Standardized Patients, Image Evaluation, Hands-On Scanning Labs, and Student Feedback Within the Ultrasound Curriculum at Eastern Virginia Medical School

Felicia Toreno

Eastern Virginia Medical School

Felicia Toreno, Ph.D., is Associate Professor and Director of Ultrasound Education at Eastern Virginia Medical School in Norfolk, VA since 2015. Previously she had been the Program Director of the Diagnostic Medical Sonography program at Tidewater Community College in Virginia Beach for over 20 years. She has more than 30 years experience as a sonographer and educator and has been registered by the American Registry of Diagnostic Medical Sonographers in Abdominal, Obstetrical and Gynecological Ultrasound, Adult Echocardiography and Vascular Technology. Dr. Toreno has worked with instructional technologies for many years, though her current academic pursuit is the integration of Ultrasound within a medical school curriculum. She continues to serve the field of sonography as a site visitor for of the Joint Review Committee on Diagnostic Medical Sonography, to which she has held the position of chair and she has previously served as an at-large director for the Society of Diagnostic Medical Sonography and currently serves on the continuing medical education committee for the American Institute for Ultrasound in Medicine. She has contributed to several sonography publications and presented on topics related to sonography and educational innovations locally, regionally, nationally, and internationally.

Lorraine Lyman

Eastern Virginia Medical School

Lorraine Lyman is a Senior Standardized Patient Educator at the Sentara Center for Simulation and Immersive Learning of Eastern Virginia Medical Center. She has been developing curriculum, training, and assessment techniques for medical and non-medical personnel and Standardized Patients since 2005. Most recently, she has been instrumental in developing procedural techniques such as EKG's, lumbar puncture, and suturing for use in simulated training. With her broad background in medical education, Ms. Lyman is a frequent presenter at the Association of Standardized Patient Educators (ASPE), the International Meeting for Simulation in Healthcare, and the Society in Europe for Simulation Applied to Medicine (SESAM). She was one of the chief architects and presenters in the development and implementation of the Master Interview Rating Scale (MIRS) introductory E-Learning Course and its corresponding training at the National University of Singapore. She is currently Chair of the Standards of Practice Committee for ASPE.

Abstract

Getting medical students to scan with Ultrasound (US) is only the start. They need frequent feedback on their images and scanning techniques and have opportunities to scan more and refine their skills. With large class cohorts this can present logistical nightmares. At EVMS standardized patients (SP’s) have evaluated professionalism routinely and now help to provide feedback in Ultrasound examinations, as well.

At EVMS medical students are exposed to US week one of their education. During the first semester US is part of their Anatomy course and formal US lectures. Lectures are followed by proctored scan labs. Students then scan independently and capture assigned images. The major weakness in this has been faculty ability to provide ongoing image feedback.

At the end of the first semester an OSCE examination evaluates US images. SP’s evaluate professionalism as well as length of scan, transducer placement, and basic equipment manipulation.

At EVMS we have made efforts to improve SP awareness of US examination requirements, preps, and required dress. We have found that this is appreciated by SP’s and that many are anxious to work in US labs.

In conjunction with Old Dominion University (ODU) we are conducting research on image evaluation by non-experts by providing a comparison ideal image and Likert scale questions. An image of kidney/Liver interface is being used for research on this process. Once results are proven consistent with experts and non-experts, ideal images and Likert scale evaluation questions will be developed for other images. This as a long term goal.

At EVMS we hope that as students scan more, they create portfolios of images to help them during their residency application process and allowing them to document participation in the US exams required to apply for US credentialing examinations.

We hope to improve the feedback that students get to their portfolios by making the evaluation system less onerous to a small percentage of the faculty. By using this system SP’s and M4’s participating in Ultrasound electives will be able to help with the image evaluation process. This will allow M1’s to work on scan techniques earlier to hone their skills.

We find students support US in their curriculum and want to increase the amount of scanning time they get and the amount of feedback they receive.

Our research shows that medical students appreciate US within the curriculum and feel it improves their medical education. We are also find SP’s invaluable in US evaluation, which involves all aspects of the exam; professionalism, patient positioning, transducer placement, and hopefully, in the future, image evaluation.

Our research shows promising results with non-expert image evaluation. With development of other master images, we are hopeful that this alleviates the gap in image evaluation. We expect SP’s to evaluate images during OSCE testing and will compare expert and SP results of images Fall 16 as part of follow-up research.

Authors

Felicia Toreno (Eastern Virginia Medical School)
Barry Knapp (Eastern Virginia Medical School)
Donald Byars (Eastern Virginia Medical School)
Craig Goodmurphy (Eas)
Mark Serbo (Old Dominion University)
Lorraine Lyman (Eastern Virginia Medical School)

Topic Areas

Use of ultrasound in Undergraduate Medical Education , Technology , New Uses

Session

B07 » Oral Presentation 6: Panel Discussion (15:00 - Friday, 23rd September, TTU SUB / Canyon)

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