Pilot Project: Does formal bedside training of medical students with a FAST exam increase their knowledge and comfort level with ultrasound use in a community family medicine practice setting?

POCUS Journal ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 15-17
Author(s):  
Rimi Sambi, MD ◽  
Heather Sawula, MD ◽  
Brent Wolfrom, MD ◽  
Joseph Newbigging, MD
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Point Of Care ◽  
Training Session ◽  
Undergraduate Curriculum ◽  
Knowledge Retention ◽  
Comfort Level ◽  
Point Of Care Ultrasound ◽  
Medical Undergraduate ◽  
Fast Exam

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.

scholarly journals Preclerkship Point-of-Care Ultrasound: Image Acquisition and Clinical Transferability

2020 ◽  
Vol 7 ◽  
pp. 238212052094361
Author(s):  
Michel Khoury ◽  
Salomon Fotsing ◽  
Alireza Jalali ◽  
Nicolas Chagnon ◽  
Stéphanie Malherbe ◽  
...  
Keyword(s):  
Medical Students ◽  
Flipped Classroom ◽  
Clinical Skills ◽  
Point Of Care ◽  
Student Perception ◽  
Ultrasound Image ◽  
Knowledge Retention ◽  
Point Of Care Ultrasound ◽  
Test Model ◽  
Post Test

Introduction: The integration of point-of-care ultrasound (POCUS) in preclerkship medical education is currently popular and based on the notion that POCUS may improve diagnostic and procedural skills in medical students. However, empirical evidence demonstrating that POCUS can enhance clinical skills in preclerkship students has been lacking. We sought to evaluate anatomical sonographic knowledge and ultrasound generation capabilities associated with the implementation of a 3-h echocardiography training camp led by 2 emergency physicians and using a flipped classroom design. Methods: Preclerkship students from the University of Ottawa (n = 32) were recruited to participate. A flipped classroom model was adopted, providing students with a 3-chaptered peer-designed, expert validated ultrasound manual before the workshop, to maximize scanning times (2 h of reading). A pretest Likert-type design was used to assess student perception of the ultrasound tool. Similarly, a pretest/post-test model was used to assess sonographic anatomical identification. In addition, a subsequent Objective Structured Clinical Examination (OSCE) test was done 3 weeks after the hands-on session, to evaluate image generation (4 cardiac views: parasternal long, parasternal short, subxiphoid, and apical 4 chambers), understanding of knobology and structural labeling. Results: For the sonographic anatomy, there was a statistically significant increase ( P < .001) between pretest (average = 12.12) and post-test (average = 18.85). The OSCE, which also ascertained knowledge retention, found that 81% of students were able to generate all 4 cardiac views perfectly, 6% were able to obtain 3 views, 10% obtained 2 views and 3% successfully generated a single view. The most challenging scan to generate was the apical 4-chamber view. Conclusion: The positive outcomes stemming from this study reinforces the notion that formal curricular integration of POCUS at the preclerkship level has tangible benefits for medical students.

scholarly journals Attitudes of medical students to electroconvulsive therapy

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S15-S15
Author(s):  
Patrick Clements ◽  
Aidan Turkington
Keyword(s):  
Medical Students ◽  
Electroconvulsive Therapy ◽  
Positive Attitude ◽  
Undergraduate Curriculum ◽  
Likert Scale ◽  
Background Information ◽  
Positive Shift ◽  
Medical Undergraduate ◽  
Queen's University ◽  
Strongly Agree

