, Department of Emergency Medicine, Elmhurst, New York
| | - Gurpreet Mudan
- Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York City, New York
| | - Christopher Strother
- Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York City, New York
| | - Nelson Wong
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts
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Mohammad A, Hefny AF, Abu-Zidan FM. Focused Assessment Sonography for Trauma (FAST) training: a systematic review. World J Surg 2014; 38:1009-18. [PMID: 24357247 DOI: 10.1007/s00268-013-2408-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of this study was to systematically review the different methods for training Focused Assessment Sonography for Trauma (FAST), course design, and requirements for hospital credentialing. METHODS We searched MEDLINE/PubMed, EMBASE, and the Cochrane database and performed a manual search of selected papers. All papers and abstracts written in English that studied training and education of FAST were included. Papers were critically evaluated, looking into training methods and models of FAST, their advantages and disadvantages, number and type of training hours, practice exams in the course, and number of cases advised to achieve hospital credentialing. RESULTS A total of 52 studies were critically analyzed. The theoretical part of the courses lasted over a median (range) of 4 (1-16) h (n = 35 studies), while the practical part lasted over a median (range) of 4 (1-32) h (n = 34 studies). The participants performed a median (range) of 10 (3-20) FAST exams during the courses (n = 13 studies). The most commonly used model was the normal human model (65 %), followed by peritoneal dialysis patients (27 %). The least used models were animal (4 %) and cadaveric models (2 %). Each of these models had their advantages and disadvantages. The median number (range) of FAST exams needed for credentialing was 50 (10-200) (n = 19 studies). CONCLUSION Standardization of FAST training is important to improving the clinical impact of FAST. Different models used in FAST training are complementary; each has its own advantages and disadvantages. It is recommended that FAST courses be at least 2 days (16 h) long. The first day should include 4 h of theory and 4 h of training on normal human models. The second day should enforce learning using animal models, case scenarios including video clips, or simulators.
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Affiliation(s)
- Alshafi Mohammad
- Trauma Group, Department of Surgery, College of Medicine and Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates
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20
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Astolfi L, Spadaro S, Zani G, Gioia A, Ferraresi A, Colamussi MV, Ragazzi R, Volta CA. Evaluation of different teaching methods for FAST examination: high fidelity simulation versus traditional training. Crit Ultrasound J 2014. [PMCID: PMC4147842 DOI: 10.1186/2036-7902-6-s2-a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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21
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Duran-Gehring PE, Guirgis FW, McKee KC, Goggans S, Tran H, Kalynych CJ, Wears RL. The bubble study: ultrasound confirmation of central venous catheter placement. Am J Emerg Med 2014; 33:315-9. [PMID: 25550065 DOI: 10.1016/j.ajem.2014.10.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 10/03/2014] [Accepted: 10/03/2014] [Indexed: 11/26/2022] Open
Abstract
STUDY OBJECTIVE The objective was to determine if ultrasound (US) can more rapidly confirm central venous catheter (CVC) position in comparison to chest radiography (CXR) in the emergency department. METHODS The study included a convenience sample of emergency department patients with supradiaphragmatic CVCs and a CXR for confirmation. Ultrasound was used for CVC confirmation by visualizing microbubble artifact in the right atrium after injection of saline through the distal port. To evaluate for pneumothorax (PTX), "sliding sign" of the pleura was noted on US of the anterior chest. Blinded chart review was performed to assess CXR timing, catheter position and CVC complications. Student's t test was used to compare US time to CXR performance time and radiologist reading time. RESULTS Fifty patients were enrolled; 4 were excluded because of inadequate views. Forty-six patients were included in the final analysis. Mean total US time was 5.0 minutes (95% confidence interval [CI], 4.2-5.9) compared to 28.2 minutes (95% CI, 16.8-39.4) for CXR performance with a mean difference of 23.1 minutes (95% CI, -34.5 to -11.8; P < .0002). When comparing only US CVC confirmation time to CXR time, US was an average of 24.0 minutes (95% CI, -35.4 to -12.7; P < .0001) faster. Comparing total US time to radiologist CXR reading time, US was an average of 294 minutes faster (95% CI, -384.5 to -203.5; P < .0000). There were a total of 3 misplaced lines and 2 patients with PTX, all of which were identified correctly on US. CONCLUSION Ultrasound can confirm CVC placement and rule out PTX significantly faster than CXR, expediting the use of CVCs in the critically ill.
