Research: Emergency medicine residents’ acquisition of point-of-care ultrasound knowledge and their satisfaction with the flipped classroom andragogy

Bashir, Khalid; Azad, Aftab; Farook, Kaleelullah Saleem; Anjum, Shahzad; Pathan, Sameer A.; Bhutta, Zain A.; Thomas, Stephen

doi:10.24908/pocus.v3i1.13301

Cited by 8 publications

(7 citation statements)

References 37 publications

(137 reference statements)

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“…Assessments in these studies focused on very short-term knowledge and/or skill retention. Several studies have demonstrated long-term knowledge or confidence retention after several weeks or months [ 22 , 25 , 51 , 52 ], however, few studies have investigated long-term skill retention [ 22 ]. The importance of investigating long-term skill retention is evident both from the results of our pilot and our review of the literature.…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…A flipped classroom in POCUS education has shown to be superior to conventional face-to-face teaching for both immediate and 2 month follow-up results. 30 Interestingly, our follow-up OSCE results, with 26 out of 32 students having scored 100%, might be indicative that the flipped classroom played an important role in the student’s knowledge retention.…”

Section: Discussionmentioning

confidence: 77%

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

Khoury

Fotsing

Jalali

et al. 2020

Journal of Medical Education and Curricular Development

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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.

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“…Assessments in these studies focused on very short-term knowledge and/or skill retention. Several studies have demonstrated long-term knowledge or con dence retention after several weeks or months [20,23,50,51], however, few studies have investigated long-term skill retention [20]. The importance of investigating long-term skill retention is evident both from the results of our pilot and our review of the literature.…”

Section: Single Primary Outcome Selection For a De Nitive Studymentioning

confidence: 84%

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. 2020

Preprint

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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). 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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Research: Emergency medicine residents’ acquisition of point-of-care ultrasound knowledge and their satisfaction with the flipped classroom andragogy

Cited by 8 publications

References 37 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

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

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

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