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Gschmack AM, Karlas T, Lucius C, Barth G, Blaivas M, Daum N, Dong Y, Goudie A, Hoffmann B, Jenssen C, Kallenbach M, Keil M, Möller K, Neubauer R, Nourkami-Tutdibi N, Recker F, Ruppert JP, Sirli R, Weimer J, Westerway SC, Zervides C, Dietrich CF. Measurement and Normal Values, Pathologies, Interpretation of findings, and Interventional Ultrasound as part of student ultrasound education. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2025; 63:513-520. [PMID: 40360143 DOI: 10.1055/a-2550-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2025]
Abstract
Ultrasound diagnostics is a widely used, radiation-free, cost-effective, and bedside-applicable imaging technique. Given its numerous advantages and broad application, it appears reasonable to integrate practical use and theory into medical education at an early stage. Since the content of student ultrasound courses varies significantly on an international scale, the aim of this paper is to establish foundations for a more standardized approach to student's ultrasound education (SUSE) especially with focus on abdominal ultrasound. This review examines to what extent measurements can be effectively incorporated into student ultrasound training and under which conditions the teaching of pathologies should be included in these courses. Additionally, the handling of false-positive and false-negative findings in student training is discussed. Considering the growing relevance of interventional ultrasound (INVUS), the paper further explores the extent to which interventional procedures should already be taught during SUSE.
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Affiliation(s)
| | - Thomas Karlas
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Claudia Lucius
- Outpatient Department of Gastroenterology, IBD Centre Helios Hospital Berlin Buch, Berlin, Germany
| | - Gregor Barth
- Department of Hematology, Oncology and Palliative Care, Brandenburg an der Havel University Hospital, Brandenburg an der Havel, Germany
| | - Michael Blaivas
- Department of Medicine, University of South Carolina School of Medicine, Columbia, United States
| | - Nils Daum
- Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt Universität zu Berlin, Berlin, Germany
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Adrian Goudie
- Emergency Physician, Fiona Stanley Hospital, Perth, Australia
| | - Beatrice Hoffmann
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, United States
| | - Christian Jenssen
- Departement for Internal Medicine, Krankenhaus Märkisch Oderland GmbH, Strausberg, Germany
- Brandenburg Institute for Clinical Ultrasound, Brandenburg Medical University, Neuruppin, Germany
| | - Michael Kallenbach
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Michael Keil
- Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, 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
| | | | - Roxana Sirli
- Gastroenterology and Hepatology, University of Medicine and Pharmacy, Timisoara, Romania
| | - Johannes Weimer
- Rudolf Frey Teaching Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | - Christoph F Dietrich
- Department of General Internal Medicine (DAIM), Clinics Beau Site, Salem and Permanence, Hirslanden, Bern, Switzerland
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Weimer J, Yilmaz D, Ille C, Weinmann-Menke J, Müller L, Büchner H, Buggenhagen H, Stäuber M, Neubauer R, Winter L, Weimer A, Dirks K, Künzel J, Rink M, Dionysopoulou A, Lorenz L, Kloeckner R, Recker F, Schiestl L. Quality assessment of a training program for undergraduate sonography peer tutors: paving the future way for peer-assisted learning in medical ultrasound education. Front Med (Lausanne) 2025; 12:1492596. [PMID: 40098924 PMCID: PMC11911324 DOI: 10.3389/fmed.2025.1492596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Accepted: 02/14/2025] [Indexed: 03/19/2025] Open
Abstract
Introduction Peer tutoring has been increasingly used to support university sonography teaching, necessitating well-qualified tutors. This study aims to evaluate the quality of a training program for sonography peer tutors developed and implemented at a university hospital. Materials and methods A training program consisting of 11 modules was developed and subsequently evaluated for success with two subjective and two objective assessments of peer-tutoring quality. The two subjective assessments measured subjective scores of the peer tutors' specialist and didactic skills using a Likert scale (1 = very low; 7 = very high) from the perspective of the individuals the peer tutor taught (assessment 1) and from the peer tutors themselves (assessment 2). The peer tutors also rated the training concept itself. The objective assessments evaluated the peer tutors' specialist skills with a theoretical test (assessment 3) and a practical examination (assessment 4). Data collection for assessment 1 began in 2017, while data for assessments 2 to 4 were collected from 2021 to 2024. Results A total of 2,980 data sets for assessment 1, 92 data sets for 2, 44 data sets for assessment 3, and 147 data sets for assessment 4 were included in the analysis. Peer tutors scored highly positively on assessments 1 [6.6 ± 0.63 scale points (SP)] and 2 (5.53 ± 0.63 SP), and these results remained consistently high throughout the semesters. Assessments 3 (74.7 ± 7.9%) and 4 (85.6 ± 10.5%) also showed strongly positive values that remained constant over time. Assessment 1 results were significantly higher than the others (p < 0.01.), while no significant differences were found between assessments 2, 3, and 4. Conclusion The data indicate that the training concept developed established and maintained high-quality peer-tutor training throughout the reviewed semesters. Future efforts should promote the development of national and international standards for peer-tutor training and provide certification opportunities for peer tutors.
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Affiliation(s)
- Johannes Weimer
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Didem Yilmaz
- Rudolf Frey Learning Clinic, 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
| | - Julia Weinmann-Menke
- I. Department of Medicine, 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
| | - Hans Büchner
- 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
| | - Marie Stäuber
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ricarda Neubauer
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Lone Winter
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Andreas Weimer
- Center of Orthopedics, Trauma Surgery, and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, Heidelberg, Germany
| | - Klaus Dirks
- Medical Clinic II, University Hospital Würzburg, Würzburg, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Maximilian Rink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Anna Dionysopoulou
- Department of Gynecology and Obstetrics, 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
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein - Campus Lübeck, Lübeck, Germany
| | - Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Lina Schiestl
- Department of Gynecology and Obstetrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Meyer HL, Einloft J, Bedenbender S, Russ P, Schlicker N, Ganser A, Hirsch MC, Görg C, Grgic I. Impact and reception of point-of-care ultrasound training across medical education levels. BMC MEDICAL EDUCATION 2025; 25:255. [PMID: 39962506 PMCID: PMC11834199 DOI: 10.1186/s12909-025-06825-4] [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: 12/05/2024] [Accepted: 02/05/2025] [Indexed: 02/20/2025]
Abstract
BACKGROUND Point-of-care ultrasound (POCUS) is a versatile and cost-effective technology that can significantly enhance medical education and clinical practice. This study examines the acceptance of POCUS among medical students and explores strategies to optimize its integration into their training. MATERIALS AND METHODS A total of 318 medical students, spanning both preclinical and clinical semesters, participated in seminars that included POCUS demonstrations and hands-on practice. Their perceptions were assessed through a voluntary questionnaire based on the Technology Acceptance Model (TAM), which furthermore explored the ideal timing and potentially suitable subjects for integrating POCUS into the curriculum, with an emphasis on its role in developing clinical skills and supporting decision-making. RESULTS Among preclinical students, 60.7% had no prior ultrasound exposure, while 97% of clinical students reported some experience, albeit often limited. Despite the majority of senior students having some ultrasound experience, many lacked confidence in its use. Confidence in sonography skills was generally low across both groups, with 95.9% of preclinical and 79.4% of clinical students expressing a lack of confidence. Importantly, both preclinical and clinical students recognized the high usefulness of POCUS skills and rated the technology as user-friendly, with clinical students perceiving it as slightly easier to use. When asked to identify the most suitable subjects for POCUS training, students most frequently cited anatomy (35.2%) and internal medicine (16.7%). Additionally, a majority of students (57.7%) advocated for POCUS education to begin as early as the first semester. CONCLUSION This study highlights a significant gap in ultrasound training among medical students, while also underscoring their strong motivation to learn and their positive perception of POCUS as a valuable tool for enhancing clinical skills and decision-making. The findings emphasize that early integration of sonography into the medical curriculum is both highly desired by students and essential for advancing medical education. This is particularly timely and important given the growing role of artificial intelligence in ultrasound technology and the opportunities expected to emerge from this integration.
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Affiliation(s)
- Hendrik Leif Meyer
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Jonas Einloft
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Simon Bedenbender
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Philipp Russ
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Nadine Schlicker
- Institute for Artificial Intelligence in Medicine, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Andre Ganser
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Martin Christian Hirsch
- Institute for Artificial Intelligence in Medicine, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Christian Görg
- Interdisciplinary Center of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Ivica Grgic
- Department of Internal Medicine and Nephrology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany.
- Institute for Artificial Intelligence in Medicine, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany.
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Khoo C, Sharma S, Jefree RA, Chee D, Koh ZN, Lee EXY, Loh NHW, Ashokka B, Paranjothy S. Self-Directed Virtual Reality-Based Training versus Traditional Physician-Led Teaching for Point-of-Care Cardiac Ultrasound: A Randomized Controlled Study. J Cardiothorac Vasc Anesth 2025; 39:95-103. [PMID: 39578116 DOI: 10.1053/j.jvca.2024.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 10/09/2024] [Accepted: 10/25/2024] [Indexed: 11/24/2024]
Abstract
OBJECTIVE To assess the learning efficacy of self-directed virtual reality ultrasound simulators as an alternative to traditional physician-led teaching for cardiac point-of-care ultrasound (POCUS) training. DESIGN Single blinded (observer), noninferiority, parallel group, randomized controlled study. SETTING Tertiary university hospital in Singapore. PARTICIPANTS Forty-three medical students with no prior formal ultrasound training. INTERVENTIONS Participants first completed an e-learning module on basic ultrasonography. Participants' baseline knowledge was subsequently assessed using a multiple-choice question (MCQ) test. Participants were then randomized to either physician-led (PL) teaching or independent learning with a virtual-reality (VR) simulator to learn the 4 cardiac POCUS views. A post-training MCQ test and a practical skills test scored by 2 blinded assessors were conducted. Students repeated the MCQ test and skills test 1 month later. MEASUREMENTS AND MAIN RESULTS The VR group had higher baseline MCQ scores compared to the PL group (mean, 13.4 v 10.7). Immediately post-training, the PL group had a greater improvement in mean MCQ scores (from baseline) and higher total practical scores compared to the VR group (p = 0.03 and p < 0.01, respectively). At 1 month post-training, the PL group similarly had a greater mean change from baseline MCQ scores, but this difference was not statistically significant (p = 0.12). For practical scores, the VR group scored higher than the PL group, although this difference was not statistically significant (p = 0.06). CONCLUSIONS Our study demonstrates that at 1 month post-training, self-directed VR training was noninferior to PL training. Although differences observed were not significant, there were trends to suggest enhanced retention of knowledge and skills with VR learning.
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Affiliation(s)
- Charlene Khoo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sagar Sharma
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ryan Ashraf Jefree
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Davidson Chee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Zheng Ning Koh
- Department of Anaesthesia, National University Hospital, Singapore
| | | | - Ne-Hooi Will Loh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Anaesthesia, National University Hospital, Singapore
| | - Balakrishnan Ashokka
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Anaesthesia, National University Hospital, Singapore
| | - Suresh Paranjothy
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Anaesthesia, National University Hospital, Singapore.
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Rajendram R, Alrasheed AO, Boqaeid AA, Alkharashi FK, Qasim SS, Hussain A. Investigating medical students' perceptions of point-of-care ultrasound integration into preclinical education. BMC MEDICAL EDUCATION 2024; 24:1513. [PMID: 39709464 DOI: 10.1186/s12909-024-06501-z] [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: 05/06/2024] [Accepted: 12/10/2024] [Indexed: 12/23/2024]
Abstract
INTRODUCTION Recent international consensus statements advocate for the integration of Point-of-Care Ultrasound (PoCUS) into the global undergraduate medical curriculum. Some medical schools outside Saudi Arabia have already incorporated PoCUS into their undergraduate curricula to enhance anatomy, physiology and pathology instruction. However, there are no data on the potential role of PoCUS in the preclinical training of medical students in Saudi Arabia. Given constraints on resources for medical education, a formal needs assessment was conducted to evaluate the potential utility of PoCUS within the basic science curriculum at our institution. METHODS All final year medical students at our institution were invited to complete a validated online survey. The questionnaire utilized a 5-point Likert scale to assess student perceptions of the potential for PoCUS to improve their understanding of basic sciences and their desire for its incorporation into the preclinical curriculum. RESULTS A total of 229 students participated (response rate 76%; male 134/200; female 95/100). Our survey demonstrated good internal consistency (Cronbach's alpha: learning basic sciences 0.81, need for curriculum integration 0.83). The vast agreed that learning PoCUS would enhance their understanding of anatomy (95%) and pathology (75%). While only 52% agreed that learning PoCUS would improve their understanding of physiology, a substantial majority (80%) agreed that all medical schools should incorporate PoCUS into their undergraduate curricula. Furthermore, 62% agreed that offering PoCUS training would make the medical school more attractive to prospective applicants. No significant differences were observed between the responses of male and female students. The results of a confirmatory factor analysis provide strong support for the hypothesized three-factor model. All factor loadings are significant (P < 0.001), CONCLUSIONS: Medical students in Saudi Arabia perceive that PoCUS would be a valuable tool to learn anatomy and pathology, aligning with the recommendations of the consensus conference on PoCUS integration in undergraduate medical education organized by the World Interactive Network Focused on Critical Ultrasound (WINFOCUS) and the Society of Ultrasound in Medical Education (SUSME). Introducing PoCUS training into preclinical medical curricula may also enhance the attractiveness of medical schools to potential applicants.
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Affiliation(s)
- Rajkumar Rajendram
- Medical Protocol Department, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.
- The Research Unit, Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
| | - Abdullah Olayan Alrasheed
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Anatomical Pathology, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Abdulaziz Ahmed Boqaeid
- Neuroscience Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | - Salman Sufian Qasim
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Division of Plastic Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Arif Hussain
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Cardiac Sciences, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
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Gram P, Purup T, Eriksen EM, Søbye S, Wielandt SK, Astorp K, Jensen MB, Andersen CA. Ultrasound education, competencies and expected future use among medical interns in Denmark: a national cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:1489. [PMID: 39695627 DOI: 10.1186/s12909-024-06510-y] [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: 09/11/2024] [Accepted: 12/10/2024] [Indexed: 12/20/2024]
Abstract
BACKGROUND Point-of-care ultrasound is increasingly used across medical specialties, calling for timely and relevant ultrasound education in specialty training. To enable customizing such education, we aimed to explore medical interns' received ultrasound education during medical school and internship, perceived scanning competencies, evaluation of received education, future expectations for using ultrasound, and tendencies for perceiving ultrasound competence. METHODS This was a national cross-sectional study. We developed a questionnaire based on a theoretical conceptual model, individual interviews with medical interns and focus groups with medical students, followed by pilot testing. The questionnaire was distributed to all medical interns in Denmark (N = 1231). Data were summarized with descriptive statistics. Differences between universities and tendencies for perceiving ultrasound competence were analyzed with Fisher's exact tests and modified Poisson regression, respectively. RESULTS Responses from 420 (34.1%) interns were included. Although varying across medical schools, 95.7% received formal ultrasound training and 86.0% encountered ultrasound examinations through clinical rotation. During internship, 44.2% received formal training, while 68.5% had to pursue it independently. Ultrasound examinations during clinical work were observed by 73.2% and performed by 47.6%. Common ultrasound usage barriers were insufficient scanning routine, supervision, knowledge, confidence and mental surplus. Ultrasound competence gain from medical school and internship was reported by 75.2% and 55.3%, respectively, but mainly to lesser/some extent. Most desired more training, expected to use ultrasound in the future (71.0%) and considered it a core competence (73.0%). Perceived ultrasound competence was significantly associated with receiving practical (RR: 4.08) or both practical and theoretical education (RR: 4.34) in medical school, and practical training on patients (RR: 1.09), required number of performed scans (RR: 1.06), competence test(s) (RR: 1.07), and/or consulting books/encyclopedia (RR:1.07) during internship. CONCLUSIONS Ultrasound training is part of medical school curricula but varies in type and extent. While most encounter and many use ultrasound during internships, formal training is less integrated. Most desire more training and attitudes towards future ultrasound usage are positive. Filled curricula pose dilemmas for prioritization and several barriers prevail for using ultrasound, representing missed opportunities for competence development and maintenance. Training governance and scaffolding continuous learning may be needed. TRIAL REGISTRATION None.
