Ultrasound Curriculum Research Articles

Assessment of knowledge retention and the value of proctored ultrasound exams after the introduction of an emergency ultrasound curriculum

BackgroundOptimal training required for proficiency in bedside ultrasound is unknown. In addition, the value of proctored training is often assumed but has never been quantified.MethodsTo compare different training regimens for both attending physicians and first year residents (interns), a prospective study was undertaken to assess knowledge retention six months after an introductory ultrasound course. Eighteen emergency physicians and twelve emergency medicine interns were assessed before and 6 months after an introductory ultrasound course using a standardized, image-based ultrasound test. In addition, the twelve emergency medicine interns were randomized to a group which received additional proctored ultrasound hands-on instruction from qualified faculty or to a control group with no hands-on instruction to determine if proctored exam training impacts ultrasound knowledge. Paired and unpaired estimates of the median shift in test scores between groups were made with the Hodges-Lehmann extension of the Wilcoxon-Mann-Whitney test.ResultsSix months after the introductory course, test scores (out of a 24 point test) were a median of 2.0 (95% CI 1.0 to 3.0) points higher for residents in the control group, 5.0 (95% CI 3.0 to 6.0) points higher for residents in the proctored group, and 2.5 (95% CI 1.0 to 4.0) points higher for the faculty group. Residents randomized to undergo proctored ultrasound examinations exhibited a higher score improvement than their cohorts who were not with a median difference of 3.0 (95% CI 1.0 to 5.0) points.ConclusionWe conclude that significant improvement in knowledge persists six months after a standard introductory ultrasound course, and incorporating proctored ultrasound training into an emergency ultrasound curriculum may yield even higher knowledge retention.

Toward an ultrasound curriculum for critical care medicine

Accurate assessment and rapid decision-making are essential to save lives and improve performance in critical care medicine. Real-time point-of-care ultrasound has become an invaluable adjunct to the clinical evaluation of critically ill and injured patients both for pre- and in-hospital situations. However, a high level of quality is necessary, guaranteed by appropriate education, experience, credentialing, quality control, continuing education, and professional development. Although educational recommendations have been proposed by a variety of nonimaging specialties, to date they are still scattered and limited examples of standards for critical and intensive care professionals. The challenge of providing adequate specialty-specific training, as encouraged by major medical societies, is made even more difficult by the diversity of critical care ultrasound utilization by various subspecialties in a variety of settings and numerous countries. In order to meet this educational challenge, a standard core curriculum is presented in this manuscript. The proposed curriculum is built on a competence, performance, and outcomes-based approach that is tailored to setting-specific training needs and prioritized according to critical problem-based pathways, rather than traditional organ-based systems. A multiple goal-oriented style fully addresses the specialty-specific approach of critical and intensive care professionals, who typically deal with disease states in complex scenarios rather than individual organ complaints. Because of the variation in the concept of what constitutes critical care worldwide, and the rate of change of information and technology, this manuscript attempts to present a learning system addressing a variety of needs for a rapidly changing world.

A Bedside Ultrasound Curriculum for Medical Students: Prospective Evaluation of Skill Acquisition

Objective: We conducted a study to evaluate the efficacy of an introductory ultrasound (US) curriculum for medical students rotating through our emergency departments. Materials and Methods: Third and 4th-year medical students indicated their previous US experience and were given a pretest consisting of static US images to assess baseline interpretation skills. They participated in a 45-min interactive didactic session followed by a 45-min session of hands-on experience practicing real-time US image acquisition on a normal model. After this session, we tested the timing and quality of their image acquisition skills on a separate normal model. Quality of images was based on a point value from 0 to 2 per image. This was followed by a posttest of static US images, which was graded in the same manner as the pretest. Results: Thirty-one students participated in the study. Median time to acquire 2 images was 112.5 sec (range = 15-420 sec). Acquisition time was unaffected by previous experience (p = .97). The mean score on the quality of 2 images (maximum score = 4) was 3.84; median was 4 (range = 1-4). Image quality was significantly better in participants with previous US experience (p = .014). Scores on interpretation of static images improved significantly from pretest to posttest by a median of 8.25 points (p = .0001). Conclusion: Our introductory US course is effective at significantly improving medical students-interpretation of static US images. The majority of students were able to acquire high quality images in a short period of time after this session.

