The Inaugural Year of an Ultrasound Curriculum for First Year Medical Students: The Standardized Patient Perspective

INTRODUCTION: Ultrasound education of undergraduate medical students often includes interactions with standardized patients. The University of Arkansas for Medical Sciences just completed the inaugural year of a longitudinal... [ view full abstract ]

INTRODUCTION: Ultrasound education of undergraduate medical students often includes interactions with standardized patients. The University of Arkansas for Medical Sciences just completed the inaugural year of a longitudinal ultrasound curriculum designed to provide first year medical students with multiple opportunities for learning anatomy-focused ultrasound while enhancing standardized patient (SP) interaction skills. Hand-held GE Vscan dual probe devices were used by students to scan the thyroid gland/carotid sheath contents, heart, abdomen, femoral/popliteal regions, and kidney/bladder/pelvic organs of SPs. Although multiple studies have reported student assessment of undergraduate ultrasound curricula, no studies have assessed these activities from the SP perspective.

METHODS: All 37 SPs involved in the ultrasound curriculum were recruited from an existing pool used by the Center for Clinical Skills. SPs could self-select to participate in four faculty guided one-hour ultrasound sessions scheduled throughout the year, as well as an optional ultrasound OSCE review session and an end-of-the-year ultrasound OSCE. The SPs were briefed upon arrival on what was going to occur in the student ultrasound session that day. Prescreening of the SPs was performed by faculty prior to student arrival to identify any potential concerns related to the region being scanned. Data regarding the SP perspectives and experiences in the ultrasound curriculum were solicited at the end of the academic year using an anonymous, 85-item evaluation consisting of multiple choice, LIKERT and open response questions.

RESULTS Preliminary responses from the survey of SPs (24/37 participant responses to date) indicate that the vast majority of respondents agreed/strongly agreed that they enjoyed being an SP during the individual ultrasound sessions (75%) and that their overall experience was positive (92%). Nearly all of them indicated they would participate in these sessions next year (98%). SPs generally appreciated students showing them their ultrasound scans (96%) and reported learning something about their body during the ultrasound sessions (88%). Two thirds of the SPs previously had a clinical US performed on them, while 46% had seen one performed on someone else. A significant number of SPs reported that they directed students on how to position their body (38%), properly drape them (29%), hold the ultrasound probe (42%), or use the Vscan device (25%). About a third of the SPs reported that the faculty identified something unique in their anatomy that they reported to the students during the session (29%) or that they had volunteered something clinically relevant about themselves during the student scanning sessions (29%). SPs indicated that they would like to learn more about ultrasound (88%), gain first hand experience scanning like the students (79%) and learn more about ultrasound in order to play a more direct role in student education (86%). The majority of SPs indicated an interest in attending an optional anatomy lecture on the organs being scanned (67%), actually viewing the anatomy of isolated cadaver organs in the gross lab (88%) or viewing organs in a cadaver in situ (79%). Positive comments included being able to serve as a normal model versus a disease presenting SP and being a part of the student “aha” moment of discovery during the scanning sessions. A few negative comments included insufficient bathroom breaks, the 3-hour length of the sessions, and feeling uncomfortable being scanned in some particular region of their body.

CONCLUSIONS: The results of our survey indicate that SP involvement in the ultrasound curriculum was a generally positive experience. Although the inclusion of SPs in the ultrasound curriculum was designed to enhance student learning, a significant portion of the SPs themselves reported learning something about their body and many of them indicated a desire to learn more about the technique as well as the anatomy of the organs that the students were scanning during the ultrasound sessions. The SP feedback obtained from the survey highlighted organizational and patient care areas that need to be further addressed in preparation for next years M1 and M2 curricular offering.