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Affiliation(s)
- Pernille Gram
- Center for General Practice, Aalborg University, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark.
| | - Thomas Purup
- Center for General Practice, Aalborg University, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
| | - Emilie Marie Eriksen
- Center for General Practice, Aalborg University, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
- Institute for Clinical Medicine, Aalborg University Hospital, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
| | - Stina Søbye
- Institute for Clinical Medicine, Aalborg University Hospital, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
| | - Simone Kjaergaard Wielandt
- Institute for Clinical Medicine, Aalborg University Hospital, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
| | - Kasper Astorp
- Institute for Clinical Medicine, Aalborg University Hospital, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
| | - Martin Bach Jensen
- Center for General Practice, Aalborg University, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
- Institute for Clinical Medicine, Aalborg University Hospital, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
| | - Camilla Aakjaer Andersen
- Center for General Practice, Aalborg University, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
- Institute for Clinical Medicine, Aalborg University Hospital, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
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Boccatonda A, Ursitti A, Frisone A, D'Alessandro P, Guagnano MT, Iannetti G, Schiavone C. Training and learning ultrasound: survey on a sample of Italian students, impact and role inside the core curriculum of degree courses in medicine and surgery. J Ultrasound 2024; 27:863-871. [PMID: 37798426 PMCID: PMC11496470 DOI: 10.1007/s40477-023-00830-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/31/2023] [Indexed: 10/07/2023] Open
Abstract
PURPOSE Ultrasound is essential in the clinical practice of many medical specialties due to non-invasiveness, rapidity of examination, low costs and simplicity. Many specialized companies and universities pointed out its potential as a teaching tool for medical students. The aim of our study is to evaluate the impact of an ultrasound course on a sample of students attending the fourth, fifth and sixth year of the degree course in Medicine, highlighting changing in satisfaction and preparation. Another target is to verify the capability of a course on ultrasound to positively impact on participants knowledge and competences. METHODS Students attending 6 training courses of Medicine held between 2017 and 2019 were recruited. Five trainings held during an Italian society of ultrasound in medicine and biology (SIUMB) congress, in a session dedicated to students, and one during an elective didactic activity (ADE) held in Chieti University. A questionnaire was given to the students before and after the course, in order to assess the impact of the course on the motivation and knowledge. Moreover, a test was also administered at the end of the theoretical part, with questions relating to the notions learned. RESULTS There was an 81% of correct response to the learning questionnaire by calculating the mean of 5 SIUMB courses performed. The students are strongly motivated to continue learning ultrasound already from the beginning of the course, and this result remains unchanged in the questionnaire administered at the end. The interest of students towards this method is high, and they would ultrasound courses within the Medicine degree, even before participating in the training. It was evident how students positively assessed the course in relation to the acquisition of skills and knowledge, albeit with a tendency to acquire more knowledge rather than skills. CONCLUSIONS Our data support the usefulness of including ultrasound into the curriculum of medical students and on its use as a teaching tool. Students are highly motivated and perceive a significant improvement in both skills and knowledge following the proposed courses. Hands-on part is necessary in the training course on ultrasonography.
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Affiliation(s)
- Andrea Boccatonda
- Internal Medicine, Bentivoglio Hospital, AUSL Bologna, 40010, Bentivoglio, Italy.
| | - Antonio Ursitti
- Internistic Ultrasound Unit, SS Annunziata Hospital, "G. D'Annunzio" University, 66100, Chieti, Italy
| | - Alessio Frisone
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
| | - Patrizio D'Alessandro
- Internistic Ultrasound Unit, SS Annunziata Hospital, "G. D'Annunzio" University, 66100, Chieti, Italy
| | - Maria Teresa Guagnano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
- Department of Medicine and Aging Science, "Clinica Medica" Institute, 'SS Annunziata' Hospital, "G. D'Annunzio" University, 66100, Chieti, Italy
| | - Giovanni Iannetti
- Ospedale S. Spirito, Università Degli Studi Chieti-Pescara, Chieti, Italy
| | - Cosima Schiavone
- Internistic Ultrasound Unit, SS Annunziata Hospital, "G. D'Annunzio" University, 66100, Chieti, Italy
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Winter L, Neubauer R, Weimer J, Dietrich CF, Wittek A, Schiestl L, Marinova M, Schäfer VS, Strizek B, Recker F. Peer teachers as ultrasound instructors? - a systematic literature review of peer teaching concepts in undergraduate ultrasound education. BMC MEDICAL EDUCATION 2024; 24:1369. [PMID: 39593017 PMCID: PMC11590509 DOI: 10.1186/s12909-024-06345-7] [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: 02/17/2024] [Accepted: 11/13/2024] [Indexed: 11/28/2024]
Abstract
BACKGROUND As ultrasound is one of the most utilized imaging procedures in clinical practice in Germany, its integration into undergraduate medical education is imperative. Thereby, the limited availability of qualified instructors is a major challenge. Peer tutors, who are trained to instruct their peers collaboratively, could resolve staff constraints. This systematic review explores the literature on peer teaching in undergraduate ultrasound education, aiming to provide an overview of methodologies, outcomes, and peer teacher training concepts. METHODS Following the PRISMA guidelines, a systematic literature review was conducted on the subject of peer teaching in undergraduate ultrasound education. Using PubMed and Google Scholar as databases, studies in English or German involving training concepts for peer teachers in undergraduate ultrasound education, published up to November 21, 2023, were included. Data extraction of original studies followed the PICOS schema with special respect to didactic concepts of peer tutor training programs and the effectiveness of peer teachers compared to faculty instructors. A modified version of the Newcastle-Ottawa Scale (NOS) was used to assess the quality of included studies. RESULTS Finally, the search resulted in 20 relevant original studies, including 16 studies exploring peer teacher training concepts. Predominantly, peer teachers studied in their 4th year of medical school and on average one year further compared to their students. Peer teacher training was integrated into curricula by course-based concepts (93.8%) and internships (50.0%). Didactic modalities varied, encompassing laboratory rotations including the scanning of patients, the scanning of fellow students, lectures, and didactic training. The median training duration was about ten days. Of six comparative studies, five found peer-assisted learning to be comparably effective and one even better than faculty-led courses. CONCLUSION Despite the growing amount of literature underlining the effectiveness and wide application of peer teaching in ultrasound education, training concepts stay heterogenous without a standardized system for training and qualifying peer teachers. Developing comprehensive guidelines for peer tutor education could increase acceptance and recognition of peer-assisted learning and ensure minimum training standards.
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Affiliation(s)
- Lone Winter
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany
| | - Ricarda Neubauer
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany
| | - Johannes Weimer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Christoph F Dietrich
- Department General Internal Medicine (DAIM), Hospitals Hirslanden Bern Beau Site, Salem and Permanence, Bern, Switzerland
| | - Agnes Wittek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany
| | - Lina Schiestl
- Department of Gynecology and Obstetrics, University Hospital, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Milka Marinova
- Department of Nuclear Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany
| | - Valentin Sebastian Schäfer
- Department of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital Bonn, Bonn, Germany
| | - Brigitte Strizek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany
| | - Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany.
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9
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Recker F, Neubauer R, Dong Y, Gschmack AM, Jenssen C, Möller K, Blaivas M, Ignacio PM, Lucius C, Ruppert J, Sänger SL, Sirli R, Weimer J, Westerway SC, Zervides C, Dietrich CF. Exploring the dynamics of ultrasound training in medical education: current trends, debates, and approaches to didactics and hands-on learning. BMC MEDICAL EDUCATION 2024; 24:1311. [PMID: 39543551 PMCID: PMC11566056 DOI: 10.1186/s12909-024-06092-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 09/26/2024] [Indexed: 11/17/2024]
Abstract
INTRODUCTION Medical education, especially in ultrasound training, is undergoing significant changes. This study examines practical issues in ultrasound medical education, emphasizing state-of-the-art teaching methods, their effectiveness, and implementation challenges. METHODS The study analyzed advancements in ultrasound education, including randomized controlled trials comparing peer-to-peer teaching with traditional faculty-led instruction. It evaluated the effectiveness of collaborative small-group training and group size impact in simulation-based training. The study also assessed practical training components outlined in the WFUMB Position Paper Part II. RESULTS Findings indicate that peer-to-peer and collaborative small-group training are effective and cost-efficient. Group size did not significantly affect training outcomes. Key practical training elements, including early hands-on sessions and exposure to various equipment, substantially improved learning outcomes. Simulation tools like virtual reality (VR), augmented reality (AR), and phantoms were crucial for teaching standardized procedures and rare pathologies. Challenges identified include developing robust image acquisition skills, scarcity of qualified student tutors, and the need for reliable ultrasound skill assessment methods. CONCLUSION Integrating peer-to-peer teaching and advanced simulation technologies significantly advances ultrasound medical education. These methods enhance cognitive and psychomotor skills but also present challenges such as ensuring quality education and developing effective assessment methods. Future research should compare different simulation tools and establish objective ultrasound proficiency assessment criteria. Continual method evaluation and improvement are essential for effective and standardized ultrasound training, ultimately enhancing patient care and clinical outcomes.
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Affiliation(s)
- Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | | | - Yi Dong
- Department of Ultrasound, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Christian Jenssen
- Department for Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg, Germany
- Brandenburg Institute for Clinical Ultrasound (BICUS) at Brandenburg Medical University, Neuruppin, Germany
| | - Kathleen Möller
- Medical Department I/Gastroenterology, SANA Hospital Lichtenberg, Berlin, Germany
| | - Michael Blaivas
- University of South Carolina School of Medicine, Department of Medicine, Columbia, SC, USA
| | - Prats Michael Ignacio
- The Ohio State University Wexner Medical Center, Department of Emergency Medicine, Columbus, OH, USA
| | - Claudia Lucius
- Outpatient Department of Gastroenterology, IBD Centre Helios Hospital Berlin Buch, 13125, Berlin, Germany
| | - Johannes Ruppert
- Department of Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Sophie-Luise Sänger
- Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Roxana Sirli
- Center for Advanced Research in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Johannes Weimer
- Rudolf Frey Learning Clinic, University Medical Center, Johannes Gutenberg University Mainz, 55131, Mainz, Germany
| | | | | | - Christoph Frank Dietrich
- University Hospital Frankfurt Johann-Wolfgang-Geothe University Frankfurt on the Main Theodor-Stern-Kai, 760596 , Frankfurt am Main, Germany.
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10
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Weimer A, Recker F, Vieth T, Buggenhagen H, Schamberger C, Berthold R, Berthold S, Stein S, Schmidmaier G, Kloeckner R, Neubauer R, Müller L, Weinmann-Menke J, Weimer J. Undergraduate musculoskeletal ultrasound training based on current national guidelines-a prospective controlled study on transferability. BMC MEDICAL EDUCATION 2024; 24:1193. [PMID: 39443912 PMCID: PMC11515732 DOI: 10.1186/s12909-024-06203-6] [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: 08/26/2024] [Accepted: 10/16/2024] [Indexed: 10/25/2024]
Abstract
INTRODUCTION Musculoskeletal ultrasound (MSUS) is integral to routine clinical diagnostics for musculoskeletal and joint disorders. This study aims to establish and validate a sonography course tailored to undergraduate medical students acquiring MSUS-specific skills at a German university. METHODS A blended learning training concept, comprising 24 instruction sessions of 45 min each, was designed based on the current national guidelines of the German Society for Ultrasound in Medicine (DEGUM). This program was integrated into the clinical phase of the undergraduate students' medical education. The self-perceived improvement in competency and the effectiveness of the course design were evaluated using a a 7-point Likert scale questionnaire. Objective learning success was evaluated via a written test and a "Direct Observation of Practical Skills" practical exam. Control groups included medical students without MSUS training (control group 1) and doctors who had completed DEGUM-certified basic MSUS courses (control group 2). Both control groups completed the written test, while control group 2 also took the practical final exam. The study involved 146 participants: 56 were allocated to the study group, 44 to control group 1, and 46 to control group 2. RESULTS The study group rated their skills significantly higher after the course (p < 0.01). Participants expressed high satisfaction with the course design, the teaching materials, and the teachers. The study group's performance on the final written test was comparable to those of control group 2 (p = 0.06) and significantly superior to control group 1 (p < 0.001). Additionally, the study group's performance on the practical final exam was not significantly different from control group 2 (p = 0.28), with both groups achieving scores exceeding 80%. CONCLUSION Both subjective and objective measures of learning suggest that an MSUS course designed for postgraduates can be effectively adapted for undergraduate medical students. Incorporating MSUS training into the clinical curriculum is recommended to enhance future medical professionals' educational experience and practical skills.
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Affiliation(s)
- Andreas Weimer
- Clinic for Trauma and Reconstructive Surgery, University Clinic Heidelberg, 69118, Heidelberg, Germany
| | - Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Thomas Vieth
- Rudolf Frey Learning Clinic, University Medical Centreof the, Johannes Gutenberg University Mainz , 55131, Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Centreof the, Johannes Gutenberg University Mainz , 55131, Mainz, Germany
| | - Christian Schamberger
- Clinic for Trauma and Reconstructive Surgery, University Clinic Heidelberg, 69118, Heidelberg, Germany
| | | | - Svenja Berthold
- Department for Orthopaedics and Trauma Surgery, University Medical Centre Mannheim, 68167, Mannheim, Germany
| | - Stephan Stein
- Clinic for Trauma and Reconstructive Surgery, University Clinic Heidelberg, 69118, Heidelberg, Germany
| | - Gerhard Schmidmaier
- Clinic for Trauma and Reconstructive Surgery, University Clinic Heidelberg, 69118, Heidelberg, Germany
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein-Campus Lübeck, Lübeck, 23538, Germany
| | - Ricarda Neubauer
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, Mainz University Hospital, Mainz, Germany
| | - Julia Weinmann-Menke
- Department of Internal Medicine I, University Medical Center of the, Johannes Gutenberg Universitätsmedizin Mainz, Langenbeckstraße 1, Mainz, 55131, Germany
| | - Johannes Weimer
- Rudolf Frey Learning Clinic, University Medical Centreof the, Johannes Gutenberg University Mainz , 55131, Mainz, Germany.
