The Effects of Content Delivery Methods on Ultrasound Knobology and Image Quality Recognition Training in First-Year Veterinary Students

A survey of the use of ultrasound by small animal veterinary clinicians

This study aimed to determine the current use of ultrasound amongst small animal veterinarians. A total of 1216 small animal veterinary practitioners responded to an electronic survey that was administered through the Veterinary Information Network to all its members. Descriptive statistics were generated; limited inferential statistics were performed to examine specific relationships. Eighty-four percent of respondents had access to an ultrasound unit, and 86% of respondents reported using their unit multiple times per week. The most common uses were assistance with cystocentesis (93%) and abdominocentesis (71%), pregnancy diagnosis (69%), limited abdominal evaluation (63%), to aid in thoracocentesis (59%), and limited thoracic evaluation (52%). Eighty-nine percent of respondents received some formal training in ultrasound, most commonly from continuing education courses. Most respondents (52%) reported receiving ≤25 h of training. Additionally, 88% of respondents believed it was either extremely or very important for there to be ultrasound training for veterinary students prior to graduation. Based on this survey, most small animal practitioners commonly use ultrasound for limited examinations, being most confident in the sonographic evaluation and centesis of the bladder and for the detection and centesis of effusion in a body cavity. With most respondents having ≤25 h of training in ultrasound, typically obtained in postgraduate courses, an expansion in standardized basic ultrasound training within the veterinary curriculum may be warranted.

The development of a systematic ultrasound protocol facilitates the visualization of foreign bodies within the canine distal limb

Ultrasonography is an excellent investigative tool that can assist with the diagnosis of soft tissue conditions. In human medicine, ultrasonography is a fundamental diagnostic tool for the investigation of suspected vegetal foreign bodies (VFB), with protocol-based ultrasonography providing increased accuracy compared to lesion-focused examinations. Protocol-based ultrasonography is an emerging tool within the veterinary field, however, compared to human medicine is not routinely employed. The objective of this study was to develop a systematic ultrasound protocol to examine the distal limb for the visualization of vegetal foreign bodies (SUEDVEG). A 12 MHz linear and an 18 MHz high-frequency small-footprint linear array transducer was used on cadaver forelimbs (n = 6) and hindlimbs (n = 6) with images obtained from three common foreign body locations within the distal limb; 1; the interdigital webbing, 2; the palmar/plantar aspect of the phalanges and metacarpus and 3; the dorsal region of the phalanges and metacarpus. From these images, a 13-step systematic musculoskeletal protocol was developed and utilized on eight clinical cases or 10 limbs that had signs typical of distal limb VFB to preliminarily validate the proposed method. Vegetal foreign bodies were successfully identified and retrieved in seven (n = 8) clinical cases with method steps 9 and 11 (orthogonal views) identifying the majority of VFBs. The described ultrasound method appears highly useful for visualizing soft tissue locations of the canine distal limb known for tracking foreign bodies. Further studies are required to validate the described systematic examination method as the preferred clinical protocol over currently used lesion-focused exploration techniques.

Natural ballistic gelatine ultrasound phantoms are suitable to be used for student education and can be produced cheaply and effectively

Practical experience in ultrasonography at medical and veterinary schools is difficult to achieve using live models due to ethical considerations. A solution to this problem has been the creation of synthetic ultrasound phantoms that allow simulation of both ultrasound scans and ultrasound-guided procedures. Whilst commercially available phantoms are expensive in a resource-limited environment, it would be desirable to create affordable, reusable, homemade phantoms which could be used to aid student learning. Recent studies have indicated that ballistic gelatine is an excellent material for this. A prospective, experimental study was performed with three ultrasound phantoms for student use. Vascular, bladder, and liver parenchymal models were produced with a natural ballistic gel, along with instructions for their construction and maintenance. Model efficacy was evaluated by assessing students' performance in completing a set of tasks when performing ultrasound on a dog. Group one received training with the models, group two received prior training without the models and the group three received no training. Entry and exit questionnaires assessed students' confidence in ultrasound scanning having used the models. Student questionnaires showed that students enjoyed using the models and found them more useful than existing teaching aids. It was also found that the models produced better practical skills in students that trained with them, in comparison to existing teaching. The models were easy to make, produced good images, and are reusable.

Exploring the use of knobology for image optimisation in final year sonography students

Introduction

Image optimisation is essential for acquisition of quality images in ultrasound and critical to the diagnostic ability of the examination. These skills are taught to sonography students early in their education, but research has found that retention of non-rehearsed knowledge decreases significantly after a year. The aim of this study was to determine which optimisation tools (knobology) final year sonography students use, how often and why they chose to adjust parameters and assess barriers to optimisation of knobology tools.

Methods

A prospective study using data from an anonymous online survey of 34 final year sonography students.

Results

Survey results showed that 19/34 (55%) of students "frequently" optimise all Doppler settings and 23/34 (67%) of students "frequently" optimise basic parameter settings (depth, focus, time gain compensation). Time constraints (24/34 (70%)) and loss of gained knowledge of sonography principles and instrumentation (17/34 (50%)) were the major barriers to the use of knobology. The majority 28/34 (82%) believed they would benefit from further training.

Conclusion

This study demonstrates that although most students are optimising settings to improve image quality, sonography principles and instrumentation knowledge loss and time constraints prevent students from maximising machine capabilities. This study supports the need for further training prior to final year clinical placement.

Case-based intensive veterinary radiology clerkship improves students' radiographic interpretation skills and overall course satisfaction scores

The variability in diagnostic imaging caseload, increasing class sizes, high hospital workloads, and the progressive departure of veterinary radiologists from academia can lead to inconsistent and reduced teaching opportunities. This one group pretest, posttest study aimed to compare the learning outcomes of students enrolled in two veterinary radiology clerkship models. Our hypothesis was that the learning and satisfaction scores of students in a case-based veterinary radiology clerkship would be higher than those in a clinical veterinary radiology clerkship. During the spring and summer semesters of 2019, students were assigned to a clinical (CRC) or case-based (CBRC) radiology clerkship model, respectively. Prior to starting the clerkship and at the conclusion thereof, all students took identical radiographic interpretation quizzes. Four major areas of learning were assessed: knowledge base (KB), diagnostic test interpretation (DTI), problem prioritization and differential diagnosis (PPDDX), and critical thinking (CrT). A total of 41 of 48 (CRC) and 130 of 151 (CBRC) students enrolled in this study; 15 and 34, respectively, were off-shore students, while the remainder were in-house students. In-house students improved their scores with CRC and CBRC, but achieved better scores in the four areas with CBRC. Off-shore students only improved their scores with CBRC. In both groups, there was a negative effect of CRC on DTI. Course satisfaction score was 3.21 on CRC and 4.38 on CBRC (range 1-5). An intensive, case-based, discussion-focused veterinary radiology clerkship can improve students' radiographic interpretation skills and overall course satisfaction scores.