Feasibility and accuracy of point-of-care pocket-size ultrasonography performed by medical students

Abstract

BackgroundPoint-of-care ultrasound performed by clinicians is a useful supplement in the treatment and assessment of patients. We aimed to investigate whether medical students with minimal training were able to successfully acquire and interpret ultrasound images using a pocket-size imaging device (PSID) as a supplement to their clinical practice.MethodsThirty 5th year (of six) medical students volunteered to participate. They were each given a personal PSID device to use as a supplement to their physical examination during their allocated hospital terms. Prior to clinical placement the students were given three evenings of hands-on training with PSID by a board certified radiologist/cardiologist, including three short lectures (<20 min). The students were shown basic ultrasound techniques and taught to assess for basic, clinically relevant pathology. They were specifically instructed to assess for the presence or absence of reduced left ventricular function (assessed as mitral annular excursion < 10 mm), pericardial effusion, pleural effusion, lung comets, hydronephrosis, bladder distension, gallstones, abdominal free-fluid, cholecystitis, and estimate the diameter of abdominal aorta and inferior vena cava.ResultsA total of 211 patients were examined creating 1151 ultrasound recordings. Acceptable organ presentation was 73.8% (95% CI 63.1-82.6) for cardiovascular and 88.4% (95% CI: 80.6-93.6) for radiological structures. Diagnostic accuracy was 93.5% (95% CI: 89.0-96.2) and 93.2% (95% CI: 87.4-96.5) respectively.ConclusionMedical students with minimal training were able to use PSID as a supplement to standard physical examination and successfully acquire acceptable relevant organ recordings for presentation and correctly interpret these with great accuracy.

A Scoping Review of Ultrasound Teaching in Undergraduate Medical Education

“…Some institutions taught students ultrasound-specific protocols such as FAST [60][61][62] or USEFUL [63] scans. Senior medical students, whose learning objectives have graduated to the diagnosing of disease in real-world patients, have demonstrated significant improvement in their ability to diagnose disease following brief, focused ultrasound teaching programs [64][65][66][67][68]. These benefits are particularly impressive when benchmarked against postgraduate medical practitioners using either physical examination [69,70] or ultrasound [71,72].…”

Hand-held ultrasonography: An opportunity for “hands-on” teaching of medicine

“…We suggest universities develop their own resources in the field which are tailored to their curriculum. Most of literature published to date reports the use of HHU devices to teach medical students to recognise cardiac pathology (13) (14) (15) (16) . Figures 2 and 3 illustrate that there are exciting concepts yet to be explored by educators when using ultrasound to teach medical students.…”

“…The published use of HHU devices has focused on teaching medical students to recognise a small number of mainly cardiac pathologies (13) (14) (15) (16) . Few publications report the use of HHU to teach other organ areas (16) (17) .…”

“…The published use of HHU devices has focused on teaching medical students to recognise a small number of mainly cardiac pathologies (13) (14) (15) (16) . Few publications report the use of HHU to teach other organ areas (16) (17) . Formal ultrasound imaging has been successfully used to improve the medical students' knowledge of living anatomy and physiology (11) (18) , as well as their motivation to learn (19) .…”

Utilidad de la ecografía clínica en el diagnóstico del paciente con disnea

“…Se observa muy bien en el plano subxifoideo y no es necesario una curva de aprendizaje prolongada para su diagnóstico con fiabilidad [11][12][13][14][15][16][17][18][19] . El derrame pericárdico es moderado cuando su espesor supera los 10 mm y severo cuando es mayor de 20 mm (figura 13).…”