The Effectiveness of Student-Led Musculoskeletal and Vascular Ultrasound Workshops at a Single Institution: A Retrospective Survey Analysis

Abstract

Introduction Point-of-care ultrasound (POCUS) is a rapidly evolving field of diagnostic medicine as its low cost, portability, and versatility have made handheld ultrasound (US) probes an invaluable tool for many modern physicians. Despite US’s benefits as a bedside evaluative tool, many medical schools have not integrated POCUS into their pre-clerkship medical education due to a lack of equipment and faculty. The first objective of our study was to determine whether student tutors (STs) would be effective resources to teach musculoskeletal (MSK) and vascular US to preclinical medical students. The second objective of our study was to determine whether students who previously attended ST-run MSK US workshops perform better in vascular US than those who did not. Methods Six POCUS workshops were led by STs after approval from experienced US faculty. These included US workshops on gastrointestinal structures, forearm structures, joint structures, basic echocardiography, and US-guided IV access. We collected data from two of our six workshops. We developed surveys to gauge the confidence and ability of students to perform US after an MSK workshop and US-guided IV access workshop led by STs. We also measured students' US abilities and collected student feedback after our US-guided IV access workshop. We evaluated students’ US competency in US-guided IV access via their ability to correctly position the US probe, angle the needle of insertion, move the probe with the needle, and access the vein based on the accuracy of the movements. We divided student results into two groups: students who previously attended the MSK workshop before attending the US-guided IV access workshop and students who did not attend the MSK workshop before attending the US-guided IV access workshop. We used averages, frequencies, and two-tailed t-tests to analyze the survey responses and US-guided IV access skill assessments. Results Fifty percent of first- and second-year surveyed students “agreed,” and 32.4% “strongly agreed” that they felt confident using US after an ST-run MSK workshop. About 29.4% of surveyed students “agreed” and 41.2% “strongly agreed” that they felt comfortable explaining basic US concepts, such as proper probe positioning and echogenicity. The group of students who attended the MSK workshop prior to the peripheral IV workshop scored similarly to the students who did not attend the MSK workshop (14.33±1.03 versus 14.20±0.84 points). Both groups of students had an average of over 94% accuracy in technique, positioning, angling, moving the US probe, and achieving US-guided venous access after being taught by STs. Qualitative surveying noted positive student feedback, such as "Teacher was great at guiding us through the procedure." Survey responses also included suggestions on adding and diversifying equipment, such as “[It would be useful to have a] different type of needle to see the difference on ultrasound.” Conclusion ...

Comparing Peer-Taught Student Tutors to Faculty-Taught Student Tutors in Educating Medical Students on Musculoskeletal Ultrasound

“…This could be due to a number of factors, one of which could be that students perceive UI as seasoned experts in their field, which in turn bolsters the students' confidence in sonographic ability since they perceive to be learning from experts rather than their peers. However, other studies have shown that STs instill more confidence in medical students in the setting of ultrasound instruction [18][19][20][21]22,23]. One of these studies stated that their data and medical student evaluations suggested that this may be due to peer tutors' ability to conform their teachings to fit the learning style of other students [24].…”

“…This paper endeavors to investigate the efficacy of STs trained by other students in imparting the fundamentals of one of the most straightforward ultrasound uses: the musculoskeletal (MSK) ultrasound of the upper extremity. Other studies exploring the use of STs to educate on MSK ultrasound exist [15], in addition to other studies with emphasis on different body systems, including cardiac, vascular, and abdominal ultrasounds [16][17][18]. However, none explored the specific potential of a peer tutoring system that is completely independent of formal ultrasound instruction by faculty members and driven solely by student-taught tutors.…”