A Bedside Ultrasound Curriculum for Medical Students: Prospective Evaluation of Skill Acquisition

Abstract Objective: We conducted a study to evaluate the efficacy of an introductory ultrasound (US) curriculum for medical students rotating through our emergency departments. Materials and Methods: Third and 4th-year medical students indicated their previous US experience and were given a pretest consisting of static US images to assess baseline interpretation skills. They participated in a 45-min interactive didactic session followed by a 45-min session of hands-on experience practicing real-time US image acquisition on a normal model. After this session, we tested the timing and quality of their image acquisition skills on a separate normal model. Quality of images was based on a point value from 0 to 2 per image. This was followed by a posttest of static US images, which was graded in the same manner as the pretest. Results: Thirty-one students participated in the study. Median time to acquire 2 images was 112.5 sec (range = 15-420 sec). Acquisition time was unaffected by previous experience (p = .97). The mean score on the quality of 2 images (maximum score = 4) was 3.84; median was 4 (range = 1-4). Image quality was significantly better in participants with previous US experience (p = .014). Scores on interpretation of static images improved significantly from pretest to posttest by a median of 8.25 points (p = .0001). Conclusion: Our introductory US course is effective at significantly improving medical students-interpretation of static US images. The majority of students were able to acquire high quality images in a short period of time after this session.

Proctored Ultrasound Examinations (PUE) Significantly Improve Success in Emergency Medicine Ultrasound Education

Study Objectives: The authors sought to determine whether proctored ultrasound examinations(PUE) improves the performance of emergency medicine interns participating in a didactic-based ultrasound curriculum.

Do Emergency Medicine Residency Programs Meet American College of Emergency Physicians Requirement of Ultrasound Curricula?

Do Emergency Medicine Residency Programs Meet American College of Emergency Physicians Requirement of Ultrasound Curricula?

Basic Ultrasound Curriculum for Medical Students: Validation of Content and Phantom

Effective use of ultrasound requires an understanding of the physics, combined with the ability to interpret the sonographic images. The aim of our study was to evaluate the impact of a basic ultrasound curriculum using a phantom to train medical students. Twenty-eight first- to fourth-year medical students were randomized to two groups: a control group that received no formal training and a trained group that received basic ultrasound training. Both groups took an initial multiple-choice written test and an ultrasound hands-on test using an agarose-based tissue mimic containing various objects. The curriculum for the trained group consisted of reading the principles of ultrasound and a hands-on session over the phantom. After training, both groups underwent a second multiple-choice exam and ultrasound practical test. The initial and the post-training test results were analyzed using a two-tailed Student's t-test. Baseline written and practical test scores were similar for both groups. After training, written test scores improved (82% trained vs. 66% control, P < 0.001). Hands-on ultrasound task performance also improved with training (96% trained vs. 60% control, P <0.001). The trained group took a shorter time to obtain a clear image and found on average one more object per scan. Parameters such as time to obtain a useful image and number of objects recognized also improved with training. Basic sonographic physics, imaging, and interpretation can be effectively taught to medical students during a short training session.

Basic Ultrasound Curriculum for Medical Students: Validation of Content and Phantom

Effective use of ultrasound requires an understanding of the physics, combined with the ability to interpret the sonographic images. The aim of our study was to evaluate the impact of a basic ultrasound curriculum using a phantom to train medical students. Twenty-eight first- to fourth-year medical students were randomized to two groups: a control group that received no formal training and a trained group that received basic ultrasound training. Both groups took an initial multiple-choice written test and an ultrasound hands-on test using an agarose-based tissue mimic containing various objects. The curriculum for the trained group consisted of reading the principles of ultrasound and a hands-on session over the phantom. After training, both groups underwent a second multiple-choice exam and ultrasound practical test. The initial and the post-training test results were analyzed using a two-tailed Student's t-test. Baseline written and practical test scores were similar for both groups. After training, written test scores improved (82% trained vs. 66% control, P < 0.001). Hands-on ultrasound task performance also improved with training (96% trained vs. 60% control, P <0.001). The trained group took a shorter time to obtain a clear image and found on average one more object per scan. Parameters such as time to obtain a useful image and number of objects recognized also improved with training. Basic sonographic physics, imaging, and interpretation can be effectively taught to medical students during a short training session.

Ultrasound Practitioner Master's Degree Curriculum and Questionnaire Response by the SDMS Membership

Following publication of the ultrasound practitioner (UP) master's degree educational proposal in August 1999, the UP Commission published a questionnaire to obtain feedback from SDMS membership to the UP concept. This article contains the results of that data collection. Additionally, as progress has been made in the development of UP programs around the country, refinement of the curriculum, as originally proposed, has begun. This article contains a breakdown of required didactic and clinical education for the midlevel provider in diagnostic ultrasound.

