Can medical learners achieve point-of-care ultrasound competency using a high-fidelity ultrasound simulator?: a pilot study

Abstract

BackgroundPoint-of-care ultrasound (PoCUS) is currently not a universal component of curricula for medical undergraduate and postgraduate training. We designed and assessed a simulation-based PoCUS training program for medical learners, incorporating image acquisition and image interpretation for simulated emergency medical pathologies. We wished to see if learners could achieve competency in simulated ultrasound following focused training in a PoCUS protocol.MethodsTwelve learners (clerks and residents) received standardized training consisting of online preparation materials, didactic teaching, and an interactive hands-on workshop using a high-fidelity ultrasound simulator (CAE Vimedix). We used the Abdominal and Cardiothoracic Evaluation by Sonography (ACES) protocol as the curriculum for PoCUS training. Participants were assessed during 72 simulated emergency cardiorespiratory scenarios. Their ability to complete an ACES scan independently was assessed. Data was analyzed using R software.ResultsParticipants independently generated 574 (99.7%) of the 576 expected ultrasound windows during the 72 simulated scenarios and correctly interpreted 67 (93%) of the 72 goal-directed PoCUS scans.ConclusionsFollowing a focused training process using medical simulation, medical learners demonstrated an ability to achieve a degree of competency to both acquire and correctly interpret cardiorespiratory PoCUS findings using a high-fidelity ultrasound simulator.

A Scoping Review of Ultrasound Teaching in Undergraduate Medical Education

“…Devices and simulators [104][105][106][107][108][109][110][111][112][113][114][115][116] The primary objective of these papers was to describe or evaluate ultrasound simulators (or 'phantoms') or devices adjunctive to the ultrasound machine itself. Ultrasound simulators are models of human anatomy designed to provide a means of practicing ultrasound skills where practice on a human is impractical, dangerous or unethical.…”

“…Ultrasound simulators are models of human anatomy designed to provide a means of practicing ultrasound skills where practice on a human is impractical, dangerous or unethical. Our search found studies that tested both commercially available simulators [104][105][106][107][108] and institutions that built their own simulators with varying degrees of complexity [109][110][111].…”

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

“…The training protocol we utilized has been described previously by our group. 12 Following PoCUS training, participants were introduced to the patient simulation suite and the high-fidelity clinical simulator, the Laerdal SimMan 3G. During this time, participants were oriented to the simulator and interviewed the simulated patient through the built-in microphone, listened to heart and lung sounds, familiarized themselves with the monitor, and identified decreased pulses and diaphoresis.…”

“…Competency was measured by image acquisition and interpretation, with learners successfully generating 99.7% of the ultrasound windows and correctly interpreting 93% of the scans. 12 High-fidelity simulation offers many benefits in medical education, including decreased reliance on patient or volunteer availability, and the ability to customize and repeat virtually any clinical scenario. Unfortunately, the fidelity, or realism, of the simulated human body is restricted by the available technologies, which limits the ability to realistically approximate actual ultrasound images.…”

Development of the ultrasonography learning model for undergraduate medical students: A case study of the Faculty of Medicine, Burapha University

“…11e13 Some studies provided US education in preclinical years and yielded a high level of student performance. 14 Several other studies incorporated US into the clinical years, 7,9,15 whereas other studies incorporated US education vertically during both the preclinical and clinical years. 12 The suitable number of proctored US examinations necessary to give students sufficient US skills remains subject to debate.…”