Ultrasound Integration in Undergraduate Medical Education: Comparison of Ultrasound Proficiency Between Trained and Untrained Medical Students.

Abstract

The benefit of formal ultrasound implementation in undergraduate medical education remains unclear. The goal of this study was to evaluate the effectiveness of ultrasound curriculum implementation during year 1 medical student physical examination teaching on the ultrasound proficiency of medical students. An ultrasound curriculum was formally implemented at our institution in August 2012 and since then has successfully trained 2 classes of medical students (year 1 and year 2). Year 3 and year 4 medical students did not receive any formal ultrasound training, as the curriculum had not yet been implemented during their preclinical years. With the use of a 22-point ultrasound objective structured clinical examination (US-OSCE), trained medical students were compared to untrained medical students. The US-OSCE tested image acquisition and interpretation of the following systems: ocular, neck, vascular, pulmonary, cardiovascular, and abdominal. Emergency medicine (EM) residents formally trained in bedside ultrasound were also tested with the US-OSCE to provide a reference standard. There were 174 year 1, 25 year 2, and 19 year 3/year 4 medical students and 30 EM residents tested on the US-OSCE. Ultrasound-trained medical students were compared to untrained medical students, and overall US-OSCE scores ± SD were 91.4% ± 14.0% versus 36.1% ± 21.4% (P < .001), respectively. The EM resident group had an overall score of 99.1% ± 1.8%. The absolute percentage differences were 7.7% between EM resident and ultrasound-trained medical student scores and 63.0% between EM resident and untrained medical student scores (P < .001). Implementation of an ultrasound curriculum in undergraduate medical education showed a significant increase in trained versus untrained medical student ultrasound capabilities.