The feasibility and efficacy of implementing a focused cardiac ultrasound course into a medical school curriculum

Abstract

BackgroundTeaching cardiac ultrasound to medical students in a brief course is a challenge. We aimed to evaluate the feasibility of teaching large groups of medical students the acquisition and interpretation of cardiac ultrasound images using a pocket ultrasound device (PUD) in a short, specially designed course.MethodsThirty-one medical students in their first clinical year participated in the study. All were novices in the use of cardiac ultrasound. The training consisted of 4 hours of frontal lectures and 4 hours of hands-on training. Students were encouraged to use PUD for individual practice. Finally, the students’ proficiency in the acquisition of ultrasound images and their ability to recognize normal and pathological states were evaluated.ResultsSixteen of 27 (59%) students were able to demonstrate all main ultrasound views (parasternal, apical, and subcostal views) in a six-minute test. The most obtainable view was the parasternal long-axis view (89%) and the least obtainable was the subcostal view (58%). Ninety-seven percent of students correctly differentiated normal from severely reduced left ventricular function, 100% correctly differentiated a normal right ventricle from a severely hypokinetic one, 100% correctly differentiated a normal mitral valve from a rheumatic one, and 88% correctly differentiated a normal aortic valve from a calcified one, while 95% of them correctly identified the presence of pericardial effusion.ConclusionsTraining of medical students in cardiac ultrasound during the first clinical year using a short, focused course is feasible and enables students with modest ability to acquire the main transthoracic ultrasound views and gain proficiency in the diagnosis of a limited number of cardiac pathologies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-017-0928-x) contains supplementary material, which is available to authorized users.

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

“…Furthermore, after training, medical students can adequately interpret images with a very simplified or binary assessment [36]. A number of previous studies employed training curricula for medical students on ultrasonography protocols [37][38][39]. Four other studies used a point-of-care ultrasonography training program to determine diagnostic performance in various clinical scenarios [36,[40][41][42].…”

Focused cardiac ultrasound training in medical students: Using an independent, simulator‐based curriculum to objectively measure skill acquisition and learning curve

“…Initially, training in FoCUS was provided on live patients and relied on direct oversight from expert sonographers or echocardiographers to provide instruction and to assess their competence. For example, Kobal et al 9 demonstrated that medical students improved in view acquisition after brief training under the guidance of trained experts; assessment was based on instructor review of acquired images using a checklist. However, instructor review of images is time consuming and labor intensive, and checklists are subject to inter‐rater variability 20 …”

“…This model of teaching basic cardiac ultrasound is rapidly becoming untenable as faculty time for one‐on‐one training and assessment of student progress is limited. Previous studies have developed FoCUS curriculum led by experts (board and society certified echocardiographers and sonographers) to instruct students in both FoCUS view acquisition and interpretation of normal images and pathologic findings 9,10 . To better optimize expert time and educational experience, we posit that the basics of view acquisition can be learned via simulator with objective measures to ensure baseline skill, thereby reserving expert time to the more advanced skills required for FoCUS image interpretation.…”

I Will Be at Your (Bed)Side – The Role of Bedside Echocardiography for Non-Cardiologists

“…Several studies have shown that even students receiving brief training in focused echocardiography can reach good diagnostic accuracy in a limited but relevant range of cardiac pathologies [45,46]. The number of studies necessary to obtain competence in bedside echocardiography is debatable.…”