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

Kumar, Anirudh; Barman, Naman; Lurie, Jacob; He, Helen; Goldman, Martin E.; McCullough, Stephen

doi:10.1016/j.echo.2018.05.008

Cited by 9 publications

(7 citation statements)

References 3 publications

(3 reference statements)

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“…However, the skill retention remains unknown due to the small sample size, even though the ES of the skill retention was large. Most previous studies investigating the learning effect of cardiac ultrasound curriculum showed psychomotor or cognitive skill outcomes were improved immediately after an initial training [10,13,14,[43][44][45][46][47][48][49][50]. Assessments in these studies focused on very short-term knowledge and/or skill retention.…”

Section: Single Primary Outcome Selection For a Definitive Studymentioning

confidence: 99%

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

Jujo

Lee-Jayaram

Sakka

et al. 2021

Pilot Feasibility Stud

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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, Butterfly Network Inc., Guilford, CT, USA). 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. To gather validity evidence of the skill test, interrater and test-retest reliability of 3 blinded raters were assessed. 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. Both interrater and test-retest reliability of the skill test were excellent. 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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Section: Single Primary Outcome Selection For a Definitive Studymentioning

confidence: 99%

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

Jujo

Lee-Jayaram

Sakka

et al. 2021

Pilot Feasibility Stud

View full text Add to dashboard Cite

show abstract

“…Promising outcomes studies in anesthesia have been reported [71][72][73][74][75][76][77]; in other critical care environments [71][72][73]75,76,[78][79][80][81][82][83][84][85][86][87][88][89][90][91][92] and in several randomised trials, the advantage of WHOBUS has been demonstrated [77,90,[92][93][94][95][96][97][98]. Training programs in WHOBUS are discussed from early medical school into numerous specialties and fellowship programs [99][100][101][102][103][104][105][106][107]. WHOBUS is becoming a part of the training and the practice of anesthesiologists and critical care physicians.…”

Section: Other Uses Of Whobusmentioning

confidence: 99%

Whole body ultrasound in the operating room and intensive care unit

Denault¹,

Canty

Azzam

et al. 2019

Korean J Anesthesiol

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Whole body ultrasound can be used to improve the speed and accuracy of evaluation of an increasing number of organ systems in the critically ill. Cardiac and abdominal ultrasound can be used to identify the mechanisms and etiology of hemodynamic instability. In hypoxemia or hypercarbia, lung ultrasound can rapidly identify the etiology of the condition with an accuracy that is equivalent to that of computed tomography. For encephalopathy, ocular ultrasound and transcranial Doppler can identify elevated intracranial pressure and midline shift. Renal and bladder ultrasound can identify the mechanisms and etiology of renal failure. Ultrasound can also improve the accuracy and safety of percutaneous procedures and should be currently used routinely for central vein catheterization and percutaneous tracheostomy.

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“…Concurrently, coronary atherosclerosis and plaque formation cause coronary artery trunk and branch stenosis and blockage, which adversely affect myocardial oxygen and blood supply, cause myocardial tissue damage, and affect cardiac function. Consequently, changes in cardiac function are visible upon ultrasonic examination[ 19 , 20 ]. Some studies have shown that E/A is significantly decreased and LVDd and LAD are significantly increased in patients with CHD.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic assessment of cardiac function and disease severity in coronary heart disease

Zhang¹,

Du²,

Hu³

et al. 2021

WJCC

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BACKGROUND Coronary heart disease (CHD) causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life. AIM To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD. METHODS A total of 106 patients with CHD (study group) and 106 healthy individuals (control group) in our hospital from March 2019 to September 2020 were selected for this study. All subjects were examined by ultrasound, and the mitral orifice’s early-to-late diastolic blood flow velocity ratio (E/A), left ventricular end-diastolic volume (LVDd), and left atrial diameter (LAD) were measured. Values were compared between the study group and healthy group, and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed. In addition, the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo. RESULTS E/A (1.46 ± 0.34) of the study group was smaller than that of the control group (1.88 ± 0.44), while LVDd (58.24 ± 5.05 mm) and LAD (43.31 ± 4.38 mm) were larger (48.15 ± 3.93 and 34.94 ± 2.81, respectively; P < 0.05). E/A for patients with grade III disease (1.41 ± 0.43) was smaller and their LVDd (60.04 ± 4.21 mm) and LA (44.16 ± 2.79 mm) were larger than those in patients with grade II disease (1.71 ± 0.48, 52.18 ± 3.67 mm, and 39.68 ± 2.37, respectively; P < 0.05). Patients with grade IV disease had smaller E/A (1.08 ± 0.39) and larger LVDd (66.81 ± 5.39 mm) and LAD (48.81 ± 3.95 mm) than patients with grade II and III disease ( P < 0.05). In patients with moderate disease, E/A (1.44 ± 0.41) was smaller and LVDd (59.95 ± 4.14 mm) and LAD (45.15 ± 2.97 mm) were larger than in patients with mild disease (1.69 ± 0.50, 51.97 ± 3.88 and 38.81 ± 2.56 mm, respectively; P < 0.05). In patients with severe disease, E/A (1.13 ± 0.36) was smaller and LVDd (67.70 ± 6.11 mm) and LAD (49.09 ± 4.05 mm) were larger than in patients with moderate disease ( P < 0.05). E/A was negatively correlated with cardiac function classification and disease severity, while LVDd and LAD were positively correlated with cardiac function classification and disease severity ( P < 0.05). E/A (1.83 ± 0.51) for patients with good prognosis was higher than that for those with poor prognosis (1.39 ± 0.32), while LVDd (49.60 ± 4.39 mm) and LAD (36.13 ± 3.05 mm) were lower ( P < 0.05). CONCLUSION The ultrasonic parameters of patients with CHD are abnormal, and differ significantly in patients with different cardiac function grades, lesion degree, and prognosis.

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

Cited by 9 publications

References 3 publications

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

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

Whole body ultrasound in the operating room and intensive care unit

Ultrasonographic assessment of cardiac function and disease severity in coronary heart disease

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