Effectiveness of a 1-Hour Extended Focused Assessment With Sonography in Trauma Session in the Medical Student Surgery Clerkship

Krause, Cassandra; Krause, Raymond J.; Gómez, Nephtali R.; Jafry, Zan; Dinh, Vi Am

doi:10.1016/j.jsurg.2017.03.007

Cited by 23 publications

(33 citation statements)

References 34 publications

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“…In our study we chose for medical students as novices (i.e., non-experts), since non-experts constitute the majority of ultrasound trained personnel in an IC and as students would not interfere with daily ICU care. Five studies reported on medical students performing CCUS in critically ill patients (3 in ED setting, 1 in operating theater and 1 in ICU) [3,[7][8][9][10]. Four out of the five studies showed that images could be acquired in a promising 82-98% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Critical care ultrasonography (CCUS) is a deliberately focused examination, aimed at rapidly answering straightforward clinical questions [1]. In the field of emergency and critical care medicine, CCUS is increasingly used to guide interventions in critically ill patients in various settings by experts and novices [2][3][4][5][6][7][8][9][10][11][12][13][14]. The training process required for users to attain competency in CCUS has varied widely between studies, reflecting the diversity in CCUS training between centers.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of cardiac output measurements in critically ill patients by medical students

et al. 2020

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Background: Critical care ultrasonography (CCUS) is increasingly applied also in the intensive care unit (ICU) and performed by non-experts, including even medical students. There is limited data on the training efforts necessary for novices to attain images of sufficient quality. There is no data on medical students performing CCUS for the measurement of cardiac output (CO), a hemodynamic variable of importance for daily critical care. Objective: The aim of this study was to explore the agreement of cardiac output measurements as well as the quality of images obtained by medical students in critically ill patients compared to the measurements obtained by experts in these images. Methods: In a prospective observational cohort study, all acutely admitted adults with an expected ICU stay over 24 h were included. CCUS was performed by students within 24 h of admission. CCUS included the images required to measure the CO, i.e., the left ventricular outflow tract (LVOT) diameter and the velocity time integral (VTI) in the LVOT. Echocardiography experts were involved in the evaluation of the quality of images obtained and the quality of the CO measurements. Results: There was an opportunity for a CCUS attempt in 1155 of the 1212 eligible patients (95%) and in 1075 of the 1212 patients (89%) CCUS examination was performed by medical students. In 871 out of 1075 patients (81%) medical students measured CO. Experts measured CO in 783 patients (73%). In 760 patients (71%) CO was measured by both which allowed for comparison; bias of CO was 0.0 L min −1 with limits of agreement of − 2.6 L min −1 to 2.7 L min −1. The percentage error was 50%, reflecting poor agreement of the CO measurement by students compared with the experts CO measurement. Conclusions: Medical students seem capable of obtaining sufficient quality CCUS images for CO measurement in the majority of critically ill patients. Measurements of CO by medical students, however, had poor agreement with expert measurements. Experts remain indispensable for reliable CO measurements.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility of cardiac output measurements in critically ill patients by medical students

et al. 2020

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“…Online quizzes in LMSs have been implemented for summative assignments, formative assessments and instructional design methods in diverse disciplines such as engineering, biology, medicine and the social sciences (Jaeger & Adair, 2017;Krause et al, 2017;Sullivan, 2016). Recent studies highlight the benefits of online quizzes and students' positive attitude towards them (Cohen & Sasson, 2016;Wallihan et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Optimising Moodle quizzes for online assessments

