A Case-based Approach to Teaching Clinical Ultrasound Applications to Junior Medical Students at the Wayne State University School of Medicine (WSUSOM)

Abstract: Background: A curriculum for teaching clinical ultrasound applications to 3rd year medical students at the WSUSOM was first introduced in 2009. This is part of the longitudinal ultrasound curriculum developed at the... [ view full abstract ]

Abstract:
Background: A curriculum for teaching clinical ultrasound applications to 3rd year medical students at the WSUSOM was first introduced in 2009. This is part of the longitudinal ultrasound curriculum developed at the medical school in 2006. The curriculum was designed using a case-based approach to teaching clinical ultrasound applications with a focus on musculoskeletal & procedural, abdominal & trauma, and echocardiography & hemodynamic concepts. About 100 medical students at one clinical site participate in these sessions which include hands-on scanning with standardized patients. The goals are; 1) to provide a description of the 3rd year ultrasound curriculum. 2) To assess pre-requisite knowledge prior to participating in these sessions. 3) To evaluate the effectiveness of the educational program after implementation.
Methodology: About 100 medical students at one clinical site during their junior year participate in three clinical ultrasound instructional sessions over a 5 month period. Students receive detailed curriculum documents focusing on musculoskeletal/procedural, abdominal/trauma and cardiac/hemodynamic applications, review articles, and a pretest to assess pre-requisite knowledge prior to each session. Sessions include hands-on image acquisition skills using standardized patients, and image recognition & interpretation using a case-based approach to teaching. These small group sessions have an instructor to student ratio of 1:4 allowing for detailed discussion of presented cases for effective learning. Students also participate in 1 hour image review sessions during core 8-week General Surgery and Internal Medicine rotations.
Results: Pre & Post test scores for the Abdominal/Trauma clinical ultrasound sessions:
Abd/Trauma
Pre-test
# students 75 0-59% 60-69% 70-79% 80-89% 90-100%
# students / %score 14/75 (18.6%) 15/75 (20%) 19/75 (29%) 12/75 (16%) 15/75 (20%)
Abd/Trauma
Post-test
# students 53
0-59% 60-69% 70-79% 80-89% 90-100%
# students / % score 8/53 (15%) 8/53 (15%) 13/53 (25%) 9/53 (17%) 15/53 (28%)
The pre-test was completed by 75% of the students but just over 50% completed the post-test for the abdominal/trauma unit. 49/84(58%) students performed very well on the Musculoskeletal & Procedural pre-test with scores over 80%. 30/67(45%) students scored >80% on the echocardiography and hemodynamics pre-test. Post-tests were administered as a comprehensive test at the conclusion of the 3rd year ultrasound sessions, and not shortly after each unit.
Conclusions: Clinical ultrasound applications provide unique opportunities for medical students to develop important skills in medical decision making regarding the choice of diagnostic tests during patient evaluation, and also offers a foundation for the development of psychomotor skills while preparing for residency.