Medical students benefit from the use of ultrasound when learning peripheral IV techniques

Abstract

BackgroundRecent studies support high success rates after a short learning period of ultrasound IV technique, and increased patient and provider satisfaction when using ultrasound as an adjunct to peripheral IV placement. No study to date has addressed the efficacy for instructing ultrasound-naive providers. We studied the introduction of ultrasound to the teaching technique of peripheral IV insertion on first- and second-year medical students.MethodsThis was a prospective, randomized, and controlled trial. A total of 69 medical students were randomly assigned to the control group with a classic, landmark-based approach (n = 36) or the real-time ultrasound-guided group (n = 33). Both groups observed a 20-min tutorial on IV placement using both techniques and then attempted vein cannulation. Students were given a survey to report their results and observations by a 10-cm visual analog scale. The survey response rate was 100%.ResultsIn the two groups, 73.9% stated that they attempted an IV previously, and 63.7% of students had used an ultrasound machine prior to the study. None had used ultrasound for IV access prior to our session. The average number of attempts at cannulation was 1.42 in either group. There was no difference between the control and ultrasound groups in terms of number of attempts (p = 0.31). In both groups, 66.7% of learners were able to cannulate in one attempt, 21.7% in two attempts, and 11.6% in three attempts. The study group commented that they felt they gained more knowledge from the experience (p < 0.005) and that it was easier with ultrasound guidance (p < 0.005).ConclusionMedical students feel they learn more when using ultrasound after a 20-min tutorial to place IVs and cannulation of the vein feels easier. Success rates are comparable between the traditional and ultrasound teaching approaches.

A Scoping Review of Ultrasound Teaching in Undergraduate Medical Education

“…Procedures [82][83][84][85][86][87][88][89][90][91] Ultrasound has been used in conjunction with 'phantom' simulators [82][83][84][85] or cadavers [86,87] to teach invasive procedures such as venous and arterial line placement and nerve blocks. McCrary et al [88] used a fresh cadaver model to teach ultrasound-guided breast biopsy to medical students on surgery clerkship.…”

“…McCrary et al [88] used a fresh cadaver model to teach ultrasound-guided breast biopsy to medical students on surgery clerkship. Two studies [84,85] used a randomised group methods to assess differences between ultrasound or landmark-based methods of teaching venous catheter placement. Griswold-Theodorson [85] found that students were safer and more successful when using ultrasound guidance, whereas Osborn et al [84] demonstrated no difference in success rates, although students' subjective ratings of knowledge gain and ease of use were greater in those who had undergone US-based teaching.…”

Successful intravenous catheterization by medical students

“…This is often the first time students are required to take their knowledge out of the classroom and apply it to patients in the hospital. In addition to the clinical knowledge that must be developed, understanding of and continued refinement of technique must be practiced across a wide range of procedures [1-4]. …”

“…It is frequently one of the first procedures that must be mastered and is critically important in patient care for the delivery of medication and other therapeutic interventions [4]. Peripheral IV catheter placement is the most common procedure performed in the emergency department with over 40% of its patients requiring blood tests and 25% receiving IV fluids [5].…”

Hand-held ultrasonography: An opportunity for “hands-on” teaching of medicine

“…The 3-week teaching course was conducted using a single HHU device and accommodated 6 students well. A large amount of literature exists about the use of portable, as opposed to HHU, ultrasound in medical education (22) (23) (24) (25) (26) (27) . Portable ultrasound equipment is available if larger group sizes need to be taught, some of which can be connected to a larger screen such as a projector (25) .…”