- Department of Internal Medicine I, University Medical Center of the, Johannes Gutenberg Universitätsmedizin Mainz, Langenbeckstraße 1, Mainz, 55131, Germany.
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11
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Daum N, Blaivas M, Goudie A, Hoffmann B, Jenssen C, Neubauer R, Recker F, Moga TV, Zervides C, Dietrich CF. Student ultrasound education, current view and controversies. Role of Artificial Intelligence, Virtual Reality and telemedicine. Ultrasound J 2024; 16:44. [PMID: 39331224 PMCID: PMC11436506 DOI: 10.1186/s13089-024-00382-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 06/11/2024] [Indexed: 09/28/2024] Open
Abstract
The digitization of medicine will play an increasingly significant role in future years. In particular, telemedicine, Virtual Reality (VR) and innovative Artificial Intelligence (AI) systems offer tremendous potential in imaging diagnostics and are expected to shape ultrasound diagnostics and teaching significantly. However, it is crucial to consider the advantages and disadvantages of employing these new technologies and how best to teach and manage their use. This paper provides an overview of telemedicine, VR and AI in student ultrasound education, presenting current perspectives and controversies.
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Affiliation(s)
- Nils Daum
- Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
- Brandenburg Institute for Clinical Ultrasound (BICUS) at Brandenburg Medical University, Neuruppin, Germany
| | - Michael Blaivas
- Department of Medicine, University of South Carolina School of Medicine, Columbia, SC, USA
| | | | - Beatrice Hoffmann
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Christian Jenssen
- Brandenburg Institute for Clinical Ultrasound (BICUS) at Brandenburg Medical University, Neuruppin, Germany
- Department for Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg, Germany
| | | | - Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Tudor Voicu Moga
- Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, Piața Eftimie Murgu 2, 300041, Timișoara, Romania
- Center of Advanced Research in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, 300041, Timisoara, Romania
| | | | - Christoph Frank Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland.
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12
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Malla M, Purna Shrestha A, Prasad Shrestha S, Shrestha R. Diagnostic Accuracy of Bedside Lung Ultrasound in Detecting Traumatic Pneumothorax by Novice Physicians in the Emergency Department of a Tertiary Care Hospital of Nepal. Emerg Med Int 2024; 2024:9956637. [PMID: 39346102 PMCID: PMC11427713 DOI: 10.1155/2024/9956637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 08/23/2024] [Accepted: 09/02/2024] [Indexed: 10/01/2024] Open
Abstract
Introduction Traumatic pneumothorax is a life-threatening condition requiring vigilant clinical assessment and urgent management. Lung ultrasound (LUS) is considered to be a safer, rapid, and accurate modality for the early diagnosis of traumatic pneumothorax. The principle objective of this study was to evaluate the diagnostic accuracy of bedside LUS performed by trained novice physicians in the diagnosis of traumatic pneumothorax as compared to supine chest X-rays (CXRs) and/or computed tomography (CT) scans and/or air leak during needle/tube thoracostomy as composite standard. Methods It is a prospective, cross-sectional, single-blinded study using a nonprobability quota sampling technique. A total of 96 patients presenting to the emergency department (ED) with polytrauma and chest injuries within a period of twelve months were included. The diagnostic accuracy of bedside LUS performed by trained novice physicians was calculated in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared with the composite standard. Results The sensitivity of LUS in diagnosing traumatic pneumothorax as compared to the composite standard was 100% (95% confidence interval (CI): 59.05%-100.00%), whereas its specificity was 97.75% (95% CI: 92.12%-99.73%). Similarly, the PPV and NPV of LUS were 77.7% (95% CI: 39.99%-97.19%) and 100% (95% CI: 95.85%-100.00%), respectively. Conclusion The results of the study showed that the application of LUS in detecting traumatic pneumothorax had similar diagnostic accuracy as supine CXR. Bedside LUS is widely available, portable, and inexpensive. It also has the capability of real-time imaging and can be repeated as necessary with less risk of radiation exposure. Therefore, physicians working in tertiary and rural health institutions must be trained adequately in order to uplift the clinical utility of LUS for the timely and cost-effective detection of traumatic pneumothorax.
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Affiliation(s)
- Monisma Malla
- Department of General Practice and Emergency Medicine Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchowk, Bagmati Province, Nepal
| | - Anmol Purna Shrestha
- Department of General Practice and Emergency Medicine Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchowk, Bagmati Province, Nepal
| | - Shailesh Prasad Shrestha
- Department of General Practice and Emergency Medicine Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchowk, Bagmati Province, Nepal
| | - Roshana Shrestha
- Department of General Practice and Emergency Medicine Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchowk, Bagmati Province, Nepal
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13
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Höhne E, Schäfer VS, Neubauer R, Gotta J, Reschke P, Wittek A, Recker F. A four year follow-up survey on the teledidactic TELUS ultrasound course: long-term benefits and implications. BMC MEDICAL EDUCATION 2024; 24:1022. [PMID: 39294583 PMCID: PMC11409468 DOI: 10.1186/s12909-024-05993-z] [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: 07/22/2024] [Accepted: 09/04/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND The COVID-19 pandemic disrupted traditional medical education, prompting innovative teaching methods for practical skills training. The teledidactic TELUS ultrasound course, launched in 2020-2021, aimed to provide remote instruction in ultrasound techniques. OBJECTIVE This study assesses the long-term impact of the teledidactic ultrasound course conducted during the study years on current clinical practice. METHODS In 2024, a follow-up survey was conducted with former TELUS course students now practicing as physicians across various specialities. Participants rated their confidence in ultrasound examinations and its frequency in practice. RESULTS 21 out of 30 participants (70%) completed the survey. 71.4% rated the course experience as excellent (5/5 points). Most reported significant learning gains, especially in the FAST module. While all agreed the course enhanced their ultrasound skills, its impact on patient care received mixed reviews. Frequency of ultrasound use varied widely among specialities, with high use in surgery and internal medicine but less in psychiatry, neurology, and ophthalmology. Notably, 42,9% had not pursued further ultrasound training post-course. CONCLUSION The teledidactic ultrasound course effectively provided remote education, integrating skills into practice. Mixed reviews on patient care impact and speciality-specific ultrasound use suggest sustained integration depends on relevance and ongoing education. Self-assessment results support online ultrasound courses, indicating potential use in resource-limited or geographically constrained settings.
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Affiliation(s)
- Elena Höhne
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Valentin S Schäfer
- Department of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital Bonn, Bonn, Germany
| | - Ricarda Neubauer
- Department of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital Bonn, Bonn, Germany
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany
| | - Jennifer Gotta
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Philipp Reschke
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Agnes Wittek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany
| | - Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, Bonn, 53127, Germany.
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14
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Höhne E, Schäfer VS, Petzinna SM, Wittek A, Gotta J, Reschke P, Recker F. First insights of integrating the Bonn Internship Curriculum for Point-of-Care Ultrasound (BI-POCUS): progress and educational aspects. BMC MEDICAL EDUCATION 2024; 24:894. [PMID: 39160520 PMCID: PMC11334524 DOI: 10.1186/s12909-024-05904-2] [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: 06/12/2024] [Accepted: 08/14/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Point-of-care ultrasound (POCUS) is rapidly gaining prominence in various clinical settings. As its use becomes more widespread, there is a growing need for comprehensive ultrasound training in medical education to ensure that future healthcare professionals are proficient in this essential diagnostic tool. OBJECTIVE This study is the first attempt by the University of Bonn to seamlessly integrate ultrasound courses and the use of ultrasound devices into the regular activities of final year medical students and to evaluate the usage of these devices. METHODS A total of forty students in their practical year were provided with a hendheld ultrasound device for a period of four months. During this time, they were invited to take part in eight optional ultrasound courses in which they acquired images and those images were rated using a specially developed rating system. At the end of the tertial, students were able to take part in a voluntary survey on the use of the equipment. RESULTS Participation in the optional ultrasound courses was well received, with the Introduction and FAST module drawing the largest number of participants (29). Among the ultrasound images acquired by students, those of the lungs obtaining the highest rating, with 18.82 (SD ± 4.30) points out of 23 points, while the aorta and vena cava images scored lowest, with an average of 16.62 (SD ± 1.55) points. The overall mean score for all images was 17.47 (SD ± 2.74). Only 21 students responded to the survey. Of the participating students, 67% used the device independently four times or fewer during the tertial. CONCLUSION The study aimed to enhance the BI-POCUS curriculum by improving students' ultrasound skills during their practical year. However, device usage was lower than expected, with most students using it only once a month or less. This raises concerns about the justification of the effort and resources. Future initiatives will focus on technical improvements, better login data provision, and closer monitoring of usage and progress, emphasizing the need for practical ultrasound training in medical education.
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Affiliation(s)
- Elena Höhne
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Valentin Sebastian Schäfer
- Department of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Simon Michael Petzinna
- Department of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Agnes Wittek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Jennifer Gotta
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Philipp Reschke
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany.
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15
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Dietrich CF, Sirli RL, Barth G, Blaivas M, Daum N, Dong Y, Essig M, Gschmack AM, Goudie A, Hofmann T, Hoffmann B, Jenssen C, Kallenbach M, Karlas T, Krutz A, Löwe A, Lucius C, Möller K, Neubauer R, Nurnberg D, Prats M, Prosch H, Recker F, Ruppert JP, Sänger SL, Wangenheim F, Weimer JM, Westerway SC, Zervides C. Student ultrasound education - current views and controversies. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2024; 45:389-394. [PMID: 38484782 DOI: 10.1055/a-2265-1070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
As an extension of the clinical examination and as a diagnostic and problem-solving tool, ultrasound has become an established technique for clinicians. A prerequisite for high-quality clinical ultrasound practice is adequate student ultrasound training. In light of the considerable heterogeneity of ultrasound curricula in medical studies worldwide, this review presents basic principles of modern medical student ultrasound education and advocates for the establishment of an ultrasound core curriculum embedded both horizontally and vertically in medical studies.
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Affiliation(s)
- Christoph F Dietrich
- Department General Internal Medicine, Hirslanden Klinik Beau-Site, Bern, Switzerland
| | - Roxana Lucia Sirli
- Department of Internal Medicine II - Gastroenterology and Hepatology, Center of Advanced Research in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Timisoara, Romania
| | - Gregor Barth
- Department of Hematology, Oncology and Palliative Care, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
| | - Michael Blaivas
- Department of Medicine, University of South Carolina School of Medicine, Columbia, United States
| | - Nils Daum
- Anesthesiology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | | | - Adrian Goudie
- Emergency, Fiona Stanley Hospital, Murdoch, Australia
| | - Tino Hofmann
- Medicine, Witten/Herdecke University, Witten, Germany
| | - Beatrice Hoffmann
- Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, United States
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland Strausberg/ Wriezen, Wriezen, Germany
| | - Michael Kallenbach
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, Universitätsklinikum Düsseldorf, Dusseldorf, Germany
| | - Thomas Karlas
- Department of Internal Medicine, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany
| | - Alexander Krutz
- Medicine, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
| | - Axel Löwe
- Department of Internal Medicine, Hirslanden Hospital Group, Bern, Switzerland
| | - Claudia Lucius
- Outpatient Department of Gastroenterology, IBD center, Policlinic Helios Klinikum Buch, Berlin, Germany
| | - Kathleen Möller
- Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Ricarda Neubauer
- Clinic of Internal Medicine III Department of Oncology, Hematology, Rheumatology and Clinical Immunology, University Hospital Bonn, Bonn, Germany
| | - Dieter Nurnberg
- Department of Internal Medicine and Gastroenterology, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Michael Prats
- Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, United States
| | - Helmut Prosch
- Abteilung für Allgemeine Radiologie und Kinderradiologie, Medizinische Universität Wien, Wien, Austria
| | - Florian Recker
- Department of Obstetrics and Gynecology, Universitätsklinikum Bonn, Bonn, Germany
| | | | | | | | - Johannes M Weimer
- Rudolf-Frey Teaching Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Susan Campbell Westerway
- School of Dentistry & Health Sciences, Charles Sturt University Australia, Wagga Wagga, Australia
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16
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Weimer J, Ruppert J, Vieth T, Weinmann-Menke J, Buggenhagen H, Künzel J, Rink M, Lorenz L, Merkel D, Ille C, Yang Y, Müller L, Kloeckner R, Weimer A. Effects of undergraduate ultrasound education on cross-sectional image understanding and visual-spatial ability - a prospective study. BMC MEDICAL EDUCATION 2024; 24:619. [PMID: 38840140 PMCID: PMC11151628 DOI: 10.1186/s12909-024-05608-7] [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: 03/14/2024] [Accepted: 05/27/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION/AIM Radiological imaging is crucial in modern clinical practice and requires thorough and early training. An understanding of cross-sectional imaging is essential for effective interpretation of such imaging. This study examines the extent to which completing an undergraduate ultrasound course has positive effects on the development of visual-spatial ability, knowledge of anatomical spatial relationships, understanding of radiological cross-sectional images, and theoretical ultrasound competencies. MATERIAL AND METHODS This prospective observational study was conducted at a medical school with 3rd year medical students as part of a voluntary extracurricular ultrasound course. The participants completed evaluations (7-level Likert response formats and dichotomous questions "yes/no") and theoretical tests at two time points (T1 = pre course; T2 = post course) to measure their subjective and objective cross-sectional imaging skills competencies. A questionnaire on baseline values and previous experience identified potential influencing factors. RESULTS A total of 141 participants were included in the study. Most participants had no previous general knowledge of ultrasound diagnostics (83%), had not yet performed a practical ultrasound examination (87%), and had not attended any courses on sonography (95%). Significant subjective and objective improvements in competencies were observed after the course, particularly in the subjective sub-area of "knowledge of anatomical spatial relationships" (p = 0.009). Similarly, participants showed improvements in the objective sub-areas of "theoretical ultrasound competencies" (p < 0.001), "radiological cross-section understanding and knowledge of anatomical spatial relationships in the abdomen" (p < 0.001), "visual-spatial ability in radiological cross-section images" (p < 0.001), and "visual-spatial ability" (p = 0.020). CONCLUSION Ultrasound training courses can enhance the development of visual-spatial ability, knowledge of anatomical spatial relationships, radiological cross-sectional image understanding, and theoretical ultrasound competencies. Due to the reciprocal positive effects of the training, students should receive radiology training at an early stage of their studies to benefit as early as possible from the improved skills, particularly in the disciplines of anatomy and radiology.
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Affiliation(s)
- Johannes Weimer
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Johannes Ruppert
- Department of Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Thomas Vieth
- 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
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Maximilian Rink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Liv Lorenz
- Department of Radiation Oncology and Radiotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Daniel Merkel
- BIKUS-Brandenburg Institute for Clinical Ultrasound, Brandenburg Medical School Theodor Fontane (MHB), Neuruppin, Germany
| | - Carlotta Ille
- Rudolf Frey Learning Clinic, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Yang Yang
- Department of Diagnostic and Interventional Radiology, 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
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein - Campus Lübeck, Lübeck, Germany
| | - Andreas Weimer
- Center of Orthopedics, Trauma Surgery, and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, Heidelberg, Germany
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Alkass J, Farber E. MUSIG: An Example Highlighting the Value of Student Led POCUS Education, Influenced by the COVID-19 Pandemic. MEDICAL SCIENCE EDUCATOR 2024; 34:299-301. [PMID: 38686163 PMCID: PMC11055807 DOI: 10.1007/s40670-023-01955-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 05/02/2024]
Abstract
There has been a recent push for more formal ultrasound teaching in medical school curricula. Faculty availability, however, presents a significant barrier to its implementation. Medical student interest groups such as the McGill Ultrasound Interest Group (MUSIG), aimed to address this barrier by using near-peer instruction (NPI) to teach ultrasound to other students. MUSIG has helped teach hundreds of students about the fundamentals of ultrasound and its applicability in clinical practice by creating ultrasound conferences, friendly ultrasound competitions, virtual lectures, and educational resources. This paper aims to use MUSIG as an example to highlight the important role students can play in changing the landscape of medical education.
