Scoping review of implementing a longitudinal curriculum in undergraduate medical education: The wake forest experience

Abstract

Background Hands-on ultrasound experience has become a desirable component for undergraduate medical education (UGME) curricula throughout medical schools in the United States (US) to enhance readiness for future training. Ultrasound integration can be a useful assistive educational method in undergraduate medical education to improve anatomy and physiology skills. Relatively few medical schools have integrated ultrasound experiences formally into their 4-year medical school curriculum due to limitations of a resource intensive set up. Methods We undertook a scoping review of published UGME ultrasound curricula integrated into all four years in peer-reviewed as well online literature. In addition, we provide a narrative review of our institutional experience in conceptualization, design and implementation of UGME ultrasound curriculum driven by need to address the fading knowledge in anatomy and physiology concepts beyond pre-clinical years. Results Integrated ultrasound curriculum at WFSOM utilizes focused ultrasonography as a teaching aid for students to gain a more thorough understanding of basic and clinical science concepts taught in the medical school curriculum. We found 18 medical schools with ultrasound curricula published in peer-reviewed literature with a total of 33 ultrasound programs discovered by adding Google search and personal communication Conclusions The results of the review and our institutional experience can help inform future educators interested in developing similar curricula in their undergraduate programs. Common standards, milestones and standardized competency-based assessments would be helpful in more widespread application of ultrasound in UGME curricula.

Ultrasonography in undergraduate medical education: a comprehensive review and the education program implemented at Jichi Medical University

“…Several reports indicate that medical schools in North America [ 107 , 130 , 131 ], Europe [ 132 , 133 ], and Asia [ 134 ] continue to integrate ultrasound into undergraduate medical curricula. A survey conducted in 2019 showed that 74% of 64 responding US medical schools had integrated ultrasound into basic science courses, 66% into practice of medicine/clinical skills courses, and 35% into clinical rotations [ 130 ].…”

“…Many schools have likely incorporated or are trying to incorporate ultrasound into 1 or 2 years of undergraduate medical education. However, vertical or longitudinal 4-year curricula are being integrated gradually among North American medical schools [ 8 , 131 ].…”

“…For example, some may feel pressured to allow their bodies to be used for education, and there is a risk that abnormal ultrasound findings could come to light in front of their peers [ 104 ]. When students volunteer to serve as ultrasound models, it must be confirmed that they have wholly consented to the act [ 131 , 143 ]. To mitigate these concerns, Ohio State University introduced an extracurricular program in which 2nd-year students served as trained simulated patients, gaining educational incentives [ 144 ].…”

“…Many of the aforementioned studies have shown that medical students enjoy ultrasound courses and express interest in receiving further ultrasound training. An active ultrasound interest group initiated by students with the support of faculty can help further the curriculum development [ 8 , 131 ]. Many programs advocate the involvement of medical students in the design and subsequent modification of ultrasound curricula [ 8 , 145 ].…”

Introductory Resident-Led Physical Medicine and Rehabilitation Case-Based Ultrasound Workshop for Medical Students

“…11,12 Medical school ultrasound curriculums have begun implementing clinical applications including the Wake Forest University. 13 The quantity and complexity of content had importance because overwhelming medical student cognitive load would result in inattention. 14 With a near peer approach to the workshop, there was less likelihood of a blind expert spot phenomenon, which can result in cognitive overload.…”