WFUMB Position Paper. Learning Gastrointestinal Ultrasound: Theory and Practice

Atkinson, Nathan; Bryant, Robert V.; Ye, Dong; Maaser, Christian; Kucharzik, Torsten; Maconi, Giovanni; Asthana, Anil Kumar; Blaivas, Michael; Goudie, Adrian; Gilja, Odd Helge; Nolsøe, Christian Pállson; Nürnberg, Dieter; Dietrich, Christoph F.

doi:10.1016/j.ultrasmedbio.2016.08.026

Cited by 63 publications

(77 citation statements)

References 61 publications

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“…Similar papers have been published in the United States [11,12,16,17]. More recent papers focus on specific organ systems [18].…”

Section: What To Teach?mentioning

confidence: 71%

Ultrasound student education

Dietrich

2017

Med Ultrason

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Ideally, training in ultrasound (US) should be easily accessible, standardized, systematic and transparent, allowing structured teaching and the acquisition of clinical skills. Conventional US is, generally speaking, the initial imaging modality used worldwide. It has been performed for more than three decades and has provided answers to a wide range of indications (questions) across numerous specialities. US facilitates an interdisciplinary approach and may link other subspecialists. In many countries, conventional US has long been incorporated in basic medical education and subspecialisation programs.Technological advancements have made the US equipment accessible and affordable, with hand-held US devices that are now no bigger than a smart phone [1][2][3]. Moreover, hand-held US has the potential to support the physical examination, validating the clinical findings, may directly answer clinical questions or guide the selection of further investigations [4]. Therefore, US can be regarded as an extension of the physical examination. US devices used in this way have been variously termed echoscopes [2,3,[5][6][7][8], visual stethoscopes [9], or sonoscopes [10] amongst other terms. With this simplified technique not only specific answers can be gained but also handheld US equipment may be utilised as aids to enhance medical student's education.The advantages of US as an extended physical examination are overwhelming, particularly the instant availability of high resolution real-time imaging without the potential risk of exposue to ionizing radiation. Real time imaging allows guidance for interventional procedures, whilst portable small ultrasound equipment allows point of care delivery. As a non-invasive imaging method, US has high patient acceptance. The limitations of ultrasound are obvious: US is highly operator-dependent, specific procedural skills are needed, requiring hands-on training, and ultrasound does not allow examination of all body compartments since air and bone cannot be penetrated.The introduction of ultrasound as part of the medical education has been reported since the early 80's of last century. "Anatomie am Lebenden" (which might be translated as "practical teaching of anatomy") was an early teaching experiment at the Hannover Medical School (MHH, Germany) under the guidance of R. Pabst and H. Lippert. The anatomy department implemented voluntary hands-on ultrasound courses performed by medical students on other students. Medical students participated as subjects, active tutors and teachers to enhance anatomical knowledge. These courses were well received by students. The preclinical use of ultrasound should facilitate and enhance the understanding of anatomy, physiology, pathophysiology and pathology.It has been shown that through its diversity, US fulfils the prerequisites for medical student clinical teaching but its role differs in the various regions of the world. Today, the majority of US educational programs for the extended physical examination in medical schools are organized by clin...

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“…Similar papers have been published in the United States [11,12,16,17]. More recent papers focus on specific organ systems [18].…”

Section: What To Teach?mentioning

confidence: 71%

Ultrasound student education

Dietrich

2017

Med Ultrason

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“…These include, for example, screening for hepatocellular carcinoma in cirrhotic patients (diagnostic/descriptive) [45-48], monitoring of inflammatory bowel disease (IBD) activity (clinical monitoring) [49-55] or percutaneous therapy of hepatocellular carcinoma (interventional guidance) [56-58]. Regarding some of the abdominal and pelvic conditions that can be identified by digestive US, an abridged list is presented in Table 1 [2, 40, 43, 59, 60]. …”

Section: The Role For Us In Gastroenterologymentioning

confidence: 99%

“…The learning process in US starts with the theoretical knowledge of anatomical structures, pathological entities and the technique, followed by an evolving ability to perform the examination itself from supervised to independent practice [40]. The recommendations concerning US practice usually comprehend progressive degrees of expertise, ranging from level 1 practitioners, who are able to perform unsupervised common US explorations, to level 3 practitioners, reserved to experts dedicated to teaching and research in US.…”

Section: The Importance Of Training In Usmentioning

confidence: 99%

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Ultrasonography in Gastroenterology: The Need for Training

Pinto¹,

Azevedo²,

Pereira³

et al. 2018

GE Port J Gastroenterol

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The use of ultrasonography (US) as an imaging modality in medicine has spread across almost every clinical specialty. This diffusion is based on the simplicity, accessibility, portability and affordability of the technique producing real-time high-resolution images using non-ionising radiation. On the other hand, this trend also extended the technique to settings other than healthcare, such as public facilities, private houses or remote sites. This tendency can be observed worldwide, from developing countries to prestigious medical schools and tertiary referral hospitals. Furthermore, point-of-care US (POCUS), i.e., US executed at the patient’s bedside to obtain real-time objective information with diagnostic and clinical monitoring purposes or to guide invasive procedures, has been incorporated in many specialties. In gastroenterology, despite the essential role of endoscopy, clinical practice is highly dependent on non-endoscopic imaging techniques. However, as in other specialties, the indications of US in gastroenterology have been increasing steadily, covering a broad range of conditions. In response to the generalised employment of US by non-radiologists, institutions such as the European Federation of Societies for Ultrasound in Medicine and Biology and the Royal College of Radiologists issued recommendations to ensure high-quality practice. These theoretical and practical requisites include performing a certain number of examinations and mandatory skills in order to achieve certification to execute unsupervised US. Therefore, there is a need for modern gastroenterology to include US as a basic skill in its clinical practice. To ensure the provision of high-quality US, adequate instruction of future specialists should be guaranteed by the gastroenterology departments and required in the residency training programme.

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“…Dynamic contrast enhanced ultrasound (DCE-US) refers to quantitative time intensity curve (TIC) analysis [11][12][13] using either bolus injection of microbubbles [13][14][15][16] or intravenous infusion with disruption-replenishment technique [17] which are used for treatment response evaluation in oncology [18] and for activity assessment in inflammation of the bowel wall in inflammatory bowel disease [19][20][21][22]. 3D CEUS refers to image acquisition of data volumes.…”

Section: An Introduction To Terminologymentioning

confidence: 99%

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2018

Ultrasound Int Open

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WFUMB Position Paper. Learning Gastrointestinal Ultrasound: Theory and Practice

Cited by 63 publications

References 61 publications

Ultrasound student education

Ultrasound student education

Ultrasonography in Gastroenterology: The Need for Training

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