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Affiliation(s)
- Petra E Duran-Gehring
- University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL.
| | - Faheem W Guirgis
- University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL
| | - Kristin C McKee
- University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL
| | - Susan Goggans
- University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL
| | - Huynh Tran
- St. Mary Mercy Hospital, St. Joseph Mercy Health System, Department of Internal Medicine, Livonia, MI
| | - Colleen J Kalynych
- University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL
| | - Robert L Wears
- University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL
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22
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Horowitz R, Gossett JG, Bailitz J, Wax D, Pierce MC. The FLUSH Study—Flush the Line and Ultrasound the Heart: Ultrasonographic Confirmation of Central Femoral Venous Line Placement. Ann Emerg Med 2014; 63:678-83. [DOI: 10.1016/j.annemergmed.2013.12.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 12/07/2013] [Accepted: 12/17/2013] [Indexed: 12/20/2022]
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Lewiss RE, Hoffmann B, Beaulieu Y, Phelan MB. Point-of-care ultrasound education: the increasing role of simulation and multimedia resources. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:27-32. [PMID: 24371095 DOI: 10.7863/ultra.33.1.27] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This article reviews the current technology, literature, teaching models, and methods associated with simulation-based point-of-care ultrasound training. Patient simulation appears particularly well suited for learning point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. Work hour limitations have reduced the opportunities for clinical practice, and simulation enables practicing a skill multiple times before it may be used on patients. Ultrasound simulators can be categorized into 2 groups: low and high fidelity. Low-fidelity simulators are usually static simulators, meaning that they have nonchanging anatomic examples for sonographic practice. Advantages are that the model may be reused over time, and some simulators can be homemade. High-fidelity simulators are usually high-tech and frequently consist of many computer-generated cases of virtual sonographic anatomy that can be scanned with a mock probe. This type of equipment is produced commercially and is more expensive. High-fidelity simulators provide students with an active and safe learning environment and make a reproducible standardized assessment of many different ultrasound cases possible. The advantages and disadvantages of using low- versus high-fidelity simulators are reviewed. An additional concept used in simulation-based ultrasound training is blended learning. Blended learning may include face-to-face or online learning often in combination with a learning management system. Increasingly, with simulation and Web-based learning technologies, tools are now available to medical educators for the standardization of both ultrasound skills training and competency assessment.
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Affiliation(s)
- Resa E Lewiss
- Department of Emergency Medicine, St Luke's-Roosevelt Hospital Center, 1111 Amsterdam Ave, New York, NY 10025 USA
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24
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Abstract
OBJECTIVE Although there are training guidelines to credential emergency physicians in bedside ultrasound, many faculty groups have members who completed residency without a mandatory curriculum. These physicians are therefore required to learn bedside ultrasound while out in practice. The objective of this descriptive report is to illustrate a single academic facility's experience with acquiring credentials for emergency physicians in bedside ultrasound and the faculty's impressions on the motivators of and barriers to completion of the requirements. DESIGN Cross-sectional survey. SETTING Two urban teaching hospitals with a combined volume of 170 000 visits a year. PARTICIPANTS 41 emergency medicine attending physicians. INTERVENTION Emergency medicine attending physicians underwent training and credentialing in the applications of aorta and pelvic ultrasound over a 9-month period. OUTCOME MEASURE After the credentialing period, we conducted a survey to evaluate the physicians' perceptions of this process. RESULTS There were 41 faculty members during the credentialing survey period. 11 of the faculty members were exempt from ultrasound training. We asked attending physicians (N=41 exempt and non-exempt) to complete a web-based survey after the completion of the credentialing period. Questions about the potential barriers and incentives were listed and responders were asked to rank answers on a five-point Likert scale. Of the 31 respondents, 21 (67.7%) completed the credentialing requirements by the 9-month deadline. 19 of 26 emergency medicine residency trained physicians completed the requirements compared with 2/5 of those that were not emergency medicine residency trained. Our pilot study data suggest an association between fewer years in practice and completion of the requirements. CONCLUSIONS This is a report on a single academic institution's experience with a faculty credentialing programme in bedside ultrasound for physicians with a diversity of prior experience in bedside ultrasonography. We describe the success of the credentialing process and identify survey-based faculty characteristics associated with fulfilling the requirements.