Ultrasound training for emergency physicians--a prospective study.

Bedside ultrasound examination by emergency physicians (EPs) is being integrated into clinical emergency practice, yet minimum training requirements have not been well defined or evaluated. This study evaluated the accuracy of EP ultrasonography following a 16-hour introductory ultrasound course. In phase I of the study, a condensed 16-hour emergency ultrasound curriculum based on Society for Academic Emergency Medicine guidelines was administered to emergency medicine houseofficers, attending staff, medical students, and physician assistants over two days. Lectures with syllabus material were used to cover the following ultrasound topics in eight hours: basic physics, pelvis, right upper quadrant, renal, aorta, trauma, and echo-cardiography. In addition, each student received eight hours of hands-on ultrasound instruction over the two-day period. All participants in this curriculum received a standardized pretest and posttest that included 24 emergency ultrasound images for interpretation. These images included positive, negative, and nondiagnostic scans in each of the above clinical categories. In phase II of the study, ultrasound examinations performed by postgraduate-year-2 (PGY2) houseofficers over a ten-month period were examined and the standardized test was readministered. In phase I, a total of 80 health professionals underwent standardized training and testing. The mean +/- SD pretest score was 15.6 +/- 4.2, 95% CI = 14. 7 to 16.5 (65% of a maximum score of 24), and the mean +/- SD posttest score was 20.2 +/- 1.6, 95% CI = 19.8 to 20.6 (84%) (p < 0. 05). In phase II, a total of 1,138 examinations were performed by 18 PGY2 houseofficers. Sensitivity was 92.4% (95% CI = 89% to 95%), specificity was 96.1% (95% CI = 94% to 98%), and overall accuracy was 94.6% (95% CI = 93% to 96%). The follow-up ultrasound written test showed continued good performance (20.7 +/- 1.2, 95% CI = 20.0 to 21.4). Emergency physicians can be taught focused ultrasonography with a high degree of accuracy, and a 16-hour course serves as a good introductory foundation.

Prevalence and structure of ultrasound curricula in emergency medicine residencies

Emergency medicine (EM) residency program directors were surveyed to determine the presence and structure of curricula for teaching ultrasound to EM residents. For those EM programs without an ultrasound curriculum (USC), information was requested on plans to implement one within the next 12 months. Ninety of 116 (78%) EM programs replied to the survey. One-half of EM residencies surveyed have USCs, and another 30% plan to implement one in the near future.

Abdominal Ultrasonography in Trauma

The use of ultrasonography for the investigation of urgent diagnostic dilemmas is by no means new. Although it has been widely used for almost 40 years, during the past two decades ultrasonography has achieved a primary role in Europe and Asia in the investigation of emergent conditions such as trauma. The use of this bedside diagnostic modality is expanding rapidly and will continue to do so. Emergency physicians have developed a fellowship program in emergency ultrasonography, have set forth a model curriculum for physician training in emergency ultrasonography, and have begun to conduct hands-on courses for academic emergency physicians. Because diagnostic ultrasonography has proven to be of value in the diagnosis and management of a variety of emergent conditions, ultrasound examination, interpretation, and clinical correlation should be immediately available around the clock in resuscitation areas. It is hoped that (1) ultrasound training will be incorporated into general surgical residency programs, (2) ultrasound curriculum and credentialing processes will be established, and (3) more surgeons will have this modality available to them as part of their diagnostic armamentarium in the evaluation of injured patients.

Expert Consensus on a Canadian Internal Medicine Ultrasound Curriculum

Ultrasonography is increasingly used at the bedside. In the absence of an already developed curriculum appropriate for Canadian internal medicine training programs, 13 representatives from internal medicine programs in five Western Canadian provinces met for 2 days to develop and propose a consensus-based internal medicine curriculum for training in the bedside use of ultrasonography in a Canadian health care context.All 13 had had interest or leadership role in those programs. The curriculum’s content was based on three overarching principles agreed upon by the group: (1) content should be selected on the basis of clinical or educational need; (2) content should be feasible (i.e., both cognitive and technical components of the curriculum could be reasonably taught and learned in a competency-based manner while minimizing potential risks to patients); and (3) content should be evidence based. A consensusbased curriculum of 16 proposed topics is to be considered for the core internal medicine residency training program (postgraduate year [PGY] 1 to PGY 3), and 22 topics are to be considered for general internal medicine subspecialty training programs (PGY 4 to PGY 5).