Point-of-care ultrasound elective MIA for many radiologists in medical school

Thanks to improved image quality from more affordable units, point-of-care ultrasound is on the rise. However, according to a recent survey published in Academic Radiology, a majority of radiologists are not offered a point-of-care ultrasound elective in medical school.

Andrew Phelps, MD, department of radiology and biomedical imaging at the University of California, San Francisco, and colleagues surveyed directors of medical student education in radiology, asking about the degree of radiologists’ involvement in ultrasound education. The survey was sent out in March 2015.

Overall, data revealed that ultrasound images were used in preclinical education in 76 percent of the schools. Students were trained to perform hands-on ultrasound exams in 49 percent of schools, and they were offered a dedicated point-of-care ultrasound elective by just 14 percent of the schools.

“The lack of point-of-care ultrasound electives is likely a reflection of the logistical hurdles including cost, educator time, student time, machine availability and patient or model availability,” the authors wrote. “At the authors' hospital and medical school, the radiology department is involved in hands-on ultrasound education integrated into the medical students' required coursework (e.g., physical examination course); however, the only dedicated point-of-care ultrasound elective is run by the emergency department. Why would it be that emergency medicine has a point-of-care ultrasound elective and not radiology?”

The authors said one reason could be workflow differences between the emergency department and a radiology ultrasound clinic. Medical students in ultrasound clinics would leave “no opportunity for medical students to practice ultrasound.”

According to the authors, another reason radiology departments may not have that point-of-care ultrasound elective is that not all radiologists go through that hands-on training, meaning they could not turn around and teach it to medical students.

Phelps et al. noted that in the free-form comment section of the survey, radiologists expressed concern about ultrasound being performed by nonradiologists.

“At one extreme, there was the opinion that teaching ultrasound to nonradiologists is an outright bad idea,” the authors wrote. “Several comments acknowledged that ultrasound should be taught to medical students at the right time, in the right context, and in the right order. For example, it was suggested that learning when to order an ultrasound should come before learning how to perform an ultrasound. One comment also emphasized that medical students need to learn about the value that a radiologist brings to patient care.”

Phelps and colleagues noted that their study had limitations. For instance, though the survey was sent to radiology educators throughout the U.S., the response rate was just 31 percent. This means the data does not truly represent educators from all over the country, as the authors planned.

Another limitation is that some respondents did not answer the survey’s final question, meaning there may have been “confusion with question wording.”