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Peer-teaching cardiac ultrasound among medical students: A real option.

ABSTRACT: INTRODUCTION:Teaching cardiac ultrasound (CU) image acquisition requires hands-on practice under qualified instructors supervision. We assessed the efficacy of teaching medical students by their previously trained classmates (teaching assistants [TAs]) compared to teaching by expert trainers (cardiologists or diagnostic medical sonographers. METHODS:Sixty-six students received 8-hour CU training: 4-hour lectures on ultrasound anatomy and imaging techniques of 6 main CU views (parasternal long [PLAV] and short axis [PSAV]; apical 4-chamber [4ch], 2-chamber [2ch], and 3-chamber [3ch]; and sub costal [SC]) followed by 4 hours of hands-on exercise in groups of ?5 students under direct supervision of a TA (group A: 44 students) or a qualified trainer (group B: 22 students). Students' proficiency was evaluated on a 6-minute test in which they were required to demonstrate 32 predetermined anatomic landmarks spread across the 6 views and ranked on a 0-100 scale according to a predetermined key. RESULTS:The 6-minute test final grade displayed superiority of group A over group B (54±17 vs. 39±21, respectively [p = 0.001]). This trend was continuous across all 6 main views: PLAV (69±18 vs. 54±23, respectively), PSAV (65±33 vs. 41±32, respectively), 4ch (57±19 vs. 43±26, respectively), 2ch (37±29 vs. 33±27, respectively), 3ch (48±23 vs. 35±25, respectively), and SC (36±27 vs. 24±28, respectively). CONCLUSIONS:Teaching medical students CU imaging acquisition by qualified classmates is feasible. Moreover, students instructors were superior to senior instructors when comparing their students' capabilities in a practical test. Replacing experienced instructors with TAs could help medical schools teach ultrasound techniques with minimal dependence on highly qualified trainers.

SUBMITTER: Ben-Sasson A

PROVIDER: S-EPMC6436682 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Peer-teaching cardiac ultrasound among medical students: A real option.

Ben-Sasson Alon A Lior Yotam Y Krispel Jonathan J Rucham Moshe M Liel-Cohen Noah N Fuchs Lior L Kobal Sergio L SL

PloS one 20190327 3

<h4>Introduction</h4>Teaching cardiac ultrasound (CU) image acquisition requires hands-on practice under qualified instructors supervision. We assessed the efficacy of teaching medical students by their previously trained classmates (teaching assistants [TAs]) compared to teaching by expert trainers (cardiologists or diagnostic medical sonographers.<h4>Methods</h4>Sixty-six students received 8-hour CU training: 4-hour lectures on ultrasound anatomy and imaging techniques of 6 main CU views (para ...[more]

PMID: 30917143

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Project description:BackgroundMedical students as future clinicians will apply their anatomy knowledge in medical imaging. There are various radiological resources available for the medical students to learn anatomy and contextualise it to the clinical setting. Ultrasound is a safe and non- invasive imaging procedure commonly used in clinical practice. This study aimed to use portable ultrasound and evaluate its impact as an adjunct to cadaveric anatomy teaching together with cross sectional anatomy images and line diagrams.MethodsUltrasound teaching was incorporated into upper limb and lower limb anatomy practical dissecting room sessions. The number of medical students who participated was 121 students from the year 2008 - 2009 and 94 students from the year 2009- 2010. The students were divided into groups of 15-20. Initially ultrasound demonstration was carried out on a volunteer and then the students were given the opportunity to use the ultrasound and identify normal anatomical structures visualized on images. For the students in the year 2009- 2010, ultrasound teaching was supplemented with cross sectional anatomy images and line diagrams. Questionnaires were distributed with seven questions rated using four point Likert scale and free text. Qualitative data was analysed using 2- proportion Z test and Fischer's exact test.ResultsThe number of students in the 2009-2010 year group who were confident in interpreting ultrasound images increased significantly when compared to the 2008-2009 year group of students. The majority of students were able to identify structures like bone, muscles and blood vessels on ultrasound images. There was a significant increase in the number of students who found the ultrasound teaching useful and also those who regarded ultrasound to have improved understanding of anatomy considerably.ConclusionsUltrasound acts as a useful adjunct to teach anatomy in a clinical context to medical students. The use of cross sectional anatomy images and line diagrams together can aid ultrasound image orientation of structures during these sessions. Early exposure to this imaging technology may prime students for later encounters with ultrasound during clinical practice.

