Can fourth-year medical students learn bedside ultrasonography?

Abstract

Study objectives: During the past decade, ultrasonography has become increasingly available in the daily practice of emergency physicians. The scope of use for bedside emergency ultrasonography is expanding daily. Emergency ultrasonographic skills and interpretation, however, are not taught in any US medical schools. We established the first emergency department (ED)–based ultrasonography medical student rotation 1 year ago. The purpose of this study is to evaluate whether fourth-year medical students can learn bedside emergency ultrasonography and whether they learn more on a 2- or 4-week rotation. Methods: A 35-question written test was designed covering the core applications of emergency ultrasonography, including diseases of the gallbladder, kidneys, vessels, eyes, reproductive organs, and trauma. An interactive DVD was also designed with live ultrasonographic video clips to accompany the examination. The questions covered ultrasonographic physics, recognition of images, and medical management of patients according to emergency ultrasonography results. Fourth-year medical students were enrolled from a number of US medical students and Europe during a 4-month period. All of the students had little or no experience in ultrasonography. The students were given the examination the first day of their rotation before they received any ultrasonography instruction. The students then spent 2- or 4-week rotations learning emergency ultrasonography. The ultrasonography course consists of 40 hours per week of clinical ultrasonography, 1 hour per week of didactic education, and 5 hours per week of quality-assurance reviewing of ultrasonography clips taped in the ED. On the final day of the rotation, the students were given the final examination. Examination results did not affect their grade for the rotation, and the students were blinded to their results. Results: Twenty-nine fourth-year medical students were enrolled in the study during a 6-month period. There were 16 students on the 2-week rotation and 13 students on the 4-week rotation. The average pretest score of all medical students on the rotation was 16.8 of 35.0, which is 48.0%, and the average posttest scores for all students was 27.7 of 35.0 (79.1%, P P =.448). The average final examination score for students on the 2-week rotation was 26.3 of 35.0 (75.1%) and for the students on the 4-week rotation was 29.4 of 35.0 (84.0%, P =.027). Conclusion: A fourth-year medical student emergency ultrasonography rotation can be an effective method of teaching emergency ultrasonography skills and interpretation. Medical students on a 4-week rotation learn more than those on a 2-week rotation.