Creating A Vertical Ultrasound Curriculum at EVMS

At Eastern Virginia Medical School (EVMS) a goal has been set to create a vertical Ultrasound curriculum involving all four years of medical students. Various mechanisms and methodologies have become part of this curriculum. ... [ view full abstract ]

At Eastern Virginia Medical School (EVMS) a goal has been set to create a vertical Ultrasound curriculum involving all four years of medical students. Various mechanisms and methodologies have become part of this curriculum.

In the M1 year students are exposed to Ultrasound from week one as part of their Anatomy course. This includes less formal scanning labs and more formal lecture/proctored lab scenarios. In the second semester of M1 and M2 years the students are exposed to Ultrasound in a similar manner tied to their current module of study. In the M3 year students share hand-held Ultrasound units in their clerkship rotations and are required to submit certain images per rotation. In the M4 year students gain Ultrasound skills in their elective rotations, which includes an Ultrasound elective. During these rotations students are encouraged to teach and become involved in mentoring the underclass students as a mechanism to improve their own scanning.

Across all four years students are periodically exposed to Ultrasound simulators as a means of enhancing their knowledge of Ultrasound anatomy and techniques as well as presenting a means of reviewing Ultrasound pathology they might not otherwise be exposed to in labs where they either self scan classmates or standardized patients. Students also started a Sonography Club where cases are presented, anatomy reviewed, and where students can get additional hands-on experience.

EVMS has made an institutional and financial decision that Ultrasound is best for student medical education. Towards that end they have hired a full-time Director of Ultrasound Education with a sonography and teaching background to ensure the technical nuances of Ultrasound are discussed. This allows student discussions on topics such as scanning ergonomics that can impact a practitioners career, but are often not discussed in physician training. It has also enhanced the interaction with standardized patients with increased establishment of clear instructions as well as providing an advocate for patients who are scanned.

At the time the Director was hired, a dedicated scanning lab was created. This will create a 10 - 12 bed scanning area that students will use during scheduled labs as well as on their own time if they want to work on scanning skills further. The longterm goal at EVMS is to see students establish a scan portfolio that they can bring with them to their residency interviews and, if desired, help them document exams required to sit for Ultrasound credentialing examinations.

EVMS has also found instructional and equipment support from their local community college sonography program at Tidewater Community College (TCC). Although few medical schools reach out to local sonography programs, they can be a source of both equipment for newly established programs as well as a source for teaching assistants with a good, solid working knowledge of sonography techniques. An added benefit has been the inter-institutional collaboration that has grown between EVMS and TCC. Examples of benefits include an EVMS physician now serving as medical advisor to the TCC sonography program, an increased awareness of sonographers and their advanced skill set by medical students, as well as the increased sense of confidence the TCC students gain by working with the staff physicians, residents, fellows, and medical students.

The graduating class of 2016 is the first class at EVMS to experience an Ultrasound curriculum across all four years of their education at EVMS. Student comments are overwhelmingly positive with more than 90% of students noting that the exposure to Ultrasound helped them feel and perform well in their residency interviews.

This process has not been easy or painless. Ultrasound can have a steep learning curve and not everyone will use it in their practice or have the inherent “knack” to scan proficiently themselves. Ultrasound labs require expensive, up-to-date equipment and space. The implementation into a curriculum require that faculty adapt and change to embrace new technologies in an already crowded curriculum. Ongoing in-house training is required to encourage clinicians to embrace Ultrasound as well. Students can’t use a tool if their clinicians don’t support it. Physicians may not feel comfortable with Ultrasound and adapting it into their practice.

At EVMS Ultrasound has been embraced by students and indicates that students want exposure to newer medical technologies as they start their careers.