Teaching point-of-care transfontanellar ultrasound for pediatricians and medical students

As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing [1]. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University. Third year medical students (n=18) were recruited to participate in a training session involving a 1-hour online video and 2-hour hands-on session. Knowledge based surveys were completed before and after the training. A survey was completed 4 months after the teaching session evaluating knowledge retention, comfort, and application of skills. Student knowledge of PoCUS and FAST increased and was maintained (pre-training 56%±20%, post-training 82%±10%, p<0.001). Self-evaluation of comfort performing a FAST examination (5-point Likert scale) similarly increased post-training session (pre-training 1.4±0.8, post-training 3.8±0.9, p<0.005), but decreased 4 months later (3±1.2, p<0.005). Students in this study were unanimously interested in ultrasound training and the methods used effectively increased theoretical knowledge and comfort with use. Students did not retain their comfort levels with FAST exam 4 months after the training session, nor did they have the opportunity to utilize the skills learned. Further evidence is required to identify the applicability of these results to undergraduate curriculum development.

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Virtual Multi‐Specialty Point‐of‐Care Ultrasound Rotation for 4 th Year Medical Students during COVID‐19: Innovative Teaching Techniques Improve Ultrasound Knowledge and Image Interpretation

AEM Education and Training ◽

10.1002/aet2.10632 ◽

2021 ◽

Author(s):

Joshua Zavitz ◽

Aarti Sarwal ◽

Jacob Schoeneck ◽

Casey Glass ◽

Brandon Hays ◽

...

Keyword(s):

Medical Students ◽

Point Of Care ◽

Image Interpretation ◽

Point Of Care Ultrasound ◽

Teaching Techniques ◽

Innovative Teaching

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TF3 Sono Buff, an Online Multimedia Point of-Care Sonography Training Instrument Designed for Medical Students, Resident Physicians, and Emergency Medicine Faculty

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2016.08.414 ◽

2016 ◽

Vol 68 (4) ◽

pp. S151

Author(s):

N.M. Hafez

Keyword(s):

Emergency Medicine ◽

Medical Students ◽

Point Of Care ◽

Resident Physicians

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Development of a Point-Of-Care Cardiovascular Ultrasound Program for Preclinical Medical Students

Journal of the American Society of Echocardiography ◽

10.1016/j.echo.2018.05.008 ◽

2018 ◽

Vol 31 (9) ◽

pp. 1064-1066.e2 ◽

Cited By ~ 3

Author(s):

Anirudh Kumar ◽

Naman Barman ◽

Jacob Lurie ◽

Helen He ◽

Martin Goldman ◽

...

Keyword(s):

Medical Students ◽

Point Of Care ◽

Preclinical Medical Students

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Feasibility and accuracy of point-of-care pocket-size ultrasonography performed by medical students

BMC Medical Education ◽

10.1186/1472-6920-14-156 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 44

Author(s):

Garrett Newton Andersen ◽

Annja Viset ◽

Ole Christian Mjølstad ◽

Øyvind Salvesen ◽

Håvard Dalen ◽

...

Keyword(s):

Medical Students ◽

Point Of Care

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P041: Accuracy of medical student-performed point-of-care ultrasound in the diagnosis of distal radius fractures in adults

CJEM ◽

10.1017/cem.2016.217 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S92-S92

Author(s):

L. Farnell ◽

A.K. Hall ◽

C. McKaigney

Keyword(s):

