Mission POCUS in Haiti.

Introduction: Point-of-care ultrasound (POCUS) has enhanced patient care and safety around the world. Clinicians can now use a small diagnostic ultrasound imaging device to answer some binary clinical questions and manage patients more effectively. Since the COVID-19 pandemic, there has been a significant adoption of POCUS by clinicians worldwide. Materials and Methods: A basic cardiac POCUS training was conducted in Haiti with focus on physics, instrumentation, and basic echocardiography. Results: The Mission POCUS team trained 15 Haitian physicians interested in better serving their patients with the implementation of POCUS cardiac in their patient assessment. Conclusion: POCUS skills will empower clinicians from around the world to make rapid and accurate diagnosis and help save lives by diagnosing life threatening conditions and manage patient appropriately. Our experience in Haiti showed that a short POCUS training course can help improve the knowledge of physicians.

Simulation-based clinical learning for the third year medical student: Effectiveness of transabdominal and transvaginal ultrasound for elucidation of OB/GYN scenarios.

PURPOSE: Point-of-care ultrasound (POCUS) is gaining recognition as a teaching modality that acts as an integrative learning tool during medical student transition to clinical rotations. This study aimed to determine if the use of ultrasound simulation enhances understanding of Obstetrical and Gynecological (Ob/Gyn) anatomy and pathology in third-year medical students (M3), and if M3 students found the simulator useful. METHODS: M3 students taking the OB/Gyn clerkship were invited to participate. Baseline knowledge of pelvic ultrasound anatomy and pathology was assessed with a multiple-choice question test. Participants received a one-hour OB/Gyn ultrasound simulation training session. A post-test assessed knowledge after the intervention. Survey data was collected regarding learning styles and learner satisfaction. RESULTS: Following simulator-based training, the median correct number of responses to the knowledge questions increased from 11 of 18 to 14 of 18 correct (P < .001). Statistically significant increases were also observed in comfort level with OB/GYN ultrasound (P < .001). All 68 students answered that the ultrasound simulator was helpful and enjoyed using the simulator. CONCLUSIONS: This study suggests that ultrasound simulators are useful for improvement in knowledge, comfort level, and ability to identify pathology in Ob/Gyn scenarios in M3 students.

A Primary Care Ultrasound Fellowship: Training for Clinical Practice and Future Educators.

As ultrasound devices become smaller, more portable, and more user friendly, there is now widespread use of this technology by physicians of all specialties, yet there are currently few structured opportunities for ultrasound education outside of emergency and critical care medicine. Anticipating the rising educational demand in the primary care specialties, the University of South Carolina School of Medicine created a primary care ultrasound fellowship in 2011, the first yearlong training program in point-of-care ultrasonography for graduates of internal medicine, medicine-pediatrics, pediatrics, and family medicine residencies. This paper reviews the history of point-of-care ultrasonography fellowships and then provides an overview of the primary care ultrasound fellowship.

The evolution of an integrated ultrasound curriculum (iUSC) for medical students: 9-year experience.

Interest in ultrasound education in medical schools has increased dramatically in recent years as reflected in a marked increase in publications on the topic and growing attendance at international meetings on ultrasound education. In 2006, the University of South Carolina School of Medicine introduced an integrated ultrasound curriculum (iUSC) across all years of medical school. That curriculum has evolved significantly over the 9 years. A review of the curriculum is presented, including curricular content, methods of delivery of the content, student assessment, and program assessment. Lessons learned in implementing and expanding an integrated ultrasound curriculum are also presented as are thoughts on future directions of undergraduate ultrasound education. Ultrasound has proven to be a valuable active learning tool that can serve as a platform for integrating the medical student curriculum across many disciplines and clinical settings. It is also well-suited for a competency-based model of medical education. Students learn ultrasound well and have embraced it as an important component of their education and future practice of medicine. An international consensus conference on ultrasound education is recommended to help define the essential elements of ultrasound education globally to ensure ultrasound is taught and ultimately practiced to its full potential. Ultrasound has the potential to fundamentally change how we teach and practice medicine to the benefit of learners and patients across the globe.

Teaching medical students ultrasound to measure liver size: comparison with experienced clinicians using physical examination alone.

BACKGROUND: Ultrasound is increasingly recognized as a valuable addition to medical school curriculum. PURPOSE: In this study, we tested the ability of rising second year students to learn and conduct an ultrasound examination of vertical liver span at the point of care. METHODS: Six patients from a GI clinic volunteered to have their liver size measured. Ten students were trained to measure vertical liver span with ultrasound. Four physicians were recruited to measure liver span with standard methods. Student and physician measurements were compared to each other and to a reference ultrasound measurement for accuracy and variability. RESULTS: Compared to the reference, students overestimated liver size an average of 1.5 cm. Physicians underestimated liver size an average of 6.7 cm. Variance in student measurements for each patient was 10% to 17% and among physicians 20% to 50%. CONCLUSION: With limited instruction and clinical experience medical students can obtain liver size measurements with ultrasound that are more accurate and have less variability than those by physicians using physical examination. Given the ease with which students can learn to use ultrasound and the teaching and clinical value of ultrasound, ultrasound should be considered as a standard of medical education in the future.

An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience.

A review of the development and implementation of a 4-year medical student integrated ultrasound curriculum is presented. Multiple teaching and assessment modalities are discussed as well as results from testing and student surveys. Lessons learned while establishing the curriculum are summarized. It is concluded that ultrasound is a well received, valuable teaching tool across all 4 years of medical school, and students learn ultrasound well, and they feel their ultrasound experience enhances their medical education.

Medical student identification of knee effusion by ultrasound.

Twenty-one fourth-year medical students were given a brief lecture on ultrasound of the knee and fifteen minutes of supervised ultrasound scanning of three cadavers which had been injected with saline to give varying degrees of knee effusions. Each student was then individually observed and required to scan both knees of a cadaver different from the practice cadavers and identify the patella, the femur, the quadriceps tendon and if a suprapatellar effusion was present, and which knee had the larger effusion. All twenty-one students correctly identified all anatomical structures, suprapatellar effusions, and which knee had the larger effusion. Identifying a knee effusion can be an important clinical finding in diagnosing and managing a patient with knee complaints. Fourth-year medical students can learn to identify knee effusions with ultrasound following a brief introductory lecture and hands-on scanning practice session.

Laparoscopic partial kidney ablation with high intensity focused ultrasound.

PURPOSE: High intensity focused ultrasound has been performed for transrectal and extracorporeal thermal ablation of tissues. We developed and tested a laparoscopic probe that allows real-time ultrasound imaging during partial renal ablation using high intensity focused ultrasound. METHODS: A Sonablate 200 (Focus Surgery, Indianapolis, Indiana) high intensity focused ultrasound system with a modified 18 mm. laparoscopic probe was used in all experiments. In 13 Yucatan mini-pigs a 5Fr ureteral catheter was inserted into the renal pelvis and 10 cc air were instilled into the collecting system. The kidney was laparoscopically dissected, the high intensity focused ultrasound probe was inserted through a 33 mm. laparoscopic port and the targeted renal pole was treated. RESULTS: Renal lesions were created in 12 of 13 treated kidneys under real-time ultrasound visualization. Median operative time was 180 minutes, average high intensity focused ultrasound activation time was 18.3 minutes and lesion size was 23 x 17 x 11 mm. At 4 and 14 days 4 (acute group) and 6 (subacute group) animals were available for renal functional and anatomical evaluation, respectively. No difference in renal function was seen in treated and untreated kidneys. Pathological examination at 14 days revealed homogenous and complete tissue necrosis throughout the whole volume of the lesion with sharp demarcation from adjacent normal tissue. CONCLUSIONS: We were able to refine a probe for laparoscopic high intensity focused ultrasound delivery capable of simultaneous ultrasound imaging. Partial renal ablation using this probe is feasible and safe, and resulted in homogenous, complete and reproducible lesions.