Teaching of clinical ultrasonography to undergraduates: Students as mentors

IntroductionPoint-of-care ultrasound (POCUS) use in clinical care is growing rapidly, and advocates have recently proposed the integration of ultrasound into undergraduate medical education (UME). The evidentiary basis for this integration has not been evaluated critically or systematically. In this study, we conducted a critical and systematic review framed by the rationales enumerated by advocates of ultrasound in UME in academic publications. MethodsThis research was conducted in two phases. First, the dominant discursive rationales for the integration of ultrasound in UME were identified using techniques from Foucauldian critical discourse analysis (CDA) from an archive of 403 academic publications. We then sought empirical evidence in support of theses rationales, using a critical synthesis methodology also adapted from CDA. ResultsWe identified four dominant discursive rationales, with different levels of evidentiary support. Ultrasound was not demonstrated to improve students' understanding of anatomy. The benefit of ultrasound in teaching physical examination was inconsistent, and rests on minimal evidence. With POCUS, students' diagnostic accuracy was improved for certain pathologies, but findings were inconsistent for others. Finally, the rationale that ultrasound training in UME will improve quality of patient care was difficult to evaluate. DiscussionOur analysis has shown that the frequently repeated rationales for the integration of ultrasound in UME are not supported by a sufficient base of empirical research. The repetition of these dominant discursive rationales in academic publications legitimizes them and may preclude further primary research. Since the value of clinical ultrasound use by medical students remains unproven, educators must consider whether the associated financial and temporal costs are justified or whether more research is required.

show abstract

“…This is asserted to lead to a better understanding of anatomy. This rationale is found in 41 articles within the archive (e.g …”

Section: Resultsmentioning

confidence: 99%

“…). A typical example of this rationale is: ‘Ultrasound facilitates the learning of anatomy, [and] aids in understanding the physiology and pathophysiology of numerous organs and systems.’…”

Section: Resultsmentioning

confidence: 99%

Ultrasound in undergraduate medical education: a systematic and critical review

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The group of mentors was composed of 30 fifth‐and sixth‐year medical students (Faculty of Medicine, Complutense University; and 12 de Octubre and Infanta Cristina Teaching Hospitals), who had volunteered to participate in a basic abdominal ultrasound training program consisting of the following elements: An online course of 6 theoretical modules with the following contents: (a) basic physical principles of ultrasound; (b) focused assessment with sonography for trauma protocol, including detection of free abdominal fluid; (c) study of the urinary tract, including the kidney and urinary bladder; (d) gallbladder and duct; and (e) large vessels, including the aorta and inferior vena cava. At the end of each module, students had to pass a multiple‐choice test. Practical training supervised by students previously trained and assessed in abdominal ultrasound in a previous study conducted at the same center 20 . This practical training consisted of performing at least 20 ultrasound explorations on different models over several sessions (a minimum of 15 hours of practical experience).…”

Section: Methodsmentioning

confidence: 99%

“…Practical training supervised by students previously trained and assessed in abdominal ultrasound in a previous study conducted at the same center 20 . This practical training consisted of performing at least 20 ultrasound explorations on different models over several sessions (a minimum of 15 hours of practical experience).…”

Section: Methodsmentioning

confidence: 99%

Basic Abdominal Point‐of‐Care Ultrasound Training in the Undergraduate

García-Casasola

Sánchez

Luordo

et al. 2016

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…Recent studies have shown that ultrasound is a teachable skill that may be applicable in the clinical setting after a short course of intensive training. [16][17][18][19] We hypothesized that first-year American medical students are capable of teaching a 4-week, intensive ultrasonography course to Indonesian primary care physicians. The aim of this study was to assess the shortterm efficacy of a 4-week ultrasound curriculum taught by American first-year medical students to general practitioners working in public health care clinics, or puskesmas, in Bandung, Indonesia.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a point of care ultrasound curriculum for Indonesian physicians taught by first-year medical students

Lee¹,

Tse²,

Keown³

et al. 2017

World Journal of Emergency Medicine

View full text Add to dashboard Cite

BACKGROUND:The purpose of this study was to assess the short-term effi cacy of a 4-week ultrasound curriculum taught by American fi rst-year medical students to general practitioners working in public health care clinics, or puskesmas, in Bandung, Indonesia. METHODS:We performed a prospective, observational study of Indonesian health care practitioners from public clinics in Bandung, Indonesia. These practitioners were enrolled in a 4-week ultrasound training course taught by first-year American medical students. A total of six sessions were held comprising of 38 ultrasound milestones. A pre-course and post-course written exam and practical exam was taken by each participant. RESULTS:We enrolled 41 clinicians in the course. The average pre-course exam score was 35.2% with a 2.4% pass rate, whereas the average post-course exam score was 82.0% with a 92.7% pass rate. The average practical score at the completion of the course was 83.2% (SD=0.145) with 82.9% of the class passing (score above 75.0%). CONCLUSION:Our data suggests that first-year medical students can effectively teach ultrasound to physicians in Indonesia using a 4-week intensive ultrasound training course. Future studies are needed to determine the amount of training required for profi ciency and to evaluate the physicians' perceptions of the student-instructors' depth of knowledge and skill in point of care ultrasound.

show abstract

Teaching of clinical ultrasonography to undergraduates: Students as mentors

Cited by 16 publications

References 22 publications

Ultrasound in undergraduate medical education: a systematic and critical review

Ultrasound in undergraduate medical education: a systematic and critical review

Basic Abdominal Point‐of‐Care Ultrasound Training in the Undergraduate

Evaluation of a point of care ultrasound curriculum for Indonesian physicians taught by first-year medical students

Contact Info

Product

Resources

About