Medical Students ◽

Diagnostic Accuracy ◽

Distal Radius ◽

Point Of Care ◽

Distal Radius Fractures ◽

Point Of Care Ultrasound ◽

Radiographic Imaging ◽

Radius Fractures ◽

Wide Range ◽

Test Probability

Introduction: Previous investigations of the diagnostic accuracy of point-of-care ultrasound (POCUS) in distal radius fractures (DRF) report a wide range of sensitivities (71%-98%) and specificities (73%-100%) when performed by medical professionals, which may reflect inconsistencies in POCUS training or sonographer experience. The purpose of this study was to determine the accuracy of POCUS performed by pre-clerkship medical students with minimal POCUS training compared to standard radiography in diagnosing DRF in adult patients with traumatic wrist injuries, in order to assess POCUS as an alternative to traditional radiographic imaging. Methods: This prospective observational study was conducted from June to September 2015. The study population consisted of adults presenting to the emergency department (ED) with distal forearm pain secondary to traumatic injury within the past seven days and for whom radiographic imaging was ordered. Patients were evaluated using POCUS performed by medical students with no prior experience who had received one hour of POCUS training taught by an emergency ultrasound fellowship-trained ED physician. A pre-test probability of fracture was stratified as low or high and documented independently by the treating physician. Students were blinded to pre-test probability and radiography results. Results: Of the 52 patients enrolled, 18 had DRF diagnosed by radiographic imaging. Compared to radiography, student-performed POCUS had 72% overall sensitivity (95% CI, 47%-90%) and 85% specificity (95% CI, 69%-95%), with 81% overall accuracy. In the high pre-test probability group (N = 20), POCUS had 80% sensitivity (95% CI, 52%-96%) and 60% specificity (95% CI, 15%-95%). In the low pre-test probability group (N = 32), POCUS had 33% sensitivity (95% CI, 1%-91%) and 90% specificity (95% CI, 73%-98%). Conclusion: POCUS performed by medical students demonstrated reasonable success in diagnosing DRF, with overall sensitivity and specificity in keeping with published data. Within the low pre-test probability group, the diagnostic accuracy of POCUS suggests that ultrasound was an unreliable alternative to radiographic imaging for DRF in this cohort. Future analysis of the factors leading to DRF missed by POCUS as being related to adequacy of POCUS training, image capture, or sonographer experience will further explore the utility of POCUS as a diagnostic alternative.

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Effectiveness of Point-of-Care Ultrasound Performed by Medical Students Compared With Physical Examination by Vascular Surgeons in the Detection of Abdominal Aortic Aneurysms

Journal of Vascular Surgery ◽

10.1016/j.jvs.2016.08.011 ◽

2016 ◽

Vol 64 (5) ◽

pp. 1533-1534

Author(s):

Trinh Mai ◽

Michael Woo ◽

Kimberly Boles ◽

Prasad Jetty

Keyword(s):

Medical Students ◽

Physical Examination ◽

Point Of Care ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Point Of Care Ultrasound ◽

Abdominal Aortic

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Pre-clinical medical student cardiac point-of-care ultrasound curriculum based on the American Society of Echocardiography recommendations: a pilot and feasibility study

10.21203/rs.3.rs-43731/v1 ◽

2020 ◽

Author(s):

Satoshi Jujo ◽

Jannet J Lee-Jayaram ◽

Brandan I Sakka ◽

Atsushi Nakahira ◽

Akihisa Kataoka ◽

...

Keyword(s):

Medical Student ◽

Medical Students ◽

Pilot Study ◽

Point Of Care ◽

Scoring Systems ◽

Recruitment Rate ◽

Point Of Care Ultrasound ◽

Hands On ◽

Test Scoring ◽

American Society

Abstract Background Cardiac point-of-care ultrasound (POCUS) training has been integrated into medical school curricula. However, there is no standardized cardiac POCUS training method for medical students. To address this issue, the American Society of Echocardiography (ASE) proposed a framework for medical student cardiac POCUS training. The objective of this pilot study was to develop a medical student cardiac POCUS curriculum with test scoring systems and test the curriculum feasibility for a future definitive study.Methods Based on the ASE-recommended framework, we developed a cardiac POCUS curriculum consisting of a pre-training online module and hands-on training with a hand-held ultrasound (Butterfly iQ). The curriculum learning effects were assessed with a 10-point maximum skill test and a 40-point maximum knowledge test at pre-, immediate post-, and 8-week post-training. To determine the curriculum feasibility, we planned to recruit 6 pre-clinical medical students. We semi-quantitatively evaluated the curriculum feasibility in terms of recruitment rate, follow-up rate 8 weeks after training, instructional design of the curriculum, the effect size (ES) of the test score improvements, and participant satisfaction. Discriminatory ability of the test scoring systems were assessed by comparing the scores of the medical students, medical interns, and experts.Results Six pre-clinical medical students participated in the curriculum. The recruitment rate was 100% (6/6 students) and the follow-up rate 8 weeks after training was 100% (6/6). ESs of skill and knowledge test score differences between pre- and immediate post-, and between pre- and 8-week post-training were large. The students reported high satisfaction with the curriculum. The test scoring systems demonstrated excellent discriminatory ability between the 3 different performance levels.Conclusions This pilot study confirmed the curriculum design as feasible with instructional design modifications including the hands-on training group size, content of the cardiac POCUS lecture, hands-on teaching instructions, and hand-held ultrasound usage. Based on the pilot study findings, we plan to conduct the definitive study with the primary outcome of long-term skill retention 8 weeks after initial training. The definitive study has been registered in ClinicalTrials.gov (Identifier: NCT04083924).

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