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Affiliation(s)
- Resa E Lewiss
- Emergency Ultrasound Division, Department of Emergency Medicine, St Luke's-Roosevelt Hospital Center, New York, New York, USA
| | - Turandot Saul
- Emergency Ultrasound Division, Department of Emergency Medicine, St Luke's-Roosevelt Hospital Center, New York, New York, USA
| | - Marina Del Rios
- Department of Emergency Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
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25
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Lewiss RE, Pearl M, Nomura JT, Baty G, Bengiamin R, Duprey K, Stone M, Theodoro D, Akhtar S. CORD-AEUS: consensus document for the emergency ultrasound milestone project. Acad Emerg Med 2013; 20:740-5. [PMID: 23859589 DOI: 10.1111/acem.12164] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 03/23/2013] [Accepted: 03/24/2013] [Indexed: 01/01/2023]
Abstract
In 2012, the Accreditation Council for Graduate Medical Education (ACGME) designated ultrasound (US) as one of 23 milestone competencies for emergency medicine (EM) residency graduates. With increasing scrutiny of medical educational programs and their effect on patient safety and health care delivery, it is imperative to ensure that US training and competency assessment is standardized. In 2011, a multiorganizational committee composed of representatives from the Council of Emergency Medicine Residency Directors (CORD), the Academy of Emergency Ultrasound of the Society for Academic Emergency Medicine (SAEM), the Ultrasound Section of the American College of Emergency Physicians (ACEM), and the Emergency Medicine Residents' Association was formed to suggest standards for resident emergency ultrasound (EUS) competency assessment and to write a document that addresses the ACGME milestones. This article contains a historical perspective on resident training in EUS and a table of core skills deemed to be a minimum standard for the graduating EM resident. A survey summary of focused EUS education in EM residencies is described, as well as a suggestion for structuring education in residency. Finally, adjuncts to a quantitative measurement of resident competency for EUS are offered.
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Affiliation(s)
- Resa E. Lewiss
- Department of Emergency Medicine; St. Luke's Roosevelt Hospital Center; New York; NY
| | - Michelle Pearl
- Department of Emergency Medicine; Cedars-Sinai Medical Center; Los Angeles; CA
| | - Jason T. Nomura
- Department of Emergency Medicine; Christiana Care Health System; Newark; DE
| | - Gillian Baty
- Department of Emergency Medicine; University of New Mexico; Albuquerque; NM
| | - Rimon Bengiamin
- Department of Emergency Medicine; University of California San Francisco at Fresno; Fresno; CA
| | - Kael Duprey
- Long Island Jewish Medical Center; New Hyde Park; NY
| | - Michael Stone
- Department of Emergency Medicine; Brigham & Women's Hospital; Boston; MA
| | - Daniel Theodoro
- Department of Emergency Medicine; Washington University Hospital Center; St. Louis; MO
| | - Saadia Akhtar
- Department of Emergency Medicine; Beth Israel Hospital Center; New York; NY
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26
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He C, Wright LM, Saul T, Lewiss RE. An Inexpensive and Easy-to-Make Simulation Model of Biliary Ultrasound That Mimics Normal Anatomy and Abnormal Biliary Conditions. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2013. [DOI: 10.1177/8756479313477730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Simulation training in sonography has been shown be an effective method of teaching and assessing user competency in image acquisition/interpretation and performance of procedures. Gallbladder simulation models that are currently commercially available are entire torso section phantoms, are generally expensive to obtain, and require maintenance. We have developed a sonographic gallbladder simulation model constructed using readily available and inexpensive materials. Models were created of normal gallbladder anatomy as well as various gallbladder pathologies such as cholelithiasis, biliary sludge, and thickening of the gallbladder wall. This model can be used to train users both to obtain and interpret sonographic images of the gallbladder.
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Affiliation(s)
- Chen He
- St Luke’s/Roosevelt Hospital Center, Department of Emergency Medicine, New York, NY, USA
| | - Leigh M. Wright
- Alaska Native Medical Center, Department of Emergency Medicine, Anchorage, AK, USA
| | - Turandot Saul
- St Luke’s/Roosevelt Hospital Center, Department of Emergency Medicine, New York, NY, USA
| | - Resa E. Lewiss
- St Luke’s/Roosevelt Hospital Center, Department of Emergency Medicine, New York, NY, USA
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Berkenstadt H, Ben-Menachem E, Simon D, Ziv A. Training in trauma management: the role of simulation-based medical education. Anesthesiol Clin 2013; 31:167-177. [PMID: 23351542 DOI: 10.1016/j.anclin.2012.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Simulation-based medical education (SBME) offers a safe and "mistake-forgiving" environment to teach and train medical professionals. The diverse range of medical-simulation modalities enables trainees to acquire and practice an array of tasks and skills. SBME offers the field of trauma training multiple opportunities to enhance the effectiveness of the education provided in this challenging domain. Further research is needed to better learn the role of simulation-based learning in trauma management and education.
