Adding New Tools to the Black Bag—Introduction of Ultrasound into the Physical Diagnosis Course

Journal of General Internal Medicine - Tập 25 - Trang 1248-1252 - 2010
Nelia Afonso1,2, David Amponsah3, James Yang3, Jennifer Mendez1, Patrick Bridge1, Gregory Hays3, Sudhir Baliga3, Karen Crist1, Simone Brennan1, Matt Jackson1, Scott Dulchavsky3
1Wayne State University School of Medicine, Detroit, Michigan
2Department of Internal Medicine, 5C-WSU Health Center, Detroit, USA
3Henry Ford Hospital, Detroit, Michigan

Tóm tắt

Ultrasound, a versatile diagnostic modality that permits real-time visualization at the patient’s bedside, can be used as an adjunct in teaching physical diagnosis (PD). Aims: (1) to study the feasibility of incorporating ultrasound into PD courses and (2) determine whether learners can demonstrate image recognition and acquisition skills. Three hundred seven second-year medical students were introduced to cardiovascular and abdominal ultrasound scanning after training in the physical examination. This consisted of a demonstration of the ultrasound examination, followed by practice on standardized patients (SPs). Pre-post tests were administered to evaluate students’ knowledge and understanding of ultrasound. Students performed an ultrasound examination during the PD final examination. Pre-post test data revealed significant improvements in image recognition. On the final exam, the highest scores (98.4%) were obtained for the internal jugular vein and lowest scores (74.6%) on the Focused Assessment with Sonography for Trauma images. Eighty-nine percent of students’ surveyed felt ultrasound was a valuable tool for physicians. An introductory ultrasound course is effective in improving medical students' acquisition and recognition of basic cardiovascular and abdominal ultrasound images. This innovative program demonstrates the feasibility of incorporating portable ultrasound as a learning tool during medical school.

Tài liệu tham khảo

Kimura BJ, Fowler SJ, Nguyen DT, Amundson SA, DeMaria AN. Detection of early carotid arterial atherosclerosis by briefly trained physicians using a hand-held US device. Am J Cardiol. 2003;92(2):239–40. Kobal SL, Trento L, Baharami S, et al. Comparison of effectiveness of hand-carried US to bedside cardiovascular physical examination. Am J Cardiol. 2005;96(7):1002–6. Kimura BJ, Shaw DJ, Agan DL, Amundson SA, Ping AC, DeMaria AN. Value of a cardiovascular limited US examination using a hand-carried US device on clinical management in an outpatient medical clinic. Am J Cardiol. 2007;100(2):321–5. Alpert JS, Mladenovic J, Hellmann DB. Should a hand-carried US machine become standard equipment for every internist? Am J Med. 2009;122(1):1–3. Rao S, van Holsbeeck L, Musial JL, et al. A pilot study of comprehensive US education at the Wayne State University School of Medicine: a pioneer year review. J US Med. 2008;27(5):745–9. Shapiro RS, Ko PP, Jacobson S. A pilot project to study the use of ultrasonography for teaching physical examination to medical students. Comput Biol Med. 2002;32(6):403–9. Angtuaco TL, Hopkins RH, DuBose TJ, Bursac Z, Angtuaco MJ, Ferris EJ. Sonographic physical diagnosis 101: teaching senior medical students basic US scanning skills using a compact US system. US Q. 2007;23(2):157–60. Arger PH, Schultz SM, Sehgal CM, Cary TW, Aronchick J. Teaching medical students diagnostic sonography. J US Med. 2005;24(10):1365–9. Wittich CM, Montgomery SC, Neben MA, et al. Teaching cardiovascular anatomy to medical students by using a handheld US device. Jama. 2002;288(9):1062–3. Decara JM, Kirkpatrick JN, Spencer KT, et al. Use of hand-carried US devices to augment the accuracy of medical student bedside cardiovascular diagnoses. J Am Soc Echocardiogr. 2005;18(3):257–63. Butter J, Grant TH, Egan M, et al. Does US training boost Year 1 medical student competence and confidence when learning abdominal examination? Med Educ. 2007;41(9):843–8. Syperda VA, Trivedi PN, Melo LC, Freeman ML, Ledermann EJ, Smith TM, Alben JO. Ultrasonography in preclinical education: a pilot study. J Am Osteopath Assoc. 2008;108(10):601–5. Fernández-Frackelton M, Peterson M, Lewis RJ, Pérez JE, Coates WC. A bedside ultrasound curriculum for medical students: prospective evaluation of skill acquisition. Teach Learn Med. 2007;19(1):14–9. Yoo MC, Villegas L, Jones DB. Basic ultrasound curriculum for medical students: validation of content and phantom. J Laparoendosc Adv Surg Tech A. 2004;14(6):374–9.