Ultrasonography in a resident training program

Snyder, Jonathan R.

doi:10.1097/00001888-198003000-00021

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“…An earlier emerging and enduring discourse focuses on the utility of ultrasound in clinical medicine and its role in improving patient care. In the earliest text in our archive (1980), ultrasound was represented as a safe, clinically important, modern technology likely to become a central skill for future physicians and a ‘routine part of resident and medical student instruction’ . Across nearly 40 years of publications a dominant representation of ultrasound in medical education is that of a very modern, almost futuristic tool, ‘the stethoscope of the future’ or ‘the stethoscope of the 21st century’, that would improve patient care .…”

Section: Resultsmentioning

confidence: 99%

Stethoscope of the 21st century: dominant discourses of ultrasound in medical education

2018

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Context In recent years, point‐of‐care ultrasound (POCUS) has become a widely used clinical tool in a number of clinical specialties. In response, POCUS has been incorporated into medical curricula across the learning continuum, bolstered by enthusiastic appraisals of the technology's benefits for learners, clinicians and patients. In this project, we have sought to identify and understand the effects of dominant discourses influencing the integration of POCUS into medical education. Methods We conducted a Foucauldian critical discourse analysis (CDA) to identify and analyse discourses that legitimise and privilege the use of POCUS in medical education. We assembled an archive of 473 texts published between 1980 and 2017. Each article in the archive was analysed to identify frequently occurring truth statements (expressing concepts whose truths are unquestioned within particular discourses) that we used to characterise the major discourses that construct representations of POCUS in medical education. Results We identified three dominant discourses: (i) a visuo‐centric discourse prioritising the visual information as truth over other clinical data; (ii) a utilitarian discourse emphasising improvements in patient care; and (iii) a modernist discourse highlighting the current and future needs of clinicians in our technological world. These discourses overlap and converge; the core discursive effect makes the further elevation of POCUS in medical education, and the resulting attenuation of other curricular priorities, appear inevitable. Conclusions The three dominant discourses identified in this paper engender ideal conditions for the proliferation of POCUS in medical education through curricular guidelines, surveys of adherence to these guidelines and authoritative position statements. By identifying and analysing these dominant discourses, we can ask questions that do not take for granted the assumed truths underpinning the discourses, highlight potential pitfalls of proposed curricular changes and ensure these changes truly improve medical education.

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Section: Resultsmentioning

confidence: 99%