Pilot Point-of-Care Ultrasound Curriculum at Harvard Medical School: Early Experience

Joshua S Rempell, Fidencio Saldana, Donald DiSalvo, Navin Kumar, Michael B Stone, Wilma Chan, Jennifer Luz, Vicki E Noble, Andrew Liteplo, Heidi Kimberly, Minna J Kohler, Joshua S Rempell, Fidencio Saldana, Donald DiSalvo, Navin Kumar, Michael B Stone, Wilma Chan, Jennifer Luz, Vicki E Noble, Andrew Liteplo, Heidi Kimberly, Minna J Kohler

Abstract

Introduction: Point-of-care ultrasound (POCUS) is expanding across all medical specialties. As the benefits of US technology are becoming apparent, efforts to integrate US into pre-clinical medical education are growing. Our objective was to describe our process of integrating POCUS as an educational tool into the medical school curriculum and how such efforts are perceived by students.

Methods: This was a pilot study to introduce ultrasonography into the Harvard Medical School curriculum to first- and second-year medical students. Didactic and hands-on sessions were introduced to first-year students during gross anatomy and to second-year students in the physical exam course. Student-perceived attitudes, understanding, and knowledge of US, and its applications to learning the physical exam, were measured by a post-assessment survey.

Results: All first-year anatomy students (n=176) participated in small group hands-on US sessions. In the second-year physical diagnosis course, 38 students participated in four sessions. All students (91%) agreed or strongly agreed that additional US teaching should be incorporated throughout the four-year medical school curriculum.

Conclusion: POCUS can effectively be integrated into the existing medical school curriculum by using didactic and small group hands-on sessions. Medical students perceived US training as valuable in understanding human anatomy and in learning physical exam skills. This innovative program demonstrates US as an additional learning modality. Future goals include expanding on this work to incorporate US education into all four years of medical school.

Conflict of interest statement

By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none

Figures

Figure
Figure
Assessment of students’ ability to identify basic structures in right upper quadrant. Liver marked with circle, kidney with stars, and diaphragm with arrows.

References

    1. Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011;364:749–57.
    1. Solomon SD, Saldana F. Point-f-care ultrasound in medical education – stop listening and look. N Engl J Med. 2014;370:1083–5.
    1. Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Emergency Medicine.
    1. Bahner DP, Royall NA. Advanced ultrasound training for fourth-year medical students: A novel training program at The Ohio State University College of Medicine. Acad Med. 2013;88:206–212.
    1. Gogalniceanu P, Sheena Y, Kashef E, et al. Is basic emergency ultrasound training feasible as part of standard undergraduate medical education? J Surg Educ. 2010;67:152–6.
    1. Syperda VA, Trivedi PN, Melo LC, et al. Ultrasonography in preclinical education: A pilot study. J Am Osteopath Assoc. 2008;108:601–5.
    1. Shapiro RS, Ko PK, Jacobson S. A pilot project to study the use of ultrasonography for teaching physical examination to medical students. Comput Biol Med. 2002;32:403–9.
    1. Decara JM, Kirkpatrick JN, Spencer KT, et al. Use of hand-carried ultrasound devises to augment the accuracy of medical student bedside cardiac diagnoses. J Am Soc Echocardiogr. 2005;18:257–63.
    1. Tshibwabwa ET, Groves HM. Integration of ultrasound in the education programme in anatomy. Med Educ. 2005;39:1148.
    1. Afonso N, Amponsah D, Yang J, et al. Adding new tools to the black bag- Introduction of ultrasound into the physical diagnosis course. J Gen Intern Med. 2010;25:1248–52.
    1. Hoppmann RA, Rao VV, Poston MB, et al. An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience. Crit Ultrasound J. 2011;3:1–12.
    1. Arger PH, Schultz SM, Sehgal CM, et al. Teaching medical students diagnostic sonography. J Ultrasound Med. 2005;24:1365–9.
    1. Kessler C, Bhandarkar S. Ultrasound training for medical students and internal medicine residents- a needs assessment. J Clin Ultrasound. 2010;38:401–8.
    1. Yoo MC, Villegas L, Jones DB. Basic ultrasound curriculum for medical students: validation of content and phantom. J Laparoendosc Adv Surg Tech A. 2004;14:374–9.
    1. Angtuaco TL, Hopkins RH, DuBose TJ, et al. Sonographic physical diagnosis 101: teaching senior medical students basic ultrasound scanning skills using a compact ultrasound system. Ultrasound Q. 2007;23:157–60.
    1. Dinh VA, Frederick J, et al. Effects of Ultrasound Implementation on Physical Examination Learning and Teaching During the First Year of Medical Education. J Ultrasound Med. 2015;34:43–50.
    1. Bahner DP, Goldman E, Way D, et al. The state of ultrasound education in U.S. medical schools: results of a national survey. Acad Med. 2014;89:181–6.
    1. Rao S, van Holsbeeck L, Musial JL, et al. A pilot study of comprehensive ultrasound education at the Wayne State University School of Medicine: A pioneer year review. J Ultrasound Med. 2008;27:745–9.
    1. Hoppmann RA, Rao VV, Poston MB, et al. An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience. Crit Ultrasound J. 2011;3:1–12.
    1. Bahner DP, Adkins EJ, Hughes D, et al. Integrated medical school ultrasound: development of an ultrasound vertical curriculum. Crit Ultrasound J. 2013;5:6.
    1. Barloon TJ, Brown BP, Abu-Youssef MM, et al. Teaching physical examination of the adult liver with use of real-time sonography. Acad Radiol. 1998;5:101.
    1. Butter J, Grant TH, Egan M, et al. Does ultrasound training boost year I medical student competence and confidence when learning abdominal examination? Med Educ. 2007;41:843–8.
    1. Kobal SL, Trento L, Baharami S, et al. Comparison of effectiveness of hand-carried ultrasound to bedside cardiovascular physical examination. Am J Cardiol. 2005;96:1002–6.
    1. Shmueli H, Burtein Y, Sagy I, et al. Briefly trained medical students can effectively identify rheumatic mitral valve injury using a hand-carried ultrasound. Echocardiography. 2013;30:621–6.
    1. Dinh VA, Frederick J, et al. Effects of Ultrasound Implementation on Physical Examination Learning and Teaching During the First Year of Medical Education. J Ultrasound Med. 2015;34:43–50.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera