Ultrasound and stethoscope as tools in medical education and practice: considerations for the archives

Abstract

ObjectivesIn recent years, the use and portability of ultrasound has threatened the utility of the stethoscope, with many debating and even advocating its replacement. The authors set out to assess opinions in this regard among faculty within a medical school and specifically within an anatomy department where ultrasound is incorporated into the curriculum from the first term.MethodsA debate was elicited during a biweekly Anatomy Journal Club session and was centered on three published papers presented. Several questions were raised regarding the possible replacement of stethoscope – the value of early exposure to students as well as how ultrasound and stethoscope should be considered by physicians, students, and teachers.ResultsThe general consensus was that the stethoscope should not be replaced but should be used in conjunction with emerging portable ultrasound. Caution was given that technology could “overcomplicate” diagnosis and lead to increased tests resulting in increased cost of care. In terms of exposing students to ultrasound, just as the stethoscope requires practice to use effectively, so does the ultrasound and should be introduced as early on as possible. As is the case with the stethoscope, students may not initially appreciate all the finer details on ultrasound; however, continual use would improve skill.ConclusionThe stethoscope should always remain part of the physical examination and ultrasound should be used in addition to, not replacement of. As technology advances the need for apprenticeship, training increases and students of the medical profession should be exposed to these technologies as early as possible. Hence, it is not yet time to archive the stethoscope. Perhaps never.

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

“…The discourse gradually shifted, with authors using the comparison of ultrasound machines with stethoscopes or other clinical tools as the rationale for research into the ability of students to learn ultrasound skills . As an example of the evocation of history to encourage current training in POCUS skills, one group of authors explicitly frames the issue thus: ‘A century ago, physicians had to master stethoscopes.…”

Point-of-care ultrasound augments physical examination learning by undergraduate medical students

“…Increased accessibility of ultrasound imaging in recent years has raised the issue of whether traditional physical examination using a stethoscope should be replaced with ultrasound imaging. 17 Undoubtedly, its non-ionising and non-invasive nature makes ultrasound imaging a very attractive tool for medical education, connecting basic science with clinical applications and enhancing direct student–teacher interaction; nonetheless, there has been no standard methodology for teaching ultrasound imaging at an undergraduate level. 18 In reality, rather than replacing traditional physical examination, ultrasound imaging can be used as an adjunct to facilitate physical examination skill acquisition and development because of the ability to instantly correlate findings of physical examination with ultrasound images.…”

Prospective Analysis of Short- and Mid-term Knowledge Retention after a Brief Ultrasound Course for Undergraduate Medical Students

“…The optimal time to introduce POCUS concepts during medical education is still a matter of debate. The American Academy of Emergency Medicine advocates offering POCUS training to medical students 2,21,22. In fact, the incorporation of ultrasonography is well accepted among students who recognize various applications of that technology 15,23.…”

“…Point-of-care ultrasound (POCUS) is becoming an integral part of the assessment of critical care patients. It is considered “the new stethoscope” by some authors 1,2 and is a useful tool for the evaluation of abdominal pain, intracranial hypertension, pleuropulmonary diseases, shock, and airway control 3,4.…”