AimsThis study explores the different attitudes among fourth year medical students in Queen's University Belfast to Electroconvulsive Therapy (ECT) and investigates whether these are influenced by teaching and exposure to ECT during their undergraduate psychiatry placement. In particular we sought to determine firstly, correlates of baseline attitudes to ECT and secondly, whether specific forms of ECT teaching improved attitudes to ECT during their placement.MethodThis study was conducted in Queen's University Belfast and agreed with their ethics committee. Participants completed a questionnaire at the beginning of their psychiatry placement and another questionnaire in the second half of their placement. The first questionnaire captured background information and baseline attitudes. The second questionnaire recorded the educational and clinical experience gained on ECT during placement (for example lectures, tutorials, informal teaching, observing ECT and interacting with ECT patients), in addition to attitudes to ECT at this timepoint. Attitudes to ECT were assessed on a 5-point Likert scale. A positive attitude to ECT was defined as scoring agree/strongly agree on a 5-point Likert scale to the statement “I would recommend ECT for a patient if clinically indicated”.Result187 students were interviewed at both time points. At the outset of the psychiatry placement 66% of students reported a positive attitude to ECT. Positive attitude was associated with age: 72% of students under 24 had a positive attitude to ECT vs 58% of students over 24 (χ2 = 3.5; P < 0.05). Of students who had previously attended a lecture on ECT (n = 117) 83% had a positive attitude to ECT vs 42% of those who had not previously attended a lecture (χ2 = 33.5; P < 0.001).Attitudes to ECT significantly improved during the placement (66% vs 94% positive; t = 7.97; P < 0.001). Students who attended a lecture on ECT during the psychiatry placement were more likely to have a positive shift in attitude (67% vs 49%; F = 6.0; P = 0.01). No other specific teaching modality was associated with a positive shift in attitude.ConclusionWe conclude that undertaking a Psychiatry placement and particularly having a lecture on ECT significantly improves attitudes of medical students to ECT. It is therefore important that lectures on ECT are included in the medical undergraduate curriculum to allow students to be accurately informed about this essential treatment for a number of psychiatric disorders.

scholarly journals Simulator-based ultrasound training for identification of endotracheal tube placement in a neonatal intensive care unit using point of care ultrasound

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Khushboo Qaim Ali ◽  
Sajid Bashir Soofi ◽  
Ali Shabbir Hussain ◽  
Uzair Ansari ◽  
Shaun Morris ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Training Session ◽  
Technical Skills ◽  
Neonatal Health ◽  
Point Of Care Ultrasound ◽  
Care Providers

Abstract Background Simulators are an extensively utilized teaching tool in clinical settings. Simulation enables learners to practice and improve their skills in a safe and controlled environment before using these skills on patients. We evaluated the effect of a training session utilizing a novel intubation ultrasound simulator on the accuracy of provider detection of tracheal versus esophageal neonatal endotracheal tube (ETT) placement using point-of-care ultrasound (POCUS). We also investigated whether the time to POCUS image interpretation decreased with repeated simulator attempts. Methods Sixty neonatal health care providers participated in a three-hour simulator-based training session in the neonatal intensive care unit (NICU) of Aga Khan University Hospital (AKUH), Karachi, Pakistan. Participants included neonatologists, neonatal fellows, pediatric residents and senior nursing staff. The training utilized a novel low-cost simulator made with gelatin, water and psyllium fiber. Training consisted of a didactic session, practice with the simulator, and practice with intubated NICU patients. At the end of training, participants underwent an objective structured assessment of technical skills (OSATS) and ten rounds of simulator-based testing of their ability to use POCUS to differentiate between simulated tracheal and esophageal intubations. Results The majority of the participants in the training had an average of 7.0 years (SD 4.9) of clinical experience. After controlling for gender, profession, years of practice and POCUS knowledge, linear mixed model and mixed effects logistic regression demonstrated marginal improvement in POCUS interpretation over repeated simulator testing. The mean time-to-interpretation decreased from 24.7 (SD 20.3) seconds for test 1 to 10.1 (SD 4.5) seconds for Test 10, p < 0.001. There was an average reduction of 1.3 s (β = − 1.3; 95% CI: − 1.66 to − 1.0) in time-to-interpretation with repeated simulator testing after adjusting for the covariates listed above. Conclusion We found a three-hour simulator-based training session had a significant impact on technical skills and performance of neonatal health care providers in identification of ETT position using POCUS. Further research is needed to examine whether these skills are transferable to intubated newborns in various health settings. Trial registration ClinicalTrials.gov Identifier: NCT03533218. Registered May 2018.