Project description:PurposePoint-of-care ultrasound (POCUS) is a sensitive, safe, and efficient tool used in many clinical settings and is an essential part of medical education in the United States. Numerous studies present improved diagnostic performances and positive clinical outcomes among POCUS users. However, others stress the degree to which the modality is user-dependent, rendering high-quality POCUS training necessary in medical education. In this study, the authors aimed to investigate the potential of an artificial intelligence (AI) based quality indicator tool as a teaching device for cardiac POCUS performance.MethodsThe authors integrated the quality indicator tool into the pre-clinical cardiac ultrasound course for 4th-year medical students and analyzed their performances. The analysis included 60 students who were assigned to one of two groups as follows: the intervention group using the AI-based quality indicator tool and the control group. Quality indicator users utilized the tool during both the course and the final test. At the end of the course, the authors tested the standard echocardiographic views, and an experienced clinician blindly graded the recorded clips. Results were analyzed and compared between the groups.ResultsThe results showed an advantage in quality indictor users' median overall scores (P = 0.002) with a relative risk of 2.3 (95% CI: 1.10, 4.93, P = 0.03) for obtaining correct cardiac views. In addition, quality indicator users also had a statistically significant advantage in the overall image quality in various cardiac views.ConclusionsThe AI-based quality indicator improved cardiac ultrasound performances among medical students who were trained with it compared to the control group, even in cardiac views in which the indicator was inactive. Performance scores, as well as image quality, were better in the AI-based group. Such tools can potentially enhance ultrasound training, warranting the expansion of the application to more views and prompting further studies on long-term learning effects.

Project description:BackgroundPeer-assisted learning has been shown to be constructive in numerous aspects of undergraduate medical education. The purpose of this study was to evaluate the effectiveness of peer-assisted teaching of medical English skills to non-native English-speaking students.MethodsA medical English conversation course was conducted at Damascus University by a group of students. Targeted participants were intermediate level fellow students from the same program. A longitudinal study was carried out between 1 st to 31 st March 2019 to assess changes in self-assessment of English language skills among course participants. Pre- and post-course appraisal involved a review of previous experience with medical English language, a self-assessment of five English language skills, and an objective measurement of medical English knowledge. In addition, participants were requested to respond to a set of statements related to the importance and the usefulness of peer-assisted teaching of medical English skills. Paired-sample Student t-test was used to compare pre- and post-course appraisal results.Results42 students attended the course and completed pre- and post-course appraisals in full. Data analyses showed a statistically significant increase in participants' confidence in speaking medical English in public ( p<0.001) and using English in various medical settings (presenting and discussing cases, writing clinical reports, interviewing patients and reading English medical texts). Objective measurements of medical English knowledge confirmed a significant increase in participants' knowledge of methods of administration of therapeutics, knowledge of human body parts in English and familiarity with English medical abbreviations. Most participants agreed that peer-education was effective in teaching medical English skills to non-native English-speaking students and in increasing their confidence when using English in real-life medical scenarios.ConclusionsThe present study highlights the effectiveness of peer-assisted teaching of medical English skills to non-native English-speaking medical students. Further validation is required and should compare the effectiveness of traditional versus peer-assisted teaching approaches.

Project description:BackgroundNear-peer teaching (NPT) is becoming an increasingly popular pedagogical tool in health professions education. Despite the shift in formal medical education from face-to-face teaching toward encompassing web-based learning activities, NPT has not experienced a similar transition. Apart from the few reports on NPT programs hastily converted to web-based learning in light of the COVID-19 pandemic, no studies to date have explored web-based learning in the specific context of NPT.ObjectiveThis qualitative study examined the nature of interactions among peer learners (PLs), peer teachers (PTs), and the learning content in a student-led, web-based NPT program for medical students.MethodsA 5-month-long voluntary NPT program to support first- and second-year medical students' biomedical science learning in the undergraduate medical curriculum was designed by 2 senior-year medical students and delivered by 25 PTs with 84 PLs participating. In total, 9 PLs and 3 PTs underwent individual semistructured interviews at the end of the program to explore general NPT experience, reasons for joining NPT, the effectiveness of NPT, the demand and importance of NPT, and the feasibility of incorporating NPT in the formal curriculum. Interview transcripts were analyzed using a thematic analysis approach.ResultsThe first general theme focused on the nature of student-student, student-teacher, and student-content interactions. Although PLs were engaged in web-based NPT, there was minimal interaction between students, as most PLs preferred to learn passively and remain anonymous. PLs believed the web-based NPT learning process to be a unidirectional transmission of knowledge from teacher to learner, with the teacher responsible for driving the interactions. This was in sharp contrast to PTs' expectation that both parties shared responsibility for learning in a collaborative effort. The second general theme identified the advantages and disadvantages of delivering NPT on a web platform, which were mainly convenience and teaching skills development and poor interactivity, respectively.ConclusionsStudent-led, web-based NPT offers a flexible and comfortable means of delivering academic and nonacademic guidance to medical students. However, the web-based mode of delivery presents unique challenges in facilitating meaningful interactions among PLs, PTs, and subject content. A blended learning approach may be best suited for this form of student-led NPT program to optimize its efficacy.