et al. 2019

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Background: Computer-aided learning management systems (LMSs) are widely used in higher education and are viewed as beneficial when transitioning from conventional face-to-face teaching to fully online courses. While LMSs have unique tools for transferring and assessing knowledge, their ability to engage and assess learners needs further investigation. This paper focuses on a study examining the LMS "Moodle" to ascertain the effectiveness of "Moodle quizzes" to improve, assess and distinguish knowledge in a civil engineering course at an Australian university. The course has a database comprising 62 formative and 61 summative quiz questions with embedded text, images, audio and video. This study investigates the use of these quiz questions with four course cohorts and 169 students. The quizzes assessed competencies of students during various stages of a study period through automated marking. The suitability of questions to assess and distinguish student knowledge levels was determined using a psychometric analysis based on facility index (FI) and the discrimination index (DI) statistics embedded within the Moodle quizzes. Results: This study highlights strategies used to set and review quiz questions for formative and summative assessments. Results indicated that students were engaged and satisfied in the formative assessment because they viewed the interactive videos between 2 and 6 times and 65% of students attempted all the formative questions. The FI indicated student pass rate for the summative questions and DI indicated the difficulty of these questions, while the combination of FI and DI results separated students with different knowledge levels.Using these Moodle statistics provided information to make effective decisions on how to improve the summative quizzes. Conclusion: The multimodal quizzes were effective in teaching and assessing a theoretical engineering course and provided efficient methods to replace conventional assessments. The FI and DI indexes are useful statistical tools in redesigning appropriate sets of questions. Time-poor academics will benefit from using these easily attainable Moodle statistics to inform decisions while revising the quizzes and making assessments more autonomous.

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“…Less time was needed to train on the EFAST than on the RUSH protocol, with training for one hour on EFAST effectively improving both performance and interpretation [19]. We recently reported that hands-on performance was acceptable in 88% of medical students after five hours of training, including one hour of didactic training, two hours of practical training with an instructor, and two hours of free practice [10].…”

Section: Discussionmentioning

confidence: 99%

“…Time constraints limit the integration of ultrasound training into undergraduate medical education [5,18]. This limitation has been overcome by the effective implementation of ultrasound teaching into training courses [13,17,[19][20]. Our recent study showed that senior medical students can effectively learn and implement the Extended Focused Assessment Sonography for Trauma (EFAST) protocol after three hours of instructor-led training [10].…”

Section: Introductionmentioning

confidence: 99%

Point-of-care Ultrasound Training During an Emergency Medicine Clerkship: A Prospective Study

Çevik

Cakal

Abu‐Zidan

2019

Cureus

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This study evaluated the effects of three-hour instructor-led training courses in the Extended Focused Assessment Sonography for Trauma (EFAST) and Rapid Ultrasound in Shock and Hypotension (RUSH) protocols on knowledge gain and retention by final-year medical students. Methods This prospective study evaluated 79 final year medical students participating in an emergency medicine (EM) clerkship during the 2017-2018 academic year. None of the included students had prior formal ultrasound training or hands-on experience. All students participated in three-hour training courses on the EFAST and RUSH protocols, with training on each protocol involving one hour of didactic training and two hours of practical training. Knowledge improvement was measured by testing before and after each course, and knowledge retention was evaluated on a final clerkship multiple choice question (MCQ) examination. Results Median scores were significantly higher after rather than before both the EFAST (15; range, 12-19 vs. 7; range, 2-18; p < 0.0001) and RUSH (16; range, 6-20 vs. 6; range, 1-13; p < 0.0001) courses. EFAST knowledge was significantly higher than RUSH knowledge before (p = 0.04) but not after (p = 0.82) taking the respective course. The RUSH score was significantly lower than the EFAST score on the final clerkship MCQ examination (p < 0.0001). Conclusions Three hours of instructor-led ultrasound training given during an EM clerkship significantly increased knowledge of both the EFAST and RUSH protocols. Knowledge retention after two weeks was higher for the EFAST than the RUSH protocol. A longer period of RUSH training may improve the retention of knowledge.

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Effectiveness of a 1-Hour Extended Focused Assessment With Sonography in Trauma Session in the Medical Student Surgery Clerkship

Cited by 23 publications

References 34 publications

Feasibility of cardiac output measurements in critically ill patients by medical students

Feasibility of cardiac output measurements in critically ill patients by medical students

Optimising Moodle quizzes for online assessments

Point-of-care Ultrasound Training During an Emergency Medicine Clerkship: A Prospective Study

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