Undergraduate medical school students should be taught to visualize fluid-filled cavities with ultrasound and how to use ultrasound to guide a needle safely into a fluid-filled cavity, sonography experts advise in an authoritative new set of educational recommendations.
These are two of 126 strongly held consensus opinions arrived at by a field of 64 multi-disciplinary ultrasound experts from 16 countries, 50 multidisciplinary ultrasound consultants and 21 medical students.
The effort, called the International Consensus Conference on Ultrasound in Medical Education, included 16 participants from the U.S.—the most from any single country—and five radiologists.
The best-represented specialties were internal medicine in its various subspecialties (30+ experts) and emergency medicine (22).
The work is chronicled The Ultrasound Journal, which is published by the World Interactive Network Focused on Critical Ultrasound .
The corresponding author of the consensus conference’s report is internist and rheumatologist Richard Hoppmann, MD, of the University of South Carolina School of Medicine and dean emeritus of the Ultrasound Institute there.
The authors position their overall effort and the meticulously detailed report it produced as, largely, a response to the rapid growth of point-of-care ultrasound—POCUS—across healthcare worldwide.
Ultrasound-Guided Procedures Best Taught on Phantoms, Not Persons
The two “strongly recommended” imperatives mentioned above fall under the fourth of four domains, curricular content, in the third part of that section, procedures and protocols.
Exemplifying the scope and detail level of the entire project, that section also reveals eight potential teaching points that are consensus-recommended minus the “strongly”—things like peripheral and central line cannulation, paracentesis, thoracentesis and arthrocentesis—and six that the field decided not to recommend at all.
The latter include “less common and more risky guided procedures” such as pericardiocentesis and lumbar puncture.
“[I]t was also expressed that how to use ultrasound to guide a needle or catheter was the important skill and there was no need to learn multiple guided procedures,” the authors write. “Learning a variety of guided procedures was best reserved for postgraduate medical training when the focus could be on procedures more relevant to the specialty pursued. It was also expressed that, in general, learning guided procedures is best done on phantom models and not on live subjects.”
Forming a Foundation for Lifelong POCUS Learning
The consensus conference considered a total of 332 statements on ultrasound education for undergraduate medical students, the journal report shows.
Along with curricular content, domains covered included curricular scope (four statements), curricular rationale (10 statements), and curricular characteristics (14 statements).
The curricular content domain was the largest, with 304 statements considered. Of the 332 statements, 145 were recommended, 126 were strongly recommended (total: 271) and 61 were not recommended.
“Important aspects of an undergraduate ultrasound curriculum identified include curricular integration across the basic and clinical sciences and a competency and entrustable professional activity-based model,” the authors comment. “The curriculum should form the foundation of a lifelong continuum of ultrasound education that prepares students for advanced training and patient care.”
The international consensus conference has provided the first comprehensive document of recommendations for a basic ultrasound curriculum. The document reflects the opinion of a diverse and representative group of international expert ultrasound practitioners, educators, and learners. These recommendations can standardize undergraduate medical student ultrasound education while serving as a basis for additional research in medical education and the application of ultrasound in clinical practice.”
The report is available in full for free.