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

CJEM ◽  
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.

scholarly journals LO83: Quick Refresher Sessions (QRS): improving chest compression training for medical students

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S37-S38
Author(s):  
A. Cormier ◽  
E. Brennan
Keyword(s):  
Medical Students ◽  
Real Time ◽  
Test Performance ◽  
Training Session ◽  
Individual Performance ◽  
Comfort Level ◽  
Secondary Outcome ◽  
Control Group ◽  
Skill Maintenance ◽  
Training Interval

Innovation Concept: High-quality cardiopulmonary resuscitation saves lives; however, current certification standards can leave providers poorly prepared to perform effective chest compressions (CCs). We designed a training program based on the emerging model of skill maintenance through frequent short practice sessions. The ideal frequency of training is currently unknown. Our goal was to provide medical students with access to efficient and effective CC training and to determine an optimal training interval. Methods: Thirty-six second-year medical students were randomized to three groups that trained at different frequencies: once every two months (q2m) (n = 12), once every four months (q4m) (n = 13), and control (n = 11). Study duration was eight months with the intervention groups, q2m and q4m, participating in five and three sessions respectively. The control group was assessed at study start and end, receiving no training in between. At each session, participants completed a one-minute pre-test of CC performance, viewed a one-minute training video, practiced CCs for two minutes with real-time feedback, and completed a one-minute post-test. Performance parameters measured were CC depth, rate, release, and hand positioning. A final “compression score” assessed integrated performance across these parameters and served as our primary outcome. Participants also reported pre- and post-training comfort with performing CCs which served as our secondary outcome. Curriculum, Tool or Material: Our “Quick Refresher Sessions” (QRS) were completed by participants independently without requiring an assessor or facilitator. A manikin with the ability to record and provide real-time quantitative feedback on CC quality was connected to a laptop running a customized interface. Participants typed in an individualized code and were guided through their six-minute sessions automatically. Conclusion: Immediately following the first training session, subjects had significant improvement in compression score (p &lt; 0.001) and skill comfort (p &lt; 0.001). At eight months, both intervention groups, q2m and q4m, achieved higher compression scores than control (p = 0.001 and p = 0.011) and showed greater increase in comfort level (p = 0.002 and p = 0.010). Performance between intervention groups at eight months was not statistically different. Overall, we conclude that independent QRS training every two or four months led to improved CC quality and provider comfort. Future directions include increasing sample size and tailoring training intervals to individual performance.

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

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).

scholarly journals Awareness of family medicine discipline among clinical medical students of Bayero University, Kano, Nigeria

2017 ◽  
Vol 59 (3) ◽  
pp. 36
Author(s):  
Tanko Salihu Tanimu ◽  
Godpower Chinedu Michael ◽  
Aliyu Ibrahim ◽  
Bukar Alhaji Grema ◽  
Abubakar Abiso Mohammed
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Healthcare System ◽  
Undergraduate Curriculum ◽  
Medical Schools ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical Specialties ◽  
Wide Range ◽  
Undergraduate Programme

Introduction: Undergraduate medical education requires the studying of a wide range of medical specialties to produce the future workforce of the healthcare system. Family medicine (FM), a relatively new specialty in Nigeria, aims at supplying doctors capable of providing comprehensive healthcare for the majority of the population. However, many Nigerian medical schools (Bayero University inclusive) are yet to include FM in their undergraduate curriculum. Methods: This was a descriptive cross-sectional study of 178 respondents randomly and proportionately selected from 400-, 500- and 600-level medical students of Bayero University Kano. Using a structured questionnaire, their awareness of FM discipline, specialty preferences, factors influencing specialty preferences and their views on the relevance of FM in improving health systems were assessed. Results: A majority of the respondents (60.7%) were males and most (93.8%) had heard of FM. However, only 19.7% of respondents were aware that FM was taught in the undergraduate programme of medical schools; 86% were aware of a postgraduate FM programme. FM (22.5%) was the second most preferred specialty following surgery (23.6%). Personal interest in the specialty was the main (76.5%) reason for preference. Only 2.9% believed the postgraduate training for FM had a longer duration. All respondents believed FM was relevant as a specialty. Conclusion: The knowledge and perception of the FM discipline among clinical medical students of Bayero University was good. They expressed that FM was relevant in the healthcare system as shown in their preference for the specialty, which ranked second among other specialties. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1313487

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