Medical Student Core Clinical Ultrasound Milestones

Abstract

A Consensus Among Directors in the United States oint-of-care ultrasound imaging is an important technical skill being incorporated into the undergraduate medical education curricula at an increasing rate in recent years. 1,2 Studies have been published demonstrating how point-of-care ultrasound improves patient safety during procedures and facilitates enhanced diagnostic abilities. 3,4 The advantages of point-of-care ultrasound is that is safely used at the bedside, obviates the need for transport to computed tomography or magnetic resonance imaging suites, does not use radiation, and gives immediate results that can be interpreted and used by the operator. 5 With the increasing use of point-of-care ultrasound by all types of providers throughout Vi Am Dinh, MD, RDMS, RDCS, Daniel Lakoff, MD, Jamie Hess, MD, David P. Bahner, MD, RDMS, Richard Hoppmann, MD, Michael Blaivas, MD, John S. Pellerito, MD, Alfred Abuhamad, MD, Sorabh Khandelwal, MD Received July 30, 2015, ORIGINAL RESEARCHObjectives-Many medical schools are implementing point-of-care ultrasound in their curricula to help augment teaching of the physical examination, anatomy, and ultimately clinical management. However, point-of-care ultrasound milestones for medical students remain unknown. The purpose of this study was to formulate a consensus on core medical student clinical point-of-care ultrasound milestones across allopathic and osteopathic medical schools in the United States. Directors who are leading the integration of ultrasound in medical education (USMED) at their respective institutions were surveyed.Methods-An initial list of 205 potential clinical ultrasound milestones was developed through a literature review. An expert panel consisting of 34 USMED directors across the United States was used to produce consensus on clinical ultrasound milestones through 2 rounds of a modified Delphi technique, an established anonymous process to obtain consensus through multiple rounds of quantitative questionnaires.Results-There was a 100% response rate from the 34 USMED directors in both rounds 1 and 2 of the modified Delphi protocol. After the first round, 2 milestones were revised to improve clarity, and 9 were added on the basis of comments from the USMED directors, resulting in 214 milestones forwarded to round 2. After the second round, only 90 milestones were found to have a high level of agreement and were included in the final medical student core clinical ultrasound milestones.Conclusions-This study established 90 core clinical milestones that all graduating medical students should obtain before graduation, based on consensus from 34 USMED directors. These core milestones can serve as a guide for curriculum deans who are initiating ultrasound curricula at their institutions. The exact method of implementation and competency assessment needs further investigation.

A Scoping Review of Ultrasound Teaching in Undergraduate Medical Education

“…This underscores the need for a structured approach to undergraduate ultrasound education which incorporates a robust image review and management system [15]. Many programs up to this point have been evaluated using various pre-and post-test questionnaires, MCQ exams and checklists; however, validated tools are emerging [21,22].…”

“…Curriculum surveys [20][21][22][23][24] Five papers featured surveys of curriculum administrators regarding incorporation of ultrasound into medical schools in the USA. Bahner [20] provides a useful cross-section of ultrasound teaching in the USA, where 62.2% of schools that responded reported that ultrasound was a part of their medical school curriculum.…”

“…Bahner [20] provides a useful cross-section of ultrasound teaching in the USA, where 62.2% of schools that responded reported that ultrasound was a part of their medical school curriculum. Two papers surveyed ultrasound experts using a 'Delphi' methodology to establish ultrasound learning milestones [21] and an assessment tool [22]. Description of subcategory [92][93][94][95][96][97][98] Training medical students in POCUS for 1 year appears to provide them with a significant advantage in the postgraduate arena [92].…”

A Near-peer Point-of-care Ultrasound Elective for Medical Students: Impact on Anatomy Knowledge, Perceptions About Ultrasound, and Self-reported Skill Level

“…The program included an instruction on the applications of ultrasound that were most relevant to core third-year clinical rotations and most important to general medical practice as determined by consensus among faculty from radiology, emergency medicine, internal medicine, anesthesiology, surgery, and family medicine. Previously published curricular guidelines were also consulted (18,19). Learning objectives for the course were finalized by the radiology and emergency medicine faculty who coordinate medical student education in ultrasound for the School of Medicine.…”

“…The design and content of the course were based on programs at other institutions (8)(9)(10)(11). A near-peer education model was adopted as it has been shown to benefit the learner and the teacher (12)(13)(14)(15) and because of the limited availability of faculty instructors, a common obstacle also encountered at other programs (16)(17)(18).…”