Effectiveness of Ultrasound Cardiovascular Images in Teaching Anatomy: A Pilot Study of an Eight-Hour Training Exposure (original) (raw)
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Ultrasound and cadavers are both recognized teaching modalities for the delivery of cardiac anatomy to undergraduate medical students. This study considers the additive effect of the two teaching modalities. We previously reported no significant difference in cardiac anatomy knowledge when taught using either ultrasound echocardiography or cadaveric prosections, both modalities significantly increasing knowledge from baseline. This study considers the cross-over effect with the ultrasound group receiving anatomy teaching with cadavers and vice versa. The results of this study show a small increase in knowledge after experiencing two modalities, but this increase was not significant. Furthermore, the order in which students received their tuition also made no significant difference. These data suggests there is no additive effect of combining cadaveric prosections with ultrasound. This has implications for curriculum design. However, these findings do not consider the hidden learning and learning experiences students will receive by two vastly different teaching modalities.
Journal of the American Society of Echocardiography, 2014
Background: Handheld ultrasound is emerging as an important tool for point-of-care cardiac assessment. Although cardiac ultrasound skills are traditionally introduced during postgraduate training, the optimal time and methodology to initiate training in focused cardiac ultrasound (FCU) are unknown. The objective of this study was to develop and evaluate a novel curriculum for training medical students in the use of FCU. Methods: The study was conducted in two phases. In the first phase, 12 first-year medical students underwent FCU training over an 8-week period. In the second phase, 45 third-year medical students were randomized to one of three educational programs. Program 1 consisted of a lecture-based approach with scan training by a sonographer. Program 2 coupled electronic education modules with sonographer scan training. Program 3 was fully self-directed, combining electronic modules with scan training on a high-fidelity ultrasound simulator. Image interpretation skills and scanning technique were evaluated after each program. Results: First-year medical students were able to modestly improve interpretation ability and acquire limited scanning skills. Third-year medical students exhibited similar improvement in mean examination score for image interpretation whether a lecture-based program or electronic modules was used. Students in the selfdirected group using an ultrasound simulator had significantly lower mean quality scores than students taught by sonographers. Conclusions: Third-year medical students were able to acquire FCU image acquisition and interpretation skills after a novel training program. Self-directed electronic modules are effective for teaching introductory FCU interpretation skills, while expert-guided training is important for developing scanning technique.
The Utility of Cardiac Ultrasound in Preclinical Medical School Curriculum
Medical science educator, 2016
Objective This study aims to explore the utility of cardiac ultrasound on medical students' understanding of cardiac anatomy and physiology. Methods First-year medical students were enrolled and randomized into control and educational groups. Prior to and upon completion of their cardiac unit, both groups completed a 20-question test. The educational group received two sessions, consisting of lectures and hands-on scanning. The educational group obtained a parasternal long axis view of the heart and identified the left ventricle and completed a survey on their experience. Results Fifty-four first-year medical students were enrolled, with 27 randomized to each group. On the pretest, the educational and control groups averaged 10.9 (SD 2.4) and 10.0 (SD 2.7) questions correct (p = 0.19), respectively. Scores on the post-test in the educational group improved to 17.4 (SD 1.6) as compared to 15.2 (SD 2.0) (p < 0.001) in the control. All students in the educational group were able to obtain a parasternal long axis view and identify the left ventricle. On the survey, all students described ultrasound as a valuable tool and recommended integration into their curriculum. Ninety-five percent felt that ultrasound improved their knowledge of cardiac anatomy, and 86 % agreed it increased their understanding of cardiac physiology. Conclusions Introduction of ultrasound into medical school curriculum is effective. This educational intervention improved students' understanding of cardiac anatomy and physiology and was effective in improving their acquisition of basic cardiac ultrasound images. Furthermore, the students felt ultrasound to be an important skill for them to learn to improve their understanding of anatomy and physiology.
BMC Medical Education
Background: Teaching cardiac ultrasound to medical students in a brief course is a challenge. We aimed to evaluate the feasibility of teaching large groups of medical students the acquisition and interpretation of cardiac ultrasound images using a pocket ultrasound device (PUD) in a short, specially designed course. Methods: Thirty-one medical students in their first clinical year participated in the study. All were novices in the use of cardiac ultrasound. The training consisted of 4 hours of frontal lectures and 4 hours of hands-on training. Students were encouraged to use PUD for individual practice. Finally, the students' proficiency in the acquisition of ultrasound images and their ability to recognize normal and pathological states were evaluated.
Anatomical Sciences Education, 2018
Medical students have difficulties in interpreting two-dimensional (2D) topographic anatomy on sectional images. Hands-on and no hands-on training in ultrasound imaging facilitate learning topographic anatomy. Hands-on training is linked with active search for patterns of anatomical structures and might train pattern recognition for image interpretation better although the added value on learning outcomes is unclear. This study explores first year medical students' knowledge in topographic anatomy of the upper abdomen after attending hands-on or no hands-on training in ultrasound in a randomized trial. While students in the hands-on ultrasound group (N 5 21) generated and interpreted standardized planes of ultrasound imaging, students in the no hands-on seminar group (N 5 22) interpreted provided ultrasound images by correlation to threedimensional (3D) anatomical prosections. Afterwards knowledge in topographic anatomy was measured repetitively by text and ultrasound image-based multiple choice (MC) examinations. As surrogate for pattern recognition, students rated whether answers were known after reflection or instantly. While intrinsic motivation was higher in the ultrasound group, no differences in the MC-examination score were found between ultrasound and seminar group instantly (66.5 610.9% vs. 64.5% 611.0%, P 5 0.551) or six weeks (62.9% 612.3% vs. 61.5% 611.0%, P 5 0.718) after training. In both groups scores in text-based questions declined (P < 0.001) while scores in image-based questions remained stable (P 5 0.895) with time. After six weeks more image-based questions were instantly known in the hands-on ultrasound compared to seminar-group (28% 617.3% vs. 16% 613.5%, P 5 0.047). Hands-on ultrasound-training is linked with faster interpreting of ultrasound images without loss in accuracy. The added value of hands-on training might be facilitation of pattern recognition.
The Role of Ultrasound in teaching Clinical Anatomy to First year Medical Students
Introduction: Undergraduate medical education training has recently shifted towards making content relevant and applicable for future clinical practice. However, students often encounter difficulties in visualizing the functional living human and apply clinically relevant anatomy content. Hence, the aim of this study is to evaluate the role and efficacy of ultrasound in teaching clinical anatomy to first year medical students. Methods: 300 Year 1 students took part in the practical sessions either using ultrasound mannequins or volunteer. All students were given a specially designed pre-test and post-test using Katz’s Percentage to assess their level of ultrasound knowledge. A feedback survey was sought from the students and anatomists after the programme. Results: The results were analyzed based on the 100 students who have taken both pre- and post-tests. The study showed that there was statistical significant difference on normal US images of abdominal organs knowledge before and after the intervention. About 98% of students would like the continuation of this programme into the clinical years. Tutor’s perception survey also revealed positive results particularly the interdepartmental collaboration. Conclusion: An ultrasound programme was successfully implemented to complement and enhance the conceptualizing of normal gross anatomy with clinical anatomy for first year medical students. Keywords: Anatomy, Medical Education Research, Ultrasound, Radiology
A Bedside Ultrasound Curriculum for Medical Students: Prospective Evaluation of Skill Acquisition
Teaching and Learning in Medicine, 2007
We conducted a study to evaluate the efficacy of an introductory ultrasound (US) curriculum for medical students rotating through our emergency department. Materials and Methods: Third-and 4th-year medical students indicated their previous US experience and were given a pretest consisting of static US images to assess baseline interpretation skills. They participated in a 45-min interactive didactic session followed by a 45-min session of hands-on experience practicing real-time US image acquisition on a normal model. After this session, we tested the timing and quality of their image acquisition skills on a separate normal model. Quality of images was based on a point value from 0 to 2 per image. This was followed by a posttest of static US images, which was graded in the same manner as the pretest. Results: Thirty-one students participated in the study. Median time to acquire 2 images was 112.5 sec (range = 15-420 sec). Acquisition time was unaffected by previous experience (p = .97). The mean score on the quality of 2 images (maximum score = 4) was 3.84; median was 4 (range = 1-4). Image quality was significantly better in participants with previous US experience (p = .014). Scores on interpretation of static images improved significantly from pretest to posttest by a median of 8.25 points (p = .0001). Conclusion: Our introductory US course is effective at significantly improving medical students' interpretation of static US images. The majority of students were able to acquire high quality images in a short period of time after this session.
Journal of Critical Care, 2019
Focused cardiac ultrasound (FCU) training in critical care is restricted by availability of instructors. Supervised training may be substituted by self-directed learning with an ultrasound simulator guided by automated electronic learning, enabling scalability. Materials and methods: We prospectively compared learning outcomes in novice critical care physicians after completion of a supervised one-and-a-half-day workshop model with a self-guided course utilizing a simulator over four weeks. Both groups had identical pre-workshop on-line learning (20h). Image quality scores were compared using FCU performed on humans without pathology. Interpretive knowledge was compared using 20MCQ tests. Results: Of 161 eligible, 145 participants consented. Total Image quality scores were higher in the Simulator group (95.2% vs. 66.0%, P b .001) and also higher for each view (all P b .001). Interpretive knowledge was not different before (78.6% vs. 79.0%) and after practical training (74.7% vs. 76.1%) and at 3 months (81.0% vs. 77.0%, all P N .1). Including purchase of the simulator and ultrasound equipment, the simulator course required lower direct costs (AUD$796 vs. $1724 per participant) and instructor time (0.5 vs.1.5 days) but similar participant time (2.8 vs. 3.0 days). Conclusions: Self-directed learning with ultrasound simulators may be a scalable alternative to conventional supervised teaching with human models.
Self-learning of point-of-care cardiac ultrasound – Can medical students teach themselves?
PLOS ONE
Background Point-of-care ultrasonography (PoCUS) is a rapidly evolving discipline that aims to train non-cardiologists, non-radiologists clinicians in performing bedside ultrasound to guide clinical decision. Training of PoCUS is challenging, time-consuming and requires large amount of resources. The objective of our study was to evaluate if this training process can be simplified by allowing medical students self-train themselves with a web-based cardiac ultrasound software. Methods A prospective, single blinded, cohort study, comparing performance of 29 medical students in performing a six-minutes cardiac ultrasound exam. Students were divided into two groups: self-learning group, using a combination of E-learning software and self-practice using pocket ultrasound device compared to formal, frontal cardiac ultrasound course. Results All 29 students completed their designated courses and performed the six-minutes exam: 20 students participated in the frontal cardiac ultrasound course and 9 completed the selflearning course. The median (Q1,Q3) test score for the self-learning group was higher than the frontal course group score, 18 (15,19) versus 15 (12,19.5), respectively. Nevertheless, no statistically significant difference was found between the two study groups (p = 0.478). All students in the self-learning course group (9/9, 100%) and 16 (16/20, 80%) of students in the frontal ultrasound course group obtained correct alignment of the parasternal long axis view (p = 0.280).
The ultrasound challenge: A novel approach to medical student ultrasound education
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine
A Novel Approach to Medical Student Ultrasound Education he development of focused bedside ultrasound has provided a means for nontraditional imaging specialists to answer clinical questions. Focused ultrasound is considered the standard of care in many areas of medicine, including central venous cannulation 1 and trauma resuscitation. 2 Furthermore, ultrasound is becoming more popular in critical care fields to evaluate for global cardiac function, volume responsiveness, and abdominal aortic aneurysm screening and to answer a number of other clinical questions. The importance of ultrasound education in medical school training cannot be overstated. Many programs have developed methods to integrate ultrasound into medical education. 4-6 Medical school graduates are increasingly expected to demonstrate proficiency using ultrasound during residency. As a result, many believe that medical schools have a duty to provide an adequate level of ultrasound education to their students.