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Affiliation(s)
- Jad Alkass
- Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
| | - Eadan Farber
- Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
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Nassar SM, Almubrik SA, Alyahya L, Alshalan M, Alhashem HM. Perception, Knowledge, Indications, and Future Prospects of Point-of-Care Ultrasound Among Medical Students in Saudi Arabia. Cureus 2024; 16:e57704. [PMID: 38586231 PMCID: PMC10998434 DOI: 10.7759/cureus.57704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Point-of-care ultrasound (POCUS) has become integral across medical specialties globally, addressing clinical queries, guiding procedures, and bridging the gap between physical examination and advanced imaging. Early ultrasound training for medical students enhances clinical decision-making and reduces diagnostic errors. Aims To evaluate the knowledge and attitude of senior medical students towards POCUS and to assess knowledge gaps and difficulties encountered by senior medical students to assist in the development of future curricula. Methodology This is an observational, cross-sectional approach to evaluate knowledge, attitude, and practice of POCUS among senior medical students in the Kingdom of Saudi Arabia. The study was conducted from January to September 2023. An electronic questionnaire was distributed through online platforms utilizing medical school databases across various regions. The survey encompassed sociodemographics, training methods, diagnostic indications, and participants' self-reported proficiency and attitudes toward POCUS. The data was chiefly collected using the Likert scale. Descriptive statistics were used to describe the quantitative and categorical variables. Bivariate and multivariate analyses were used to examine correlations. Results A total of 359 senior medical students completed the survey. Most responders were females (57.9%) with the predominating age group being ≤ 24 years (83.6%). The students predominantly were from the Central region of Saudi Arabia (75.5%). Ultrasound training varied among responders; 31.5% received formal courses (median duration: two hours) and 23.4% informal courses (median duration: four hours). Around 17.3% practiced POCUS self-teaching (median duration: four hours). A total of 3.6% had formal POCUS accreditation. A gargantuan 82.2% never used POCUS in their attached hospital for a variety of reasons. Multivariable logistic binary regression analysis showed a positive correlation between students' self-teaching of POCUS and their perceived difficulty performing an ultrasound examination for patients in daily practice. Discussion A comparable study was done at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in 2022 surveying 229 senior medical students by Rajendram et al. In their study, 21.4% completed formal courses and 12.7% took informal courses. While many students in our study were not exposed to POCUS (82.2%), KSAU-HS reported a higher percentage reaching 94.8%. A study by Russel et al. demonstrated more than half of 154 surveyed medical schools in the United States have implemented POCUS into their students' curriculum. Conclusion POCUS stands as a valuable skill that can enhance the educational journey of undergraduate medical students. Considering that a significant number of participants haven't yet taken formal medical school courses suggests a lack of awareness about its significance in the medical field. Offering additional courses with practical components could enhance the proficiency, confidence, and outlook of medical students toward POCUS.
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Affiliation(s)
- Saeed M Nassar
- Department of Emergency Medicine, King Saud University Medical City, Riyadh, SAU
| | - Sarah A Almubrik
- Department of Emergency Medicine, King Saud University Medical City, Riyadh, SAU
| | - Lama Alyahya
- Department of Emergency Medicine, King Saud University, Riyadh, SAU
| | | | - Hussain M Alhashem
- Department of Emergency Medicine, King Saud University Medical City, Riyadh, SAU
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19
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Dupriez F, Niset A, Couvreur C, Marissiaux L, Gendebien F, Peyskens L, Germeau B, Fasseaux A, Rodrigues de Castro B, Penaloza A, Vanpee D, Bobbia X. Evaluation of point-of-care ultrasound use in the diagnostic approach for right upper quadrant abdominal pain management in the emergency department: a prospective study. Intern Emerg Med 2024; 19:803-811. [PMID: 38041765 DOI: 10.1007/s11739-023-03480-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 11/04/2023] [Indexed: 12/03/2023]
Abstract
Point-of-care ultrasound (PoCUS) is commonly used at the bedside in the emergency department (ED) as part of clinical examinations. Studies frequently investigate PoCUS diagnostic accuracy, although its contribution to the overall diagnostic approach is less often evaluated. The primary objective of this prospective, multicenter, cohort study was to assess the contribution of PoCUS to the overall diagnostic approach of patients with right upper quadrant abdominal pain. Two independent members of an adjudication committee, who were blind to the intervention, independently evaluated the diagnostic approaches before and after PoCUS for the same patient. The study included 62 patients admitted to the ED with non-traumatic right upper quadrant abdominal pain from September 1, 2022, to March 6, 2023. The contribution of PoCUS to the diagnostic approach was evaluated using a proportion test assuming that 75% of diagnostic approaches would be better or comparable with PoCUS. Wilcoxon signed-rank tests evaluated the impact of PoCUS on the mean number of differential diagnoses, planned treatments, and complementary diagnostic tests. Overall, 60 (97%) diagnostic approaches were comparable or better with PoCUS (χ2 = 15.9, p < 0.01). With PoCUS, the mean number of differential diagnoses significantly decreased by 2.3 (95% CI - 2.7 to - 1.5) (p < 0.01), proposed treatments by 1.3 (95% CI - 1.8 to - 0.9) (p < 0.01), and complementary diagnostic tests by 1.3 (95% CI - 1.7 to - 1.0) (p < 0.01). These findings show that PoCUS positively impacts the diagnostic approach and significantly decreases the mean number of differential diagnoses, treatments, and complementary tests.
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Affiliation(s)
- Florence Dupriez
- Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium.
| | - Alexandre Niset
- Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Claire Couvreur
- Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Laurent Marissiaux
- Emergency Department, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Félix Gendebien
- Emergency Department, Hôpital de Jolimont, Lobbes, Lobbes, Belgium
| | - Laurent Peyskens
- Emergency Department, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Boris Germeau
- Emergency Department, Cliniques Saint-Pierre Ottignies, Ottignies, Belgium
| | - Antoine Fasseaux
- Emergency Department, Hôpital de Jolimont, Lobbes, Haine Saint Paul, Belgium
| | | | - Andrea Penaloza
- Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Dominique Vanpee
- Institute of Health and Society and CHU UCL Namur, UCLOUVAIN, Ottignies-Louvain-la-Neuve, Belgium
| | - Xavier Bobbia
- Emergency Department, CHU Montpellier, Montpellier, France
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20
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Dupriez F, Hall A, Diop T, Collard A, de Castro BR, Smets F, Penaloza A, Vanpee D. Point-of-Care Ultrasound training in undergraduate education in the European Union: current situation and perspectives. Ultrasound J 2024; 16:9. [PMID: 38349580 PMCID: PMC10864236 DOI: 10.1186/s13089-024-00361-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Given the widespread use of Point-of-Care UltraSound (PoCUS) in clinical practice, with ultrasound machines becoming more portable and affordable, recommendations and position statements from ultrasound societies now promote teaching PoCUS in the undergraduate curriculum. Nevertheless, surveys about PoCUS teaching in European medical schools are lacking. This survey aims to overview the current and future undergraduate PoCUS courses in the European Union (EU). RESULTS A questionnaire was sent to medical schools in 26 of the 27 countries of the EU; Luxembourg is the only country without a medical school. The survey was completed by the dean or a member of the medical school with knowledge of the medical curriculum. Of the 58 medical schools from 19 countries that responded to the survey, 18 (31.0%) from 13 (68.4%) EU countries reported the existence of an undergraduate PoCUS curriculum and a further 16 (27.6%) from 12 (41.4%) EU countries intended to offer it in the future. No significant difference was observed between the current and future PoCUS curricula regarding its content and purpose. Less than 40 h of theoretical teaching is provided in all the medical schools and less than 40 h of practical training is provided in 12 (75%) of the 16 medical schools which answered this specific question. Of the 40 (69%) surveyed medical schools that do not currently teach PoCUS, 20 (50%) intend to offer PoCUS courses in the future. CONCLUSION Although the lack of teaching hours in curricula suggests that most PoCUS courses are introductory in nature and that medical students are possibly not trained to become autonomous in clinical practice, evaluating the feasibility and impact of PoCUS teaching on clinical practice should be promoted. The medical schools that intend to develop this curriculum should be encouraged to implement validated tools to objectively assess their programs and students' performances.
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Affiliation(s)
- Florence Dupriez
- Emergency Department, Cliniques Universitaires Saint Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium.
| | - Audrey Hall
- Emergency Department, Cliniques Universitaires Saint Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Toumane Diop
- Emergency Department, Cliniques Universitaires Saint Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Alix Collard
- Statistical Support Unit, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Françoise Smets
- Faculty of Medicine and Dental Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Andrea Penaloza
- Faculty of Medicine and Dental Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Dominique Vanpee
- Institute of Health and Society and CHU UCL Namur, UCLOUVAIN, Brussels, Belgium
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21
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Hari R, Caprez R, Dolmans D, Huwendiek S, Robbiani S, Stalmeijer RE. Describing Ultrasound Skills Teaching by Near-Peer and Faculty Tutors Using Cognitive Apprenticeship. TEACHING AND LEARNING IN MEDICINE 2024; 36:33-42. [PMID: 36322510 DOI: 10.1080/10401334.2022.2140430] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Phenomenon: Ultrasound skills are becoming increasingly important in clinical practice but are resource-intensive to teach. Near-peer tutors often alleviate faculty teaching burden, but little is known about what teaching methods near-peer and faculty tutors use. Using the lens of cognitive apprenticeship, this study describes how much time faculty and near-peer tutors spend on different teaching methods during abdominal ultrasound skills training. Approach: Sixteen near-peer and 16 faculty tutors were videotaped during one 55-min practical ultrasound lesson with randomly assigned students. Videos were directly coded using Cognitive Apprenticeship teaching methods and activities. Segment durations were summed up and compared quantitatively. Findings: All 32 tutors spent most of the time on observing and helping students (Coaching, Median 29:14 minutes), followed by asking open and stimulating questions (Articulation, 12:04 minutes and demonstrating and giving explanations (Modeling, 04:50 minutes). Overall, distributions of teaching methods used were similar between faculty and near-peer tutors. However, faculty tutors spent more time on helping students manually, whereas near-peer tutors spent more time on exploring students' learning gaps and establishing a safe learning climate. Cognitive Apprenticeship was well suited as observational framework to describe ultrasound skills. Insights: Ultrasound train-the-tutor programs should particularly focus on coaching and articulation. Near-peers' similar use of teaching methods adds to the evidence that supports the use of near-peer teaching in ultrasound skills education.
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Affiliation(s)
- Roman Hari
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Reto Caprez
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Diana Dolmans
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sören Huwendiek
- Department for Assessment and Evaluation, Institute for Medical Education, University of Bern, Bern, Switzerland
| | - Sara Robbiani
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Renée E Stalmeijer
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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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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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: 5] [Impact Index Per Article: 2.5] [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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Atalla M, Yacoub A, Al-Ali H, Lupia B, Ezzeddine L, Barzani S, Moussa M, Coey J, Alambrouk T, Hilal H. Investigating the Skill Development of Medical Students in Focused Assessment With Sonography for Trauma (FAST) Ultrasound: A Comparative Analysis Across Different Stages of Medical Training. Cureus 2023; 15:e44414. [PMID: 37664275 PMCID: PMC10469331 DOI: 10.7759/cureus.44414] [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: 08/30/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION Focused assessment with sonography for trauma (FAST) ultrasound (US) is a valuable medical examination used in trauma settings, particularly for rapid responses to events such as natural disasters. Although the efficacy and benefits of FAST in patient care have been extensively studied, there is limited research on training medical students in FAST. Previous studies have found that medical students can proficiently perform a FAST US after two days of training. However, these studies exclusively included first-year medical students without considering variations in their medical knowledge. Particularly, the advantage of medical students having US experience before undergoing FAST training has not been previously examined. OBJECTIVES Assess the performance and knowledge acquisition of medical students with and without prior US experience after completing a FAST training course. METHODS The study included a total of 71 students, consisting of 33 males and 38 females, who were between the ages of 18 and 31, with an average age of 24.6 and a standard deviation of 2.4. The inclusion criteria targeted first- and second-year medical school students who participated on a volunteer basis. Students were divided into two groups: group A, consisting of those without prior US experience, and group B, made up of those who had previous US experience. All students completed a pre-training survey to share their comfort and confidence in US use and knowledge. A baseline FAST exam was conducted to establish initial performance. A comprehensive three-hour training session was then provided. Post-training, students performed another FAST exam to assess improvement, followed by a post-training survey to evaluate comfort and confidence. RESULTS Medical students who had prior experience in the US (group B) performed significantly better (p<0.01) in both the pre- and post-training FAST exams when compared to students without previous US experience. Specifically, in locating the liver, right kidney, hepatorenal recess, and left kidney, as well as detecting fluid accumulation when in a supine position. Additionally, medical students with prior US experience (group B) exhibited higher baseline confidence (p<0.005-p<0.01) in their ability to perform a FAST exam, as indicated by the results of the pre-testing survey. CONCLUSION Previous experience with US significantly boosted confidence and knowledge gains following FAST training. This emphasizes the value of including US training in medical school programs after earlier exposure, offering evident benefits. The study reveals the unexplored benefit of having prior US experience for medical students undergoing FAST training, thus addressing a previously unexplored area in current research. The conclusions stress the necessity of integrating US training into medical school curricula after initial exposure. This understanding can direct medical educators in refining the education process, enabling students to be better equipped for real-world medical situations involving FAST.
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Affiliation(s)
- Michael Atalla
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
- Medical Imaging, University of Toronto, Toronto, CAN
| | - Andrew Yacoub
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Hasan Al-Ali
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Bianca Lupia
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Layal Ezzeddine
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Shaliz Barzani
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Michelle Moussa
- School of Medicine, St. George's University School of Medicine, True Blue, GRD
- Faculty of Science, University of Waterloo, Waterloo, CAN
| | - James Coey
- Anatomy, St. George's University School of Medicine, Newcastle upon Tyne, GBR
| | - Tarek Alambrouk
- School of Medicine, St. George's University School of Medicine, Newcastle upon Tyne, GRD
| | - Haider Hilal
- School of Medicine, St. George's University School of Medicine, Newcastle upon Tyne, GBR
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25
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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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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: 0.5] [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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DeBiasio C, Pageau P, Shefrin A, Woo MY, Cheung WJ. Point-of-Care-ultrasound in undergraduate medical education: a scoping review of assessment methods. Ultrasound J 2023; 15:30. [PMID: 37302105 PMCID: PMC10258183 DOI: 10.1186/s13089-023-00325-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Point-of-Care-Ultrasound (POCUS) curricula have rapidly expanded in undergraduate medical education (UME). However, the assessments used in UME remain variable without national standards. This scoping review characterizes and categorizes current assessment methods using Miller's pyramid for skills, performance, and competence of POCUS in UME. A structured protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). A literature search of MEDLINE was performed from January 1, 2010, to June 15, 2021. Two independent reviewers screened all titles and abstracts for articles that met inclusion criteria. The authors included all POCUS UME publications in which POCUS-related knowledge, skills, or competence were taught and objectively assessed. Articles were excluded if there were no assessment methods used, if they exclusively used self-assessment of learned skills, were duplicate articles, or were summaries of other literature. Full text analysis and data extraction of included articles were performed by two independent reviewers. A consensus-based approach was used to categorize data and a thematic analysis was performed. RESULTS A total of 643 articles were retrieved and 157 articles met inclusion criteria for full review. Most articles (n = 132; 84%) used technical skill assessments including objective structured clinical examinations (n = 27; 17%), and/or other technical skill-based formats including image acquisition (n = 107; 68%). Retention was assessed in n = 98 (62%) studies. One or more levels of Miller's pyramid were included in 72 (46%) articles. A total of four articles (2.5%) assessed for students' integration of the skill into medical decision making and daily practice. CONCLUSIONS Our findings demonstrate a lack of clinical assessment in UME POCUS that focus on integration of skills in daily clinical practice of medical students corresponding to the highest level of Miller's Pyramid. There exists opportunities to develop and integrate assessment that evaluate higher level competencies of POCUS skills of medical students. A mixture of assessment methods that correspond to multiple levels of Miller's pyramid should be used to best assess POCUS competence in UME.
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Affiliation(s)
- Celina DeBiasio
- Division of Dermatology, Ottawa Hospital and University of Ottawa, Ottawa, ON Canada
| | - Paul Pageau
- Department of Emergency Medicine, University of Ottawa, Ottawa Hospital, 1053 Carling Avenue Ottawa, Ottawa, ON Canada
| | - Allan Shefrin
- Division of Emergency Medicine, Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON Canada
| | - Michael Y. Woo
- Department of Emergency Medicine, University of Ottawa, Ottawa Hospital, 1053 Carling Avenue Ottawa, Ottawa, ON Canada
- Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Warren J. Cheung
- Department of Emergency Medicine, University of Ottawa, Ottawa Hospital, 1053 Carling Avenue Ottawa, Ottawa, ON Canada
- Ottawa Hospital Research Institute, Ottawa, ON Canada
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Rathbun KM, Patel AN, Jackowski JR, Parrish MT, Hatfield RM, Powell TE. Incorporating ultrasound training into undergraduate medical education in a faculty-limited setting. BMC MEDICAL EDUCATION 2023; 23:263. [PMID: 37076831 PMCID: PMC10113991 DOI: 10.1186/s12909-023-04227-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Point of care ultrasound (POCUS) is becoming a major extension of patient care. From diagnostic efficacy to its widespread accessibility, POCUS has expanded beyond emergency departments to be a tool utilized by many specialties. With the expansion of its use, medical education has begun to implement ultrasound education earlier in curricula. However, at institutions without a formal ultrasound fellowship or curriculum, these students lack the fundamental knowledge of ultrasound. At our institution, we set out to incorporate an ultrasound curriculum, into undergraduate medical education utilizing a single faculty member and minimal curricular time. METHODS Our stepwise implementation began with the development of a 3-hour fourth-year (M4) Emergency Medicine clerkship ultrasound teaching session, which included pre- and post-tests as well as a survey. The success with this session progressed to the development of a designated fourth-year ultrasound elective, which was evaluated with narrative feedback. Finally, we developed six 1-hour ultrasound sessions that correlated with first-year (M1) gross anatomy and physiology. A single faculty member was responsible for this curriculum and other instructors included residents, M4 students, and second-year (M2) near-peer tutors. These sessions also included pre- and post-tests and a survey. Due to curricular time limitations, all but the M4 Emergency Medicine clerkship session were optional. RESULTS 87 students participated in the emergency medicine clerkship ultrasound session and 166 M1 students participated in the voluntary anatomy and physiology ultrasound sessions. All participants agreed or strongly agreed that they would like more ultrasound training, that ultrasound training should be integrated into all four years of undergraduate medical education. Students were in strong agreement that the ultrasound sessions helped increase understanding of anatomy and anatomical identification with ultrasound. CONCLUSION We describe the stepwise addition of ultrasound into the undergraduate medical education curriculum of an institution with limited faculty and curricular time.
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Affiliation(s)
- Kimberly M Rathbun
- Department of Emergency Medicine, Augusta University, University of Georgia Medical Partnership, Athens, GA, Greece.
| | - Arjun N Patel
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | | | | | - Ryan M Hatfield
- Department of Emergency Medicine, Prisma Health, Columbia, SC, USA
| | - Tyler E Powell
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
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Dupriez F, de Castro BR, Gendebien F, Fasseaux A, Gensburger M, Marissiaux L, Penaloza A, Bobbia X, Jarman R. Is gallbladder PoCUS diagnostic accuracy accessible to medical students after PoCUS training exclusively on healthy volunteers? A pilot randomized control trial. Ultrasound J 2023; 15:18. [PMID: 37036612 PMCID: PMC10086079 DOI: 10.1186/s13089-023-00317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 03/22/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Point-of-care ultrasound (PoCUS) is increasingly used in clinical practice and is now included in many undergraduate curricula. Here, we aimed to determine whether medical students who participated in a PoCUS teaching program with several practical training sessions involving healthy volunteers could achieve a good level of diagnostic accuracy in identifying gallbladder pathologies. The intervention group (IG) was trained exclusively on volunteers with a healthy gallbladder, whereas the control group (CG) had access to volunteers with a pathological gallbladder as recommended in most PoCUS curricula. MATERIALS AND METHODS Twenty medical students were randomly assigned to the IG and CG. After completing the training program over 2 months, students were evaluated by three independent examiners. Students and examiners were blind to group allocation and study outcome. Sensitivity and specificity of students' PoCUS gallstone diagnosis were assessed. Secondary outcomes were students' confidence, image quality, acquisition time, and PoCUS skills. RESULTS Sensitivity and specificity for gallstone diagnosis were, respectively, 0.85 and 0.97 in the IG and 0.80 and 0.83 in the CG. Areas under the curve (AUC) based on the receiver operating characteristic curve analysis were 0.91 and 0.82 in the IG and CG, respectively, with no significant difference (p = 0.271) and an AUC difference of -0.092. No significant between-group difference was found for the secondary outcomes. CONCLUSIONS Our pilot study showed that medical students can develop PoCUS diagnostic accuracy after training on healthy volunteers. If these findings are confirmed in a larger sample, this could favor the delivery of large practical teaching sessions without the need to include patients with pathology, thus facilitating PoCUS training for students.
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Affiliation(s)
- Florence Dupriez
- Emergency Department, Cliniques Universitaires Saint Luc, Av Hippocrate 10, 1200, Brussels, Belgium.
| | | | - Félix Gendebien
- Emergency Department, Cliniques Universitaires Saint Luc, Av Hippocrate 10, 1200, Brussels, Belgium
- Emergency Department, Hôpital de Jolimont - Lobbes, Lobbes, Belgium
| | - Antoine Fasseaux
- Emergency Department, Hôpital de Jolimont - Lobbes, Haine-Saint-Paul, Belgium
| | - Matthieu Gensburger
- Emergency Department, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Laurent Marissiaux
- Emergency Department, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Andrea Penaloza
- Emergency Department, Cliniques Universitaires Saint Luc, Av Hippocrate 10, 1200, Brussels, Belgium
| | - Xavier Bobbia
- Emergency Department, CHU Montpellier, Montpellier, France
| | - Robert Jarman
- Emergency Department, Royal Victoria Infirmary, Newcastle, UK
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Apenteng PN, Lilford R. UK medical education should include training in point-of-care ultrasound. BMJ 2023; 380:574. [PMID: 36898723 DOI: 10.1136/bmj.p574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Affiliation(s)
| | - Richard Lilford
- Institute of Applied Health Research, University of Birmingham
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Weimer J, Rolef P, Müller L, Bellhäuser H, Göbel S, Buggenhagen H, Weimer A, Waezsada E, Kirchhoff F, Weinmann-Menke J. FoCUS cardiac ultrasound training for undergraduates based on current national guidelines: a prospective, controlled, single-center study on transferability. BMC MEDICAL EDUCATION 2023; 23:80. [PMID: 36726093 PMCID: PMC9893662 DOI: 10.1186/s12909-023-04062-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION In emergency and critical-care medicine, focused cardiac ultrasound (FoCUS) is indispensable for assessing a patient's cardiac status. The aim of this study was to establish and validate a peer-to-peer-supported ultrasound course for learning FoCUS-specific skills during undergraduate studies at a German university. METHODS A 1-day, 12 teaching units training course was developed for students in the clinical section of medical college, with content based on the current national guidelines. A total of 217 students participated in the study (97 in the course group and 120 in the control group). The course and the participants' subjective assessment of improved skills were evaluated using a questionnaire (7-point Likert scale; 7 = complete agreement and 1 = no agreement at all). Objective learning gains were assessed by tests before and after the course. These consisted of a test of figural intelligence (eight items) and a test of technical knowledge (13 items). RESULTS The course participants experienced significant improvement (P < 0.001) from before to after the course, with a large effect size of η2part = 0.26. In addition, the course group had significantly better results (P < 0.001) than the control group in the post-test, with a medium to large effect size of η2part = 0.14. No significant differences (P = 0.27) were detected in the test section on figural intelligence. The evaluations showed that the participants had a high degree of satisfaction with the course approach, teaching materials, and tutors. There was also a positive increase in their subjective assessment of their own skills, including areas such as technical knowledge, ultrasound anatomy, and performance of the examination. CONCLUSION The results of both the objective learning assessment and the subjective evaluations suggest that a FoCUS course originally intended for qualified physicians is equally suitable for students. With the development and provision of modern digital teaching media, even more students will be able to benefit from this approach in the future.
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Affiliation(s)
- Johannes Weimer
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - Peter Rolef
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University of Mainz, Mainz, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Sebastian Göbel
- Department of Medicine II, Cardiology Center, Department of Medicine, University of Mainz, Mainz, Germany
| | - Holger Buggenhagen
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Andreas Weimer
- Center for Orthopedics, Emergency Surgery, and Paraplegics, Department of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Elias Waezsada
- Department of Cardiology, Kerckhoff Hospital, Bad Nauheim, Germany
| | - Friederike Kirchhoff
- Rudolf-Frey Lernklinik, Department of Medicine, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Julia Weinmann-Menke
- Department of Medicine I, Nephrology Center, Department of Medicine, University of Mainz, Mainz, Germany
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Sheppard G, Williams KL, Metcalfe B, Clark M, Bromley M, Pageau P, Woo M, Yi Y, Devasahayam AJ, Dubrowski A. Using Kane's framework to build an assessment tool for undergraduate medical student's clinical competency with point of care ultrasound. BMC MEDICAL EDUCATION 2023; 23:43. [PMID: 36658642 PMCID: PMC9854184 DOI: 10.1186/s12909-023-04030-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/13/2023] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Point-of-care ultrasonography (POCUS) is a portable imaging technology used in clinical settings. There is a need for valid tools to assess clinical competency in POCUS in medical students. The primary aim of this study was to use Kane's framework to evaluate an interpretation-use argument (IUA) for an undergraduate POCUS assessment tool. METHODS Participants from Memorial University of Newfoundland, the University of Calgary, and the University of Ottawa were recruited between 2014 and 2018. A total of 86 participants and seven expert raters were recruited. The participants performed abdominal, sub-xiphoid cardiac, and aorta POCUS scans on a volunteer patient after watching an instruction video. The participant-generated POCUS images were assessed by the raters using a checklist and a global rating scale. Kane's framework was used to determine validity evidence for the scoring inference. Fleiss' kappa was used to measure agreement between seven raters on five questions that reflected clinical competence. The descriptive comments collected from the raters were systematically coded and analyzed. RESULTS The overall agreement between the seven raters on five questions on clinical competency ranged from fair to moderate (κ = 0.32 to 0.55). The themes from the qualitative data were poor image generation and interpretation (22%), items not applicable (20%), poor audio and video quality (20%), poor probe handling (10%), and participant did not verbalize findings (14%). CONCLUSION The POCUS assessment tool requires further modification and testing prior before it can be used for reliable undergraduate POCUS assessment.
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Affiliation(s)
- Gillian Sheppard
- Discipline of Emergency Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - Kerry-Lynn Williams
- Discipline of Emergency Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Brian Metcalfe
- Discipline of Emergency Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Marcia Clark
- Division of Orthopedic Surgery, University of Calgary, Calgary, Canada
| | - Mark Bromley
- Division of Emergency Medicine, University of Calgary, Calgary, Canada
| | - Paul Pageau
- Department of Emergency Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Canada
| | - Michael Woo
- Department of Emergency Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Canada
| | - Yanqing Yi
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | | | - Adam Dubrowski
- Faculty of Health Sciences, Ontario Technology University, Oshawa, Canada
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Recker F, Schäfer VS, Holzgreve W, Brossart P, Petzinna S. Development and implementation of a comprehensive ultrasound curriculum for medical students: The Bonn internship point-of-care-ultrasound curriculum (BI-POCUS). Front Med (Lausanne) 2023; 10:1072326. [PMID: 37035342 PMCID: PMC10080124 DOI: 10.3389/fmed.2023.1072326] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background Point-of-care ultrasound (POCUS) is rapidly gaining ground within different areas of applications. Despite the high and increasing relevance of ultrasound, the availability of structured training programs in medical schools is still limited. Therefore, many doctors keep acquiring all their ultrasound skills throughout their postgraduate training. As a result, new residents lack theoretical and practical ultrasound abilities that are critical in everyday clinical practice. In order to improve this, we created and implemented a complete ultrasound curriculum for all medical students throughout their internship year that focuses on hands-on abilities in ultrasound imaging. Methods We used Kern's six-step model of curricular development comprising (1) problem identification and general needs assessment, (2) needs assessment of the targeted learners, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback by board-certified ultrasound experts. A two rounds Delphi process with multilevel, self-completed questionnaires and individual using a 9-point Likert scale and free text comments was used to identify learning objectives and reach agreement on the content of the curriculum. Results The curriculum developed is aimed at students with no or little experience in their internship year and will be taught as part of their weekly-based internship training courses consisting of 2 hours of theory and 3 hours of practical training. The training will be conducted within a modular framework focusing on the key requirements of POCUS with increasing levels of complexity in accordance with the recommendations of the German Society for Ultrasound in Medicine (DEGUM), the European Federation of Societies for ultrasound in Medicine and Biology (EFSUMB) and the World Federation for ultrasound in Medicine and Biology (WFUMB). A longitudinal e-learning system will be implemented in addition to the practical and theoretical teaching units to track and examine the progress of the students. Conclusion Early integration of ultrasound training into medical education as part of a structured and standardized broad ultrasound curriculum enables medical students to acquire basic skills and apply them practically. Fundamental scanning skills are acquired by hands-on exercises in small, supervised groups as part of BI-POCUS. BI-POCUS therefore provides an excellent opportunity to improve the clinical skills of future physicians. More research is needed to analyze the learning outcomes for medical students and the improvement of the patient's outcome by establishing such an ultrasound curriculum.
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Affiliation(s)
- Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
- *Correspondence: Florian Recker,
| | - Valentin Sebastian Schäfer
- Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology, and Clinical Immunology, University Hospital Bonn, Bonn, Germany
| | | | - Peter Brossart
- Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology, and Clinical Immunology, University Hospital Bonn, Bonn, Germany
| | - Simon Petzinna
- Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology, and Clinical Immunology, University Hospital Bonn, Bonn, Germany
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Shao MY, Vagg T, Seibold M, Doughty M. Towards a Low-Cost Monitor-Based Augmented Reality Training Platform for At-Home Ultrasound Skill Development. J Imaging 2022; 8:305. [PMID: 36354878 PMCID: PMC9698513 DOI: 10.3390/jimaging8110305] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/20/2022] [Accepted: 11/07/2022] [Indexed: 09/10/2023] Open
Abstract
Ultrasound education traditionally involves theoretical and practical training on patients or on simulators; however, difficulty accessing training equipment during the COVID-19 pandemic has highlighted the need for home-based training systems. Due to the prohibitive cost of ultrasound probes, few medical students have access to the equipment required for at home training. Our proof of concept study focused on the development and assessment of the technical feasibility and training performance of an at-home training solution to teach the basics of interpreting and generating ultrasound data. The training solution relies on monitor-based augmented reality for displaying virtual content and requires only a marker printed on paper and a computer with webcam. With input webcam video, we performed body pose estimation to track the student's limbs and used surface tracking of printed fiducials to track the position of a simulated ultrasound probe. The novelty of our work is in its combination of printed markers with marker-free body pose tracking. In a small user study, four ultrasound lecturers evaluated the training quality with a questionnaire and indicated the potential of our system. The strength of our method is that it allows students to learn the manipulation of an ultrasound probe through the simulated probe combined with the tracking system and to learn how to read ultrasounds in B-mode and Doppler mode.
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Affiliation(s)
- Marine Y. Shao
- Centre For Print Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
| | - Tamara Vagg
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital & HRB Clinical Research Facility Cork, University College Cork & School of Computer Science and Information Technology, University College Cork, T12 XF62 Cork, Ireland
| | - Matthias Seibold
- Computer Aided Medical Procedures (CAMP), Technical University of Munich, 85748 Munich, Germany
- Research in Orthopedic Computer Science (ROCS), University Hospital Balgrist, University of Zurich, 8008 Zurich, Switzerland
| | - Mitchell Doughty
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5S 1A1, Canada
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Recker F, Dugar M, Böckenhoff P, Gembruch U, Geipel A. Development and implementation of a comprehensive postgraduate ultrasound curriculum for residents in obstetrics and gynecology: a feasibility study. Arch Gynecol Obstet 2022; 306:1045-1051. [PMID: 35430714 PMCID: PMC9470601 DOI: 10.1007/s00404-022-06554-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/25/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND In obstetric and gynecological practice, ultrasound is the essential diagnostic tool. Nevertheless, few clinics have standardized and structured training curricula for young obstetricians in the field of obstetric and gynecological ultrasound. Since ultrasound is best learned hands-on in small supervised groups, we developed and implemented a comprehensive ultrasound curriculum for all postgraduate residents of our department using a peer-teaching concept. METHODS We used Kern's six-step model of curricular development comprising (1) problem identification and general needs assessment, (2) needs assessment of the targeted learners, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback. RESULTS Assistant physicians in the 1st and 2nd year of training received a theoretical and practical ultrasound basic course (six modules) in addition to their obligatory clinic rotations. The six main topics were prioritized according to service relevance and included the main features according to DEGUM, EBCOG and ISUOG. The units focused on a three-level training based on the AMEE levels: theoretical knowledge, well-founded theoretical knowledge and basic practical skills under guidance and self-employment of practical skills. CONCLUSION Structured and standardized sonographic training allows young gynecology and obstetrics residents to conceptually grasp and practically implement topic-related themes. Furthermore, the course concept demonstrates the high inter-rater agreement among DEGUM-certified examiners. More research is needed to analyze the learning outcomes for residents and the improvement of the patient's outcome by establishing such an ultrasound curriculum.
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Affiliation(s)
- Florian Recker
- Department for Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | - Martina Dugar
- Department for Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Paul Böckenhoff
- Department for Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Ulrich Gembruch
- Department for Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Annegret Geipel
- Department for Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
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36
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Teichgräber U, Ingwersen M, Ehlers C, Mentzel HJ, Redies C, Stallmach A, Behringer W, Guntinas-Lichius O. Integration of ultrasonography training into undergraduate medical education: catch up with professional needs. Insights Imaging 2022; 13:150. [PMID: 36153444 PMCID: PMC9509508 DOI: 10.1186/s13244-022-01296-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
Ultrasonography (US) has become the first-line imaging modality even for physicians who are not imaging specialists. The progress has not yet been sufficiently considered in medical education. The aim was to develop a curriculum that integrates US as a compulsory part into medical education directly from the start, to build up professional competencies toward residency.
Methods
Development was based on Kern’s six-step approach to identify problems, specify needs, define goals, outline strategies, and propose methods.
Results
The proposed curriculum follows a spiral course within which students should pass through four levels of training with increasing complexity. Students will be asked to independently prepare for courses by using learning videos. On the first training level, US should be closely linked to anatomy and physiology courses. Competency-centered courses should be held in small groups. On the second level, in the third year of education, students will apply point-of-care ultrasonography concerning multiple medical disciplines. On the third level, they will select a compulsory course in a specialty of their choice, held at five consecutive dates. From then on, US will be conducted in patients. Finally, during the final year, students are expected to use US under pro-active supervision with a large degree of independence and confidence. Throughout the curriculum, the discipline of radiology combines vertically with foundational sciences and horizontally with other medical specialties.
Conclusion
The conceptual proposal for a longitudinal US curriculum presented here has been developed by radiologists to equip students with competencies needed for contemporary patient care.
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37
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Hoppmann RA, Mladenovic J, Melniker L, Badea R, Blaivas M, Montorfano M, Abuhamad A, Noble V, Hussain A, Prosen G, Villen T, Via G, Nogue R, Goodmurphy C, Bastos M, Nace GS, Volpicelli G, Wakefield RJ, Wilson S, Bhagra A, Kim J, Bahner D, Fox C, Riley R, Steinmetz P, Nelson BP, Pellerito J, Nazarian LN, Wilson LB, Ma IWY, Amponsah D, Barron KR, Dversdal RK, Wagner M, Dean AJ, Tierney D, Tsung JW, Nocera P, Pazeli J, Liu R, Price S, Neri L, Piccirillo B, Osman A, Lee V, Naqvi N, Petrovic T, Bornemann P, Valois M, Lanctot JF, Haddad R, Govil D, Hurtado LA, Dinh VA, DePhilip RM, Hoffmann B, Lewiss RE, Parange NA, Nishisaki A, Doniger SJ, Dallas P, Bergman K, Barahona JO, Wortsman X, Smith RS, Sisson CA, Palma J, Mallin M, Ahmed L, Mustafa H. International consensus conference recommendations on ultrasound education for undergraduate medical students. Ultrasound J 2022; 14:31. [PMID: 35895165 PMCID: PMC9329507 DOI: 10.1186/s13089-022-00279-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/05/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The purpose of this study is to provide expert consensus recommendations to establish a global ultrasound curriculum for undergraduate medical students. METHODS 64 multi-disciplinary ultrasound experts from 16 countries, 50 multi-disciplinary ultrasound consultants, and 21 medical students and residents contributed to these recommendations. A modified Delphi consensus method was used that included a systematic literature search, evaluation of the quality of literature by the GRADE system, and the RAND appropriateness method for panel judgment and consensus decisions. The process included four in-person international discussion sessions and two rounds of online voting. RESULTS A total of 332 consensus conference statements in four curricular domains were considered: (1) curricular scope (4 statements), (2) curricular rationale (10 statements), (3) curricular characteristics (14 statements), and (4) curricular content (304 statements). Of these 332 statements, 145 were recommended, 126 were strongly recommended, and 61 were not recommended. Important aspects of an undergraduate ultrasound curriculum identified include curricular integration across the basic and clinical sciences and a competency and entrustable professional activity-based model. The curriculum should form the foundation of a life-long continuum of ultrasound education that prepares students for advanced training and patient care. In addition, the curriculum should complement and support the medical school curriculum as a whole with enhanced understanding of anatomy, physiology, pathophysiological processes and clinical practice without displacing other important undergraduate learning. The content of the curriculum should be appropriate for the medical student level of training, evidence and expert opinion based, and include ongoing collaborative research and development to ensure optimum educational value and patient care. CONCLUSIONS The international consensus conference has provided the first comprehensive document of recommendations for a basic ultrasound curriculum. The document reflects the opinion of a diverse and representative group of international expert ultrasound practitioners, educators, and learners. These recommendations can standardize undergraduate medical student ultrasound education while serving as a basis for additional research in medical education and the application of ultrasound in clinical practice.
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Affiliation(s)
- Richard A. Hoppmann
- grid.254567.70000 0000 9075 106XInternal Medicine, University of South Carolina School of Medicine, 6311 Garners Ferry Road, Bldg 3, Room 306, Columbia, SC 29209 USA
| | - Jeanette Mladenovic
- grid.414996.70000 0004 5902 8841Foundation for the Advancement of International Medical Education and Research, Philadelphia, USA
| | - Lawrence Melniker
- grid.413734.60000 0000 8499 1112Quality Emergency Department, NewYork-Presbyterian Health System, New York, USA
| | - Radu Badea
- grid.411040.00000 0004 0571 5814Internal Medicine and Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Michael Blaivas
- grid.254567.70000 0000 9075 106XInternal Medicine, University of South Carolina School of Medicine, Columbia, USA
| | - Miguel Montorfano
- grid.414463.00000 0004 0638 1756Ultrasound and Doppler Department, Hospital de Emergencias “Dr. Clemente Alvarez”, Rosario, Argentina
| | - Alfred Abuhamad
- grid.255414.30000 0001 2182 3733Eastern Virginia School of Medicine, Norfolk, USA
| | - Vicki Noble
- grid.443867.a0000 0000 9149 4843Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA
| | - Arif Hussain
- grid.415254.30000 0004 1790 7311Cardiac Critical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Gregor Prosen
- grid.412415.70000 0001 0685 1285Emergency Medicine, University Medical Centre Maribor, Maribor, Slovenia
| | - Tomás Villen
- grid.449795.20000 0001 2193 453XFrancisco de Vitoria University School of Medicine, Madrid, Spain
| | - Gabriele Via
- grid.469433.f0000 0004 0514 7845Department of Cardiac Anesthesia and Intensive Care, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Ramon Nogue
- grid.15043.330000 0001 2163 1432Emergency Medicine, University of Lleida School of Medicine, Lleida, Spain
| | - Craig Goodmurphy
- grid.240473.60000 0004 0543 9901Ultrasound Education, Penn State College of Medicine, Hershey, USA
| | - Marcus Bastos
- Ultrasound Point of Care, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora - SUPREMA, Juiz de Fora, Brazil
| | - G. Stephen Nace
- grid.267301.10000 0004 0386 9246Medical Education and Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Giovanni Volpicelli
- grid.415081.90000 0004 0493 6869Internal Medicine, Emergency Medicine, San Luigi Gonzaga University Hospital, Turin, Italy
| | - Richard J. Wakefield
- grid.9909.90000 0004 1936 8403Rheumatology, University of Leeds, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Steve Wilson
- grid.254567.70000 0000 9075 106XUniversity of South Carolina School of Medicine, Columbia, USA
| | - Anjali Bhagra
- grid.66875.3a0000 0004 0459 167XInternal Medicine, Mayo Clinic, Rochester, USA
| | - Jongyeol Kim
- grid.416992.10000 0001 2179 3554Neurology, School of Medicine Texas Tech University Health Sciences Center, Lubbock, USA
| | - David Bahner
- grid.261331.40000 0001 2285 7943Department of Emergency Medicine, The Ohio State University, Columbus, USA
| | - Chris Fox
- grid.266093.80000 0001 0668 7243Department Emergency Medicine, University of California Irvine, Irvine, USA
| | - Ruth Riley
- grid.254567.70000 0000 9075 106XLibrary Services, University of South Carolina School of Medicine, Columbia, USA
| | - Peter Steinmetz
- grid.14709.3b0000 0004 1936 8649Family Medicine, McGill University, Montreal, Canada
| | - Bret P. Nelson
- grid.59734.3c0000 0001 0670 2351Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - John Pellerito
- grid.512756.20000 0004 0370 4759Radiology and Science Education, Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, USA
| | - Levon N. Nazarian
- grid.265008.90000 0001 2166 5843Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA
| | - L. Britt Wilson
- grid.254567.70000 0000 9075 106XPhysiology, University of South Carolina School of Medicine, Columbia, USA
| | - Irene W. Y. Ma
- grid.22072.350000 0004 1936 7697Medicine, Division of General Internal Medicine, University of Calgary, Calgary, Canada
| | - David Amponsah
- grid.413103.40000 0001 2160 8953Department of Emergency Medicine, Henry Ford Hospital, Detroit, USA
| | - Keith R. Barron
- grid.254567.70000 0000 9075 106XDepartment of Internal Medicine, University of South Carolina School of Medicine, Columbia, USA
| | - Renee K. Dversdal
- grid.5288.70000 0000 9758 5690Internal Medicine, Oregon Health & Science University, Portland, USA
| | - Mike Wagner
- grid.254567.70000 0000 9075 106XMedicine, University of South Carolina School of Medicine-Greenville, Greenville, USA
| | - Anthony J. Dean
- grid.25879.310000 0004 1936 8972Emeritus Department of Emergency Medicine, Perelman University of Pennsylvania School of Medicine, Philadelphia, USA
| | - David Tierney
- grid.413195.b0000 0000 8795 611XInternal Medicine, Abbott Northwestern Hospital, Minneapolis, USA
| | - James W. Tsung
- grid.59734.3c0000 0001 0670 2351Emergency Medicine and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Paula Nocera
- grid.413471.40000 0000 9080 8521Anesthesiologist, Hospital Sírio Libanês, São Paulo, Brazil
| | - José Pazeli
- Nephology and Critical Care, Barbacena’s School of Medicine, Barbacena, Brazil
| | - Rachel Liu
- grid.47100.320000000419368710Emergency Medicine, Yale School of Medicine, New Haven, USA
| | - Susanna Price
- grid.439338.60000 0001 1114 4366Cardiology and Intensive Care, Royal Brompton Hospital, London, England
| | - Luca Neri
- grid.415280.a0000 0004 0402 3867Emergency and Intensive Care Medicine, King Fahad Specialist Hospital Dammam, Ad Dammām, Saudi Arabia
| | - Barbara Piccirillo
- grid.260914.80000 0001 2322 1832New York Institute of Technology, Bellmore, USA
| | - Adi Osman
- Emergency Physician & ED Critical Care, Trauma & Emergency Department, Hospital Raja Permaisuri, Ipoh, Perak Malaysia
| | - Vaughan Lee
- grid.267153.40000 0000 9552 1255Medical Education, University of South Alabama College of Medicine, Mobile, USA
| | - Nitha Naqvi
- grid.420545.20000 0004 0489 3985Royal Brompton Hospital Part of Guy’s and St Thomas’ NHS Foundation Trust, London, England
| | | | - Paul Bornemann
- grid.254567.70000 0000 9075 106XDepartment of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, USA
| | - Maxime Valois
- Medicine, McGill and Sherbrooke Universities, Montreal, Canada
| | | | - Robert Haddad
- grid.254567.70000 0000 9075 106XUltrasound Education - Ultrasound Institute, University of South Carolina School of Medicine, Columbia, USA
| | - Deepak Govil
- grid.429252.a0000 0004 1764 4857Critical Care Medicine, Medanta - The Medicity, Gurgaon, India
| | - Laura A. Hurtado
- grid.7345.50000 0001 0056 1981Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Vi Am Dinh
- grid.411390.e0000 0000 9340 4063Emergency Medicine and Internal Medicine, Loma Linda University Medical Center, Loma Linda, USA
| | - Robert M. DePhilip
- grid.261331.40000 0001 2285 7943Emeritus Biomedical Education and Anatomy, The Ohio State University, Columbus, USA
| | - Beatrice Hoffmann
- grid.38142.3c000000041936754XDepartment of Emergency Medicine, Harvard Medical School, Boston, USA
| | - Resa E. Lewiss
- grid.265008.90000 0001 2166 5843Emergency Medicine and Radiology, Thomas Jefferson University, Philadelphia, USA
| | - Nayana A. Parange
- grid.1026.50000 0000 8994 5086Medical Sonography, University of South Australia Allied Health and Human Performance, Adelaide, Australia
| | - Akira Nishisaki
- grid.25879.310000 0004 1936 8972Anesthesia, Critical Care, and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Stephanie J. Doniger
- Pediatric Emergency Medicine, Children’s Hospital in Orange California, Orange, USA
| | - Paul Dallas
- grid.438526.e0000 0001 0694 4940Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, USA
| | - Kevin Bergman
- grid.266102.10000 0001 2297 6811Family and Community Medicine, University of California - San Francisco, Martinez, USA
| | - J. Oscar Barahona
- grid.423309.f0000 0000 8901 8514Greenwich Ultrasound Services, Greenwich Ultrasound Associates, PC, Greenwich, USA
| | - Ximena Wortsman
- grid.443909.30000 0004 0385 4466Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - R. Stephen Smith
- grid.15276.370000 0004 1936 8091Surgery, University of Florida College of Medicine, Gainesville, USA
| | - Craig A. Sisson
- grid.267309.90000 0001 0629 5880Emergency Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - James Palma
- grid.265436.00000 0001 0421 5525Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, USA
| | | | - Liju Ahmed
- King Faisal Specialist Hospital and Research Center, Madinah, Kingdom of Saudi Arabia
| | - Hassan Mustafa
- grid.21613.370000 0004 1936 9609Internal Medicine, University of Manitoba, Manitoba, Canada
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Kloth C, Schmidt SA, Graeter T, Nikolaou K, Kaufmann S, Beer M, Thaiss WM. Evaluation of an elective ultrasound course for medical students. Clin Anat 2022; 35:354-358. [PMID: 35128729 DOI: 10.1002/ca.23838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/23/2021] [Accepted: 01/21/2022] [Indexed: 01/08/2023]
Abstract
To evaluate the educational benefits of teaching ultrasound in an elective radiological course for medical students. We conducted a single-center retrospective analysis of a one-week elective ultrasound course in which 39 medical students (25 female; median age 25.8 ± 2.8 years, range 21-35, 4th and 5th years of undergraduate medical education) participated as part of their radiological training. The students completed a pre- and post-course questionnaire using a five-point Likert scale for self-assessment of technical knowledge, confidence in the procedure regarding different organs, motivation for performing ultrasound, and the importance of ultrasound in medical education. The students also assessed the value of ultrasound teaching in the context of their general medical degree. Pre-test and post-test scores showed significantly improved radiology knowledge (p ≤ 0.001) concerning all abdominal organs (liver, spleen, gallbladder, kidney, urinary bladder, aorta and retroperitoneum). A significant improvement was registered in performing ultrasound of peripheral arteries and venous structures (each p = 0.001), and also of the thyroid gland (p = 0.006). General surveys at the end of the elective were overwhelmingly positive, with constructive criticism and complimentary comments. Systematic training in ultrasound markedly improved the students' skills. This was especially pronounced for solid organ structures, while students requested more education regarding the retroperitoneum and vascular structures. Teaching ultrasound in an elective hands-on training course improves anatomical understanding and practical skills associated with increased motivation. The results affirm the necessity and clinical relevance of the course during the radiological training of medical students.
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Affiliation(s)
- Christopher Kloth
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany
| | - Stefan Andreas Schmidt
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany
| | - Tilmann Graeter
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany.,Department of Neuroradiology, Vascular and Interventional Radiology, LKH University Clinic, Auenbruggerplatz, 1, 8036 Graz, Austria
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany
| | - Sascha Kaufmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany.,Clinic of Urology, Siloah St. Trudpert Klinikum, Pforzheim, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany
| | - Wolfgang Maximilian Thaiss
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany.,Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany.,Department of Nuclear Medicine, Ulm University Medical Center, Ulm, Germany
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39
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Cantisani V, Jenssen C, Dietrich CF, Ewertsen C, Piscaglia F. Clinical Practice Guidance and Education in Ultrasound: Evidence and experience are two sides of one coin! ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:7-11. [PMID: 35135016 DOI: 10.1055/a-1699-7473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Vito Cantisani
- Radiological and Anatomo-Pathological and Oncological Sciences, Univ. Sapienza, Rome
| | - Christian Jenssen
- Brandenburg Institute for Clinical Ultrasound at Medical University Brandenburg, Neuruppin, Germany and Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg, Germany
| | - Christoph Frank Dietrich
- Department Allgemeine Innere Medizin (DAIM) Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Caroline Ewertsen
- Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Fabio Piscaglia
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
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40
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Rajendram R, Alrasheed AO, Boqaeid AA, Alkharashi FK, Qasim SS, Hussain A. Training medical students in physical examination and point-of-care ultrasound: An assessment of the needs and barriers to acquiring skills in point-of-care ultrasound. J Family Community Med 2022; 29:62-70. [PMID: 35197730 PMCID: PMC8802732 DOI: 10.4103/jfcm.jfcm_369_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/10/2021] [Accepted: 12/18/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND: With growth of the use of point of care ultrasound (PoCUS) around the world, some medical schools have incorporated this skill into their undergraduate curricula. However, because of epidemiology of disease and regional differences in approaches to patient care, global application of PoCUS might not be possible. Before creating a PoCUS teaching course, it is critical to perform a needs analysis and recognize the training obstacles. MATERIALS AND METHODS: A validated online questionnaire was given to final-year medical students at our institution to evaluate their perceptions of the applicability of specific clinical findings, and their own capability to detect these signs clinically and with PoCUS. The skill insufficiency was assessed by deducting the self-reported clinical and ultrasound skill level from the perceived usefulness of each clinical finding. RESULTS: The levels of expertise and knowledge in the 229 students who participated were not up to the expected standard. The applicability of detection of abdominal aortic aneurysm (AAA) (3.9 ± standard deviation [SD] 1.4) was the highest. However, detection of interstitial syndrome (3.0 ± SD 1.1) was perceived as the least applicable. The deficit was highest in the detection of AAA (mean 0.95 ± SD 2.4) and lowest for hepatomegaly (mean 0.57 ± SD 2.3). Although the majority agreed that training of preclinical and clinical medical students would be beneficial, 52 (22.7%) showed no interest, and 60% (n = 136) reported that they did not have the time to develop the skill. CONCLUSION: Although medical students in Saudi Arabia claim that PoCUS is an important skill, there are significant gaps in their skill, indicating the need for PoCUS training. However, a number of obstacles must be overcome in the process.
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Affiliation(s)
- Rajkumar Rajendram
- Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah O Alrasheed
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulaziz A Boqaeid
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Faris K Alkharashi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salman S Qasim
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Arif Hussain
- Department of Cardiac Sciences, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
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41
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Meuwly JY, Mandralis K, Tenisch E, Gullo G, Frossard P, Morend L. Use of an Online Ultrasound Simulator to Teach Basic Psychomotor Skills to Medical Students During the Initial COVID-19 Lockdown: Quality Control Study. JMIR MEDICAL EDUCATION 2021; 7:e31132. [PMID: 34723818 PMCID: PMC8593817 DOI: 10.2196/31132] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/11/2021] [Accepted: 09/27/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Teaching medical ultrasound has increased in popularity in medical schools with hands-on workshops as an essential part of teaching. However, the lockdown due to COVID-19 kept medical schools from conducting these workshops. OBJECTIVE The aim of this paper is to describe an alternative method used by our medical school to allow our students to acquire the essential psychomotor skills to produce ultrasound images. METHODS Our students took online ultrasound courses. Consequently, they had to practice ultrasound exercises on a virtual simulator, using the mouse of their computer to control a simulated transducer. Our team measured the precision reached at the completion of simulation exercises. Before and after completion of the courses and simulator's exercises, students had to complete a questionnaire dedicated to psychomotor skills. A general evaluation questionnaire was also submitted. RESULTS A total of 193 students returned the precourse questionnaire. A total of 184 performed all the simulator exercises and 181 answered the postcourse questionnaire. Of the 180 general evaluation questionnaires that were sent out, 136 (76%) were returned. The average precourse score was 4.23 (SD 2.14). After exercising, the average postcourse score was 6.36 (SD 1.82), with a significant improvement (P<.001). The postcourse score was related to the accuracy with which the simulator exercises were performed (Spearman rho 0.2664; P<.001). Nearly two-thirds (n=84, 62.6%) of the students said they enjoyed working on the simulator. A total of 79 (58.0%) students felt that they had achieved the course's objective of reproducing ultrasound images. Inadequate connection speed had been a problem for 40.2% (n=54) of students. CONCLUSIONS The integration of an online simulator for the practical learning of ultrasound in remote learning situations has allowed for substantial acquisitions in the psychomotor field of ultrasound diagnosis. Despite the absence of workshops, the students were able to learn and practice how to handle an ultrasound probe to reproduce standard images. This study enhances the value of online programs in medical education, even for practical skills.
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Affiliation(s)
- Jean-Yves Meuwly
- Department of Radiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Katerina Mandralis
- Department of Radiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Estelle Tenisch
- Department of Radiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Giuseppe Gullo
- Department of Radiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Pierre Frossard
- Department of Radiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Laura Morend
- Medical Pedagogy Unit, University of Lausanne, Lausanne, Switzerland
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42
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McMenamin L, Brown FE, Arora M, Barnard J, Smith LE, Stockell DJ, Tung P, Wakefield RJ, Weerasinghe A, Wolstenhulme S. Twelve tips for integrating ultrasound guided peripheral intravenous access clinical skills teaching into undergraduate medical education. MEDICAL TEACHER 2021; 43:1010-1018. [PMID: 33161823 DOI: 10.1080/0142159x.2020.1841127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Peripheral Intravenous access (PIV) is a procedure undertaken by Medical Practitioners and Non-Medical Practitioners. Traditional PIV uses a visual and tactile technique to locate blood vessels close to the surface of the skin. Chronic medical conditions, dehydration, obesity and recurrent intravenous access can make PIV challenging. Ultrasound (US) guided PIV is recommended to aid the identification of the arm arteries and veins and improve the success rate of needle placement in difficult cases. Medical and non-medical schools, and hospital organisations, are recognising the importance of US guided PIV education for undergraduate and postgraduate Medical and Non-Medical Practitioners. This to promote independence, efficiency and to improve patient safety. The aim of this 12 tips article is to highlight the considerations and practicalities of integrating and delivering, a practical based skills (PBS) session, on the use of US guided practice as an adjunct in difficult PIV, into the undergraduate medical education curricula.
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Affiliation(s)
- Luke McMenamin
- Department of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Medical Education, University of Leeds, Leeds, UK
| | - Fiona E Brown
- James Cook University Teaching Hospital, South Tees Hospitals NHS Foundation Trust Middlesbrough, UK
| | - Mohit Arora
- Department of Emergency Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - James Barnard
- Leeds Institute of Medical Education, University of Leeds, Leeds, UK
| | - Laura E Smith
- Leeds Institute of Medical Education, University of Leeds, Leeds, UK
| | - David J Stockell
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Patrick Tung
- Department of Emergency Medicine, Dewsbury and District Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Richard J Wakefield
- Department of Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Asoka Weerasinghe
- Department of Emergency Medicine, Dewsbury and District Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
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Naganuma H, Ishida H. One-day seminar for residents for implementing abdominal pocket-sized ultrasound. World J Methodol 2021; 11:208-221. [PMID: 34322370 PMCID: PMC8299907 DOI: 10.5662/wjm.v11.i4.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/10/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023] Open
Abstract
Despite its proven high utility, integration of pocked-sized portable ultrasound (US) into internal medicine residency training remains inconsistent. For 10 years, we have held a 1-d seminar biannually, consisting of lecture (half-day) and hands-on training (half-day) on pocket-sized US of the abdomen and lungs. The lecture consists of training on US physics and clinical applications of pocket-sized US, followed by a lecture covering the basic anatomy of the abdomen and lungs and introducing the systemic scanning method. Given the simple structure of pocket-sized US devices, understanding the basic physics is sufficient yet necessary to operate the pocket-sized US device. It is important to understand the selection of probes, adjustment of B mode gain, adjustment of color gain, and acoustic impedance. Basic comprehension may have a significant positive impact on the overall utilization of pocket-sized US devices. The easiest and most reliable way to observe the whole abdomen and lungs is a combination of transverse, sagittal, and oblique scanning, pursuing the main vascular system from the center to the periphery of the organ in the abdomen and systemic scanning of the pleura. There is usually a marked change in knowledge and attitudes among the program participants, although skill gaps remain among them. We discuss the limitations and problems to this education system as well.
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Affiliation(s)
- Hiroko Naganuma
- Department of Gastroenterology, Yokote Municipal Hospital, Yokote 0138602, Akita, Japan
| | - Hideaki Ishida
- Department of Gastroenterology, Akita Red Cross Hospital, Akita-City 010-1495, Japan
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Medical imaging community outreach program: lesson to students and impact to the community. J Ultrasound 2020; 24:493-498. [PMID: 33236258 DOI: 10.1007/s40477-020-00530-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/09/2020] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND The community outreach program is one of the main activities of the University of Rwanda, and both staff and students get involved in this tremendous initiative to serve the community free of charge. PURPOSE The main objectives of this community engagement activity were to raise awareness of medical imaging services and abdominal ultrasound screening. METHODS The project proposal was planned by the Medical Imaging Department, University of Rwanda College of Medicine and Health Sciences, Remera Campus. It took place at Kigali's main car park. Two ultrasound machines were used, and screening was done by students under supervision of registered sonographers. A cross-sectional design with random sampling was employed, and SPSS version 21 was used for data analysis. Statistical techniques were used to calculate inter-observer reliability by comparing patient complaints and sonographic diagnosis. RESULTS Herein we report the first medical imaging community outreach, on which 86 patients received ultrasound abdominal scans free of charge. Of these, 33 (38.5%) were male and 53 (61.5%) were female. Their ages varied from 20 to 76 years, with a mean age of 48. The screened organs included the liver, gall bladder, pancreas, spleen, kidneys, urinary bladder, prostate, uterus and ovaries, and abnormalities were identified in different organs. The results showed a high degree of reliability between what was presented by the patients and measurements found after diagnosis by the sonographer. The average measure of the intraclass correlation coefficient was 0.973, with 95% confidence intervals ranging from 0.959 to 0.983 (F (85,85) = 37.537, p < 0.001). CONCLUSION This experience was beneficial to the Medical Imaging Sciences Department staff and students, as well as to the Society of Medical Imaging and Radiation in Rwanda. The results showed that this outreach was also very positive for the community at large.
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Welle R, Seufferlein T, Kratzer W. [Current state of under- and postgraduate education in abdominal ultrasonography at German university hospitals. A panel study over 20 years]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2020; 59:225-240. [PMID: 33045754 DOI: 10.1055/a-1246-3519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE In Germany, there is no standardized ultrasound training. This study aims to provide a survey into the current state of abdominal ultrasonography training at German university hospitals as well as a comparative analysis of the results from studies conducted in 1999 and 2009. METHODS Chief gastroenterologists from Germany's 34 university hospitals were invited to respond to a postal survey asking about technical equipment, the number of ultrasound scans, the role of professional societies and undergraduate as well as postgraduate training. The response rate was 79 %. In addition, 1183 medical students from 34 faculties completed a complementary online teaching evaluation. RESULTS At university hospitals, abdominal ultrasonography is conducted in an increasingly interdisciplinary context. Today, 29 % of university hospitals have interdisciplinary ultrasound centers. The study shows that the number of available ultrasound machines has increased - each hospital has an average of 5.2 systems. This is an increase of 30 % in comparison to 2009 and of 27 % in comparison to 1999. However, the willingness to invest in modern ultrasound machines has decreased. The total number of ultrasound scans as well as the number of contrast-enhanced ultrasound scans have steadily increased over the past years - with a maximum increase of 28 % between 2009 and 2018. The German Society of Ultrasound in Medicine (DEGUM) is increasingly present at university hospitals. It has further strengthened its prominent role in quality assurance and specialist training. Today, 96 % of the chief gastroenterologists are members of DEGUM and 89 % have obtained further qualification offered by the society. Concerning the duration of the training, the number of mandatory examinations and the amount of supervision, there are still considerable differences among the departments. On average, more doctors are trained per department and year. A 6-month full-time training has been established at most hospitals. Sonography enjoys a high standing among students and the findings show a strong readiness for work in that field. The number of practical courses and students has been increasing over the past years. However, there is often an imbalance between the number of courses offered and students who want to enroll. CONCLUSIONS Training conditions have improved for medical staff as well as students despite the fact that there are still considerable differences in quality among the hospitals. The number of ultrasound scans is steadily increasing in all departments. The study did not show any adequate improvement in the availability of technical equipment. The German Society of Ultrasound in Medicine (DEGUM) has further strengthened its leading position in the field of sonography.
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Affiliation(s)
- Reinhard Welle
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
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Nausheen F, Young C, Brazil J, Dunagan T, Bhupathy R, Elango S, Crowley J. Confidence Level and Ability of Medical Students to Identify Abdominal Structures After Integrated Ultrasound Sessions. Ultrasound Int Open 2020; 6:E7-E13. [PMID: 32728657 PMCID: PMC7383059 DOI: 10.1055/a-1199-1578] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/10/2020] [Indexed: 01/14/2023] Open
Abstract
Purpose Determine the confidence level and ability of first year medical
students to identify abdominal structures using a wireless portable ultrasound
scanner. Methods The students were assessed for their confidence and ability to
perform abdominal ultrasound. The 5-point Likert survey included questions on
their perception about ultrasound as a resource for learning anatomy, physical
examination skills, and the quality of the pre-session instructions. Data was
also recorded by the faculty about the students’ ultrasound skills and
confidence. Goodman and Kruskal's gamma was used to demonstrate an
association between the students’ ability to identify the structures and
the self-reported student confidence level. Results Most of the students had confidence and were able to identify the
liver, kidney, and urinary bladder, while almost half of them needed faculty
help them to identify the inferior vena cava and aorta. The spleen and gall
bladder were the most difficult to locate even for the very confident students.
The perception of supervising faculty was that the confidence level was low in
most of the students and only 13–20% of students felt
“very confident” about performing ultrasound. Almost 37%
needed encouragement and support and almost 10% of the students were not
willing to try to locate difficult organs. Some students started locating the
ureteric jet and portal vein. Most of the students agreed that ultrasound is an
excellent resource for learning anatomy and physical examination skills. All
students suggested having more ultrasound sessions. Conclusion Most of the students feel confident about performing
ultrasound and they perceive that ultrasound can enhance their basic sciences
and physical examination skills.
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Affiliation(s)
- Fauzia Nausheen
- Medical Education, California University of Science and Medicine, San Bernardino, United States
| | - Corey Young
- Medical Education, California University of Science and Medicine, San Bernardino, United States
| | - John Brazil
- Medical Education, California University of Science and Medicine, San Bernardino, United States
| | - Timothy Dunagan
- Medical Education, California University of Science and Medicine, San Bernardino, United States
| | - Renu Bhupathy
- Medical Education, California University of Science and Medicine, San Bernardino, United States
| | - Sambandam Elango
- Medical Education, California University of Science and Medicine, San Bernardino, United States
| | - Jason Crowley
- Medical Education, California University of Science and Medicine, San Bernardino, United States
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Ma IWY, Steinmetz P, Weerdenburg K, Woo MY, Olszynski P, Heslop CL, Miller S, Sheppard G, Daniels V, Desy J, Valois M, Devine L, Curtis H, Romano MJ, Martel P, Jelic T, Topping C, Thompson D, Power B, Profetto J, Tonseth P. The Canadian Medical Student Ultrasound Curriculum: A Statement From the Canadian Ultrasound Consensus for Undergraduate Medical Education Group. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1279-1287. [PMID: 31943311 PMCID: PMC7317450 DOI: 10.1002/jum.15218] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 05/03/2023]
Abstract
OBJECTIVES This study sought to establish by expert review a consensus-based, focused ultrasound curriculum, consisting of a foundational set of focused ultrasound skills that all Canadian medical students would be expected to attain at the end of the medical school program. METHODS An expert panel of 21 point-of-care ultrasound and educational leaders representing 15 of 17 (88%) Canadian medical schools was formed and participated in a modified Delphi consensus method. Experts anonymously rated 195 curricular elements on their appropriateness to include in a medical school curriculum using a 5-point Likert scale. The group defined consensus as 70% or more experts agreeing to include or exclude an element. We determined a priori that no more than 3 rounds of voting would be performed. RESULTS Of the 195 curricular elements considered in the first round of voting, the group reached consensus to include 78 and exclude 24. In the second round, consensus was reached to include 4 and exclude 63 elements. In our final round, with 1 additional item added to the survey, the group reached consensus to include an additional 3 and exclude 8 elements. A total of 85 curricular elements reached consensus to be included, with 95 to be excluded. Sixteen elements did not reach consensus to be included or excluded. CONCLUSIONS By expert opinion-based consensus, the Canadian Ultrasound Consensus for Undergraduate Medical Education Group recommends that 85 curricular elements be considered for inclusion for teaching in the Canadian medical school focused ultrasound curricula.
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Affiliation(s)
- Irene W. Y. Ma
- Division of General Internal MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Peter Steinmetz
- Department of Family MedicineMcGill UniversityMontrealQuebecCanada
| | - Kirstin Weerdenburg
- Department of Pediatric Emergency MedicineIWK Health Center and Dalhousie UniversityHalifaxNova ScotiaCanada
| | - Michael Y. Woo
- Department of Emergency MedicineUniversity of Ottawa and Ottawa Hospital Research InstituteOttawaOntarioCanada
| | - Paul Olszynski
- Department of Emergency MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - Claire L. Heslop
- Division of Emergency Medicine, Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Stephen Miller
- Department of Emergency Medicine, Skilled Clinician Program, Undergraduate Medical EducationDalhousie UniversityHalifaxNova ScotiaCanada
| | - Gillian Sheppard
- Department of Emergency MedicineMemorial University of NewfoundlandSt John'sNewfoundlandCanada
| | - Vijay Daniels
- Division of General Internal MedicineUniversity of AlbertaEdmontonAlbertaCanada
| | - Janeve Desy
- Division of General Internal MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Maxime Valois
- Department of Emergency MedicineMcGill UniversityMontrealQuebecCanada
- Department of Emergency MedicineSherbrooke UniversitySherbrookeQuebecCanada
| | - Luke Devine
- Division of General Internal MedicineUniversity of TorontoTorontoOntarioCanada
| | - Heather Curtis
- Department of Diagnostic ImagingDalhousie UniversityHalifaxNova ScotiaCanada
| | - Michael J. Romano
- Division of Emergency Medicine, Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Patrick Martel
- Department of Emergency Medicine, Thunder Bay Regional Health Sciences CenterNorth Ontario School of MedicineThunder BayOntarioCanada
| | - Tomislav Jelic
- Department of Emergency MedicineUniversity of ManitobaWinnipegManitobaCanada
| | - Claude Topping
- Departments of Family Medicine and Emergency MedicineLaval University, QuebecQuebecCanada
| | - Drew Thompson
- Department of Emergency MedicineWestern UniversityLondonOntarioCanada
| | - Barbara Power
- Department of Medicine, EducationUniversity of OttawaOttawaOntarioCanada
| | - Jason Profetto
- Department of Family MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Pete Tonseth
- Department of RadiologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
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Prosch H, Radzina M, Dietrich CF, Nielsen MB, Baumann S, Ewertsen C, Jenssen C, Kabaalioğlu A, Kosiak W, Kratzer W, Lim A, Popescu A, Mitkov V, Schiavone C, Wohlin M, Wüstner M, Cantisani V. Ultrasound Curricula of Student Education in Europe: Summary of the Experience. Ultrasound Int Open 2020; 6:E25-E33. [PMID: 32885138 PMCID: PMC7458842 DOI: 10.1055/a-1183-3009] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/13/2020] [Indexed: 12/13/2022] Open
Abstract
Background Despite the increasing role of ultrasound, structured ultrasound teaching is only slowly being integrated into the curricula of medical schools and universities all over Europe. Aim To survey the current situation at European universities regarding the integration of ultrasound in student medical education and to report on models of student ultrasound training from selected European universities. Methods A questionnaire survey focusing on the implementation of curricular ultrasound education was sent out to the 28 presidents of the national ultrasound societies of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), who were asked to distribute the questionnaires to the medical universities of their countries. Results Overall, 53 questionnaires were returned from 46 universities in 17 European countries. In most of the universities (40/46 universities, 87%), the theoretical background of ultrasound is taught. However, in only a minority of universities is ultrasound integrated in anatomy courses (8/46 universities, 17%) or basic science courses (16/46 universities, 35%). Practical skills in ultrasound are taught in 56% of the universities (26/46 universities) and tested in a practical exam in seven of the responding universities (15%). The number of hours in which ultrasound was taught ranged from one to 58 (mean, seven). The respondents reported that lack of time and limited faculty funding were major hurdles. Conclusion According to our survey, only a minority of European universities has integrated ultrasound into the preclinical curriculum thus far. Future EFSUMB initiatives will continue to promote the introduction of ultrasound as an integrative part of the core curriculum of student medical education, and the preparation of proper teaching material.
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Affiliation(s)
- Helmut Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical
University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Maija Radzina
- Riga Stradins University, Radiology department, Riga,
Latvia
- University of Latvia, Medical Faculty, Paula Stradina clinical
university hospital, Diagnostic Radiology Institute Riga, Latvia
| | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site,
Salem und Permanence, Bern, Switzerland
| | - Michael Bachmann Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen,
Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen,
Denmark
| | - Sven Baumann
- Department of Internal Medicine I, Ulm University Hospital, Ulm,
Germany
| | | | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch-Oderland,
Strausberg, and Brandenburg Institute for Clinical Ultrasound, Neuruppin,
Germany
| | | | - Wojciech Kosiak
- Department of Paediatrics, Haematology and Oncology, Medical University
of Gdansk, Poland
| | - Wolfgang Kratzer
- Department of Internal Medicine I, Ulm University Hospital, Ulm,
Germany
| | - Adrian Lim
- Department of Imaging, Imperial College London and Healthcare Trust,
UK
| | - Alina Popescu
- Department of Gastroenterology, "Victor Babeș"
University of Medicine and Pharmacy Timișoara, Timișoara, Romania
| | - Vladimir Mitkov
- Diagnostic Ultrasound Department, Russian Medical Academy of Continuous
Professional Education, Moscow, Russian Federation)
| | - Cosima Schiavone
- Unit of Internistic Ultrasound, Department of Medicine and Science of
Aging, „G. d’Annunzio“ University, Chieti,
Italy
| | - Martin Wohlin
- Department of Medical Sciences, Uppsala Universitet, Uppsala,
Sweden
| | - Matthias Wüstner
- Central Interdisciplinary Sonography, Krankenhaus der Barmherzigen
Brüder Trier, Germany
| | - Vito Cantisani
- Department of Radiological, Oncologic and Anatomo-pathologic Sciences,
University of Rome La Sapienza, Roma, Italy
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Leidi A, Rouyer F, Marti C, Reny JL, Grosgurin O. Point of care ultrasonography from the emergency department to the internal medicine ward: current trends and perspectives. Intern Emerg Med 2020; 15:395-408. [PMID: 32034674 DOI: 10.1007/s11739-020-02284-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/22/2020] [Indexed: 12/20/2022]
Abstract
The advent of portable devices in the early 80s has brought ultrasonography to the patient's bedside. Currently referred to as 'point of care ultrasonography' (POCUS), it has become an essential tool for clinicians. Initially developed in the emergency and critical care settings, POCUS has gained increasing importance in internal medicine wards in the last decade, with both its growing diagnostic accuracy and portability making POCUS an optimal instrument for everyday clinical assessment and procedures. There is large body of evidence to confirm POCUS' superiority when compared to clinical examination and standard X-ray imaging in a variety of clinical situations. On the contrary, only few indications, such as procedural guidance, have a proven additional benefit for patients. Since POCUS is highly user-dependent, pre- and post-graduate curricula are needed and the range of use should be clearly defined. This review focuses on trends and perspectives of POCUS in the management of diseases frequently encountered in emergency and internal medicine. In addition, questions are raised regarding the teaching and supervision of POCUS needing to be addressed in the near future.
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Affiliation(s)
- Antonio Leidi
- General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Frédéric Rouyer
- Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Marti
- General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Luc Reny
- General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Olivier Grosgurin
- General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.
- Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
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Ticinesi A, Lauretani F, Nouvenne A, Ungar A, Incalzi RA, Scarlata S. Chest ultrasound in Italian geriatric wards: use, applications and clinicians’ attitudes. JOURNAL OF GERONTOLOGY AND GERIATRICS 2020. [DOI: 10.36150/2499-6564-337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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