Project description:PhenomenonResearch literacy remains important for equipping clinicians with the analytical skills to tackle an ever-evolving medical landscape and maintain an evidence-based approach when treating patients. While the role of research in medical education has been justified and established, the nuances involving modes of instruction and relevant outcomes for students have yet to be analyzed. Institutions acknowledge an increasing need to dedicate time and resources towards educating medical undergraduates on research but have individually implemented different pedagogies over differing lengths of time.ApproachWhile individual studies have evaluated the efficacy of these curricula, the evaluations of educational methods and curriculum design have not been reviewed systematically. This study thereby aims to perform a systematic review of studies incorporating research into the undergraduate medical curriculum, to provide insights on various pedagogies utilized to educate medical students on research.FindingsStudies predominantly described two major components of research curricula-(1) imparting basic research skills and the (2) longitudinal application of research skills. Studies were assessed according to the 4-level Kirkpatrick model for evaluation. Programs that spanned minimally an academic year had the greatest proportion of level 3 outcomes (50%). One study observed a level 4 outcome by assessing the post-intervention effects on participants. Studies primarily highlighted a shortage of time (53%), resulting in inadequate coverage of content.InsightsThis study highlighted the value in long-term programs that support students in acquiring research skills, by providing appropriate mentors, resources, and guidance to facilitate their learning. The Dreyfus model of skill acquisition underscored the importance of tailoring educational interventions to allow students with varying experience to develop their skills. There is still room for further investigation of multiple factors such as duration of intervention, student voluntariness, and participants' prior research experience. Nevertheless, it stands that mentoring is a crucial aspect of curricula that has allowed studies to achieve level 3 Kirkpatrick outcomes and engender enduring changes in students.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-020-01183-w.

Project description:BackgroundPoint-of-care ultrasonography (PoCUS) is a rapidly evolving discipline that aims to train non-cardiologists, non-radiologists clinicians in performing bedside ultrasound to guide clinical decision. Training of PoCUS is challenging, time-consuming and requires large amount of resources. The objective of our study was to evaluate if this training process can be simplified by allowing medical students self-train themselves with a web-based cardiac ultrasound software.MethodsA prospective, single blinded, cohort study, comparing performance of 29 medical students in performing a six-minutes cardiac ultrasound exam. Students were divided into two groups: self-learning group, using a combination of E-learning software and self-practice using pocket ultrasound device compared to formal, frontal cardiac ultrasound course.ResultsAll 29 students completed their designated courses and performed the six-minutes exam: 20 students participated in the frontal cardiac ultrasound course and 9 completed the self-learning course. The median (Q1,Q3) test score for the self-learning group was higher than the frontal course group score, 18 (15,19) versus 15 (12,19.5), respectively. Nevertheless, no statistically significant difference was found between the two study groups (p = 0.478). All students in the self-learning course group (9/9, 100%) and 16 (16/20, 80%) of students in the frontal ultrasound course group obtained correct alignment of the parasternal long axis view (p = 0.280).ConclusionsSelf-learning students combining E-learning software with self-practice cardiac ultrasound were as good as students who received a validated, bedside, frontal cardiac ultrasound course. Our findings suggest that independent cardiac ultrasound learning, combining utilization of E-learning software and self-practice, is feasible. Self-E- learning of cardiac ultrasound may serve as an important, cost-effective adjunct to heavily resource consuming traditional teaching.

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Peer-teaching cardiac ultrasound among medical students: A real option.

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Peer-teaching cardiac ultrasound among medical students: A real option.

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