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Affiliation(s)
- Haim Berkenstadt
- The Israel Center for Medical Simulation (MSR), Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel.
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Fisher J, Lin M, Coates WC, Kuhn GJ, Farrell SE, Maggio LA, Shayne P. Critical appraisal of emergency medicine educational research: the best publications of 2011. Acad Emerg Med 2013; 20:200-8. [PMID: 23406080 DOI: 10.1111/acem.12070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 08/21/2012] [Accepted: 08/30/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight medical education research studies published in 2011 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). METHODS A search of the English language literature in 2011 querying PubMed, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified EM studies that used hypothesis-testing or observational investigations of educational interventions. Six reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This method was used previously to appraise medical education published in 2008, 2009, and 2010. RESULTS Forty-eight educational research papers were identified. Comparing the literature of 2011 to that of 2008 through 2010, the number of published educational research papers meeting the criteria increased over time from 30, to 36, to 41, and now to 48. Five medical education research studies met the a priori criteria for inclusion as exemplary and are reviewed and summarized in this article. The number of funded studies remained fairly stable over the past 3 years, at 13 (2008), 16 (2009), 9 (2010), and 13 (2011). As in past years, research involving the use of technology accounted for almost half (n = 22) of the publications. Observational study designs accounted for 28 of the papers, while nine studies featured an experimental design. CONCLUSIONS Forty-eight EM educational studies published in 2011 and meeting the criteria were identified. This critical appraisal reviews and highlights five studies that met a priori quality indicators. Current trends and common methodologic pitfalls in the 2011 papers are noted.
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Affiliation(s)
- Jonathan Fisher
- Department of Emergency Medicine; Beth Israel Deaconess Medical Center; Boston; MA
| | - Michelle Lin
- The Department of Emergency Medicine; University of California at San Francisco; San Francisco; CA
| | - Wendy C. Coates
- The Department of Emergency Medicine; Harbor-UCLA Medical Center; University of California, Los Angeles-David Geffen School of Medicine, and Los Angeles Biomedical Research Institute at Harbor-UCLA; Los Angeles; CA
| | - Gloria J. Kuhn
- The Department of Emergency Medicine; Wayne State University; Farming Hills; MI
| | - Susan E. Farrell
- The Office of Graduate Medical Education; Partners Healthcare System; Center for Teaching and Learning; Harvard Medical School; and Department of Emergency Medicine; Brigham and Women's Hospital; Boston; MA
| | - Lauren A. Maggio
- The Lane Medical Library; Stanford University School of Medicine; Stanford; CA
| | - Philip Shayne
- and The Department of Emergency Medicine; Emory University School of Medicine; Atlanta; GA
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29
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Jeppesen KM, Bahner DP. Teaching bedside sonography using peer mentoring: a prospective randomized trial. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:455-9. [PMID: 22368136 DOI: 10.7863/jum.2012.31.3.455] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVES Bedside sonography is a growing field of medicine, but there is little evidence about how to teach it to medical students. A peer-mentoring system may help preclinical medical students learn bedside sonography. METHODS In 2008 and 2009, participating first-year medical students completed an image recognition test at 0, 2, and 4 months and were randomized to an early or a late intervention group. In hands-on sessions, senior medical students taught the early intervention group how to perform a Trinity hypotensive ultrasound protocol between months 0 and 2 and then taught the late intervention group the Trinity protocol between months 2 and 4. Participants completed a practical examination at month 4. We measured the improvement in knowledge after the intervention and retention of knowledge and skills in the early intervention group at month 4. First-year medical students completed precourse and postcourse surveys about comfort and skills with sonography. RESULTS Eighty-six first-year medical students enrolled; 79 completed the precourse survey; 54 completed all knowledge tests; 52 completed the practical examination; and 49 completed the postcourse survey. Of the 125 nonparticipants, 109 completed the precourse survey, and 25 completed the postcourse survey. Participants' knowledge scores increased by 30% after the intervention. The early intervention group retained 92% of the knowledge gained. Thirty-six percent of participants were able to complete the Trinity protocol in 15 minutes during the practical examination, with no significant difference between the early and late intervention groups. Participants responded positively about the experience and indicated that hands-on sessions were helpful. CONCLUSIONS Peer mentoring is a useful method for teaching sonography to preclinical medical students.
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Affiliation(s)
- Kelly M Jeppesen
- Department of Family Medicine, McKay-Dee Hospital Center, 1074 E 4050 S, Ogden, UT 84403, USA.
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