Focus on POCUS

Medical Student Fellowship in Emergency Ultrasound

Montano NM, Medeiros SE, Schick MA. (2017, April-8). Focus on POCUS: A Longitudinal Elective for Senior Medical Students. Abstract presented at: Western Regional Society of Academic Emergency Medicine; Palo Alto, CA, USA. CA.

The curriculum is directed towards students who wish to gain a greater proficiency of point-of-care ultrasound. It will be particularly useful for those students who will pursue careers that will use this modality heavily in clinical practice such as emergency medicine and critical care. The initial content goal will aim to meet the 90 milestones for ultrasound in medical education outlined in the Journal of Ultrasound in Medicine, 2016. Briefly, students will strive for proficiency in point-of-care ultrasound machine use, ultrasound physics, cardiology, thoracic, abdominal, genitourinary, obstetrics, vascular, musculoskeletal, and ultrasound-guided procedures. This should be accomplished using a variety of platforms including online lectures, in-person lectures, online didactics, in-person didactics, hands-on learning sessions, online “meet ups”, image review and feedback. The student’s image acquisition will in large part be in the department of emergency medicine, but will also take place in other specialty areas depending on the student’s personalized learning goals.

It is important to include with this curriculum a system that allows students to save their images/videos for review, feedback, and storage. Also, we encourage the use of a state-of-the-art ultrasound simulatorm, such as SonoSim, that they can take with them throughout the year. This allows the student to go through exams, anatomy, and clinical cases in a systematic fashion in order to build their skills while simultaneous allowing instructors the ability to track their student’s progress and provide guidance and feedback.

Students will have additional goals and opportunities to develop skills in greater depth, provide instruction, develop lectures and educational content, participate in monthly journal clubs, learn how to do image review and quality assurance, as well as develop a personal independent study track. The independent study track will focus on the student’s particular interest and future career goals. Students will matriculate the course with an ultrasound portfolio.

Objective & Goals

Our primary objective is to meet the 90 core clinical milestones for ultrasound in medical education outlined in the journal of Ultrasound in Medicine, 2016 [Dinh et al, 2016]. Our secondary learning goals are as follows:

1. Facilitate opportunities to instruct other students in order to develop teaching skills.
2. Provide regular journal review and discussion opportunities so the student will be up-to-date on current literature and develop literature assessment skills for the field of point-of-care ultrasound (POCUS).
3. The student will develop at least one of their own lectures in a topic of their choosing to further their knowledge and develop their presentation skills. They will give this lecture to a group of their peers.
4. Provide ample opportunities for image review, quality assurance, and administrative exposure so that students understand how an ultrasound program ought to function.
5. Help the student develop an independent study project, fostering their personal interest with the hopes of spring-boarding a lifelong interest in the field.

Methods

Clinical experiences occur primarily at the UC Davis Medical Center in the Department of Emergency Medicine, where the Intern functions as a member of the emergency medicine team by performing clinical and diagnostic bedside ultrasonography. Clinical experiences also include off-service rotations with radiology and cardiology ultrasound teams.

Didactic learning occurs primarily via the Asynchronous Crowdsource Education for Clinical Ultrasound (ACE4CUS Curriculum). This is a comprehensive, resident-level, year-long curriculum with objectives, educational methods, and assessment measures. Application quizzes and block tests are utilized throughout the curricula and reviewed regularly by the Internship’s Instructors of Record (IoR).

Teaching experiences involve lectures and workshops in the UC Davis School of Medicine’s M.D. Program, UC Davis Undergraduate “First-Year Seminars”, and several special events focused on promoting ultrasound in medical education. Currently, we have facilitated workshops and lectures in the following courses: Doctoring (MS1-3), Human Anatomy (MS1), Transition to Clerkship (MS3), OB/GYN Clerkship (MS3), Emergency Ultrasound Elective (MS4), Ultrasound Office Hrs (MS1-4), Ultrasound Interest Group (MS1-4), Ultrasound Funk – Physics in Action (1st year undergraduates).

Evaluation will be done formally by UC Davis ultrasound faculty throughout the internship. Curriculum review will be done throughout the year to tailor the program to the areas of interest and needs of the Intern. Quality Assurance of acquired images will be done weekly, with UC Davis ultrasound faculty. Proof of completion of asynchronous online learning will be submitted by the Intern.

Results