scholarly journals MP16: Which PoCUS skills are retained over time for medical students?

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S47-S48
Author(s):  
L. Edgar ◽  
L. Fraccaro ◽  
L. Park ◽  
J. MacIsaac ◽  
P. Pageau ◽  
...  

Introduction: Point-of-care ultrasonography (PoCUS) is being incorporated into Canadian undergraduate medical school curricula. The purpose of this study was to evaluate novel PoCUS education sessions to determine what aspects of the sessions benefitted from hands-on training and which PoCUS skills were retained over time. Methods: Second year medical students voluntarily received three different PoCUS training sessions, each lasting three hours. Prior to the sessions, participants prepared independently with pre-circulated online learning materials. After a 15-minute lecture, experienced PoCUS providers led small group (1 instructor: 5 students), live scanning sessions. Evaluations were conducted before and after each session using expert validated multiple choice questions testing general and procedural knowledge, image recognition and interpretation. Volunteer students were evaluated via direct observation of live scanning using an objective structured assessment of technical skills (OSAT) based on the O-score and then re-evaluated at 2 months post-training to assess PoCUS skills retention. Results: 40 second year medical students participated in extended Focused Assessment with Sonography for Trauma (eFAST), cardiac, and gallbladder PoCUS sessions. The live-training sessions significantly improved student PoCUS knowledge beyond what they learned independently for eFAST (p < 0.001), cardiac (p < 0.001), and gallbladder (p = 0.02). The largest improvement was noted in procedural knowledge test scores improving from 44.0% to 84.0% (n = 38). 16 students were evaluated after each session with a mean O-score of 2.37. 8 students returned two months later to be re-evaluated demonstrating a change in O-scores for eFAST (2.00 to 2.38, p = 0.15), cardiac (2.28 to 2.00, p = 0.32), and gallbladder (2.91 to 1.88, p < 0.001). Conclusion: Procedural PoCUS knowledge benefited the most with hands-on training. eFAST and cardiac PoCUS competency was maintained over time while gallbladder PoCUS competency degraded suggesting that targeted PoCUS skills training may be possible. Further study is required to determine the best use of PoCUS resources in undergraduate medical education.

2020 ◽  
Author(s):  
Rohit Gummi ◽  
Ross Smith ◽  
Raghav Govindarajan

Abstract Background: SIGN chapters across the country provide opportunities for medical students to participate in clinical, research, and service activities in neurology. Despite these, enrollment in SIGN chapters has been traditionally low.Methods: Following changes were introduced: an open board style SIGN chapter executive committee with greater active engagement of first and second year students, new types SIