Skills acquisition for novice learners after a point-of-care ultrasound course: does clinical rank matter? (original) (raw)
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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.
Faculty Development in Proficiency and Application of Point-Of-Care Ultrasound
2022
Objective: To increase proficiency and comfort level with ultrasound skills, apply ultrasound skills to different clinical settings such as outpatient and inpatient, and address barriers to learning and improving ultrasound skills. Design: We created a point-of-care ultrasound (POCUS) pilot program at a small academic center to assess faculty members' knowledge and perception of ultrasound in surgical settings. We conducted an observational cross-sectional study to test the hypothesis and hypothesized that members would have increased confidence in their proficiency. Participants attended a 2-hour session with expert faculty. During this session, participants took a pre-test assessment survey, attended a one-hour didactic lecture and a hands-on workshop with an ultrasound simulation machine and live standardized patient, and then took a post-test assessment survey. If desired, faculty were allowed to return for further selfdirected learning with an ultrasound simulation machine after the pilot program. Results: There was a statistically significant difference in pre-and post-survey questions that addressed comfort using ultrasound in a clinical setting and critical care setting, comfort in using ultrasound at bedside rounds, comfort in teaching medical students and residents, comfort performing FAST (Focused Abdominal Sonogram for Trauma) exam and comfort in doing basic bedside echocardiography. Faculty indicated time, availability of ultrasound equipment to faculty and house staff, and cost of equipment as important barriers to utilization of ultrasound in the clinical set. Conclusions: Our pilot POCUS course showed improved confidence in ultrasound skills among faculty members. It is important to address barriers such as limited equipment availability and adequate preparation time for future POCUS curriculums.
Piloting a Graduate Medical Education Point-of-Care Ultrasound Curriculum
Cureus
As point-of-care ultrasound (POCUS) use grows, training in graduate medical education (GME) is increasingly needed. We piloted a multispecialty GME POCUS curriculum and assessed feasibility, knowledge, and comfort with performing POCUS exams. Methods Residents were selected from the following residency programs: internal medicine, family medicine, emergency medicine, and a combined internal medicine/pediatrics program. Didactics occurred through an online curriculum that consisted of five modules: physics and machine operation, cardiac, lung, soft tissue, and extended focused sonography in trauma applications. Residents completed a pre-and post-curriculum questionnaire, as well as knowledge assessments before and after each module. One-hour hands-on training sessions were held for each module. Differences between pre-and post-participation questionnaire responses were analyzed using the Wilcoxon rank sum. Results Of the 24 residents selected, 21 (86%) were postgraduate year two or three, and 16 (65%) were from the internal medicine program. Eighteen (67%) residents reported limited prior POCUS experience. All pre-to post-knowledge assessment scores increased (p<0.05). Statistically significant increases pre-to postcurriculum were found for frequency of POCUS use (p = 0.003), comfort in using POCUS for assessing for abdominal aortic aneurysm, soft tissue abscess detection, undifferentiated hypotension and dyspnea, cardiac arrest and heart failure (p<0.025); and competency in machine use, acquiring and interpreting images and incorporating POCUS into clinical practice (p<0.001). All participants felt the skills learned during this curriculum were essential to their future practice. Conclusions In this pilot, we found using a combination of online and hands-on training to be feasible, with improvement in residents' knowledge, comfort, and use of POCUS.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2015
The benefit of formal ultrasound implementation in undergraduate medical education remains unclear. The goal of this study was to evaluate the effectiveness of ultrasound curriculum implementation during year 1 medical student physical examination teaching on the ultrasound proficiency of medical students. An ultrasound curriculum was formally implemented at our institution in August 2012 and since then has successfully trained 2 classes of medical students (year 1 and year 2). Year 3 and year 4 medical students did not receive any formal ultrasound training, as the curriculum had not yet been implemented during their preclinical years. With the use of a 22-point ultrasound objective structured clinical examination (US-OSCE), trained medical students were compared to untrained medical students. The US-OSCE tested image acquisition and interpretation of the following systems: ocular, neck, vascular, pulmonary, cardiovascular, and abdominal. Emergency medicine (EM) residents formally ...
Benefits of a dedicated ultrasound education for medical students: A 3 year experience
MedEdPublish, 2019
Objective An accelerated ultrasound education curriculum was designed specifically for second-year medical students. Our goal was to effectively measure this teaching methodology and to assess the practicality of this concept. Materials and Methods After analyzing the existing ultrasound training for medical students, improvements were made to the existing curriculum for 2nd-year students that addressed the drawbacks in ultrasound education, including instrumentation, anatomy, and ultrasound-guided procedures. Prior to exposure to ultrasound education, all students participated in an anonymous quiz to determine and document their baseline knowledge. The ultrasound immersion week included; hands-on education and lectures. Students were divided into small groups with radiologists supervising ultrasound skills on standardized patients and intervention using phantom models. After the week-long exposure to radiology and ultrasound, students took a post-exposure assessment to evaluate their knowledge. Efficacy of the program was determined by comparing pre and post-exposure test results. Results Students from Cohort A and B had a 19% improvement, and Cohort C had a 39% improvement. Pre and Post immersion quiz analysis were validated with statistical testing with a p-value <0.01. A thorough analysis of all three years showed significant improvement among medical students. Conclusion The study proved that short, accelerated ultrasound education programs are effective in educating second-year medical students. By the standardized questionnaire, it also demonstrated that there is a significant impact in ultrasound knowledge among students through a week of focused education. Using homemade phantoms promoted
Brief report of a novel advanced practice provider–led course for ultrasound novices
Journal of the American Association of Nurse Practitioners, 2018
Background and purpose: Formal training for ultrasound use is essential for critical care providers. Despite a national increase in the utilization of advanced practice providers in critical care, ultrasound education is not routinely provided in their training programs. This study describes and evaluates a 1-day advanced care provider (APP)-led course designed to provide fellow APPs with the skills to obtain and evaluate basic ultrasound images. Methods: A 15-question pretest was administered via anonymous use of a clicker response system. Participants had didactic lectures followed by hands-on experience with live models and instructor. Posttest was administered after achievement of basic ultrasound views. Postcourse evaluations were also administered. Conclusions: Pretest and posttest questions included identifying anatomy, pathology, quantifying cardiac function, and clinical decision making. Scores improved from 58% on the pretest to 78% on the posttest. All participants acknowledged the need for the course and their ability to transfer the course into practice. Implications for practice: This course established that APPs can both teach and learn from their peers in a formal setting. In addition, this course demonstrated that an APP-led course with a combined hands-on and didactic approach is an effective method for critical care ultrasound skills acquisition in ultrasound-novice APPs.
Cureus
The objectives of this study were to determine if a multimodular introductory ultrasound course improved emergency medicine intern confidence in performing a point-of-care ultrasound and if our educational objectives could be met with our chosen structure. Methods This is a prospective, observational study evaluating three consecutive incoming emergency medicine residency classes from three residency programs. A one-day introductory ultrasound course was delivered. The course consisted of 1) flipped classroom didactics, 2) in-person, casebased interactive teaching sessions, and 3) check-listed, goal-driven, hands-on instruction. Results Over three years, 73 residents participated in this study. There was no significant difference in performance on the written test (p = 0.54) or the skills assessment (p = 0.16) between years. Performance on the written pre-test was not a predictor of performance on the skills test (R 2 = 0.028; p = 0.19). Prior to training, residents were most confident in performing a focused assessment with sonography for trauma examination (median confidence 5.5 (interquartile range (IQR): 3-7) on a 10-point Likert scale where 1 represents low confidence and 10 represents high confidence). They reported the lowest confidence in performing a cardiac ultrasound (3 (IQR: 2-6)). Following training, residents reported increased confidence with all applications (p < 0.001). Eighty-five percent (confidence interval (CI): 73, 92) of residents agreed that the online ultrasound lectures effectively teach point-of-care ultrasound applications and 98% (CI: 88, 100) agreed that case-based interactive sessions helped them understand how ultrasound changes the management of acutely ill patients.
Journal of hospital medicine, 2018
Literature supports the use of point-ofcare ultrasound performed by the treating hospitalist in the diagnosis of common diseases. There is no consensus on the training paradigm or the evaluation of skill retention for hospitalists. To evaluate the effectiveness of a comprehensive bedside ultrasound training program with postcourse competency assessments for hospitalists. A retrospective report of a training program with 53 hospitalists. The program consisted of online modules, a 3-day in-person course, portfolios, 1-day refresher training, monthly scanning, and assessments. Hospitalists were rated by using similar pre- and postcourse competency assessments and self-rating parameters during the 3-day and refresher courses. A large tertiary-care center. Skills increased after the 3-day course from a median preassessment score of 15% correct (interquartile range [IQR] 10%-25%) to a median postassessment score of 90% (IQR 80%-95%; P < .0001). At the time of the refresher course, the ...
Implementation and Assessment of a Curriculum for Bedside Ultrasound Training
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2015
This study assessed a curriculum for bedside ultrasound (US) and compared outcomes from 2 common training pathways. The program consisted of e-learning paired with expert-led hands-on training administered to pulmonary/critical care and cardiology fellows with no prior formal training in bedside US. This "simulation-based learner" group completed a survey of attitudes and confidence before and after training, and knowledge and skills were assessed after training. The surveys and scores of the simulation-based learners were compared to the scores of "experts," who were US-trained emergency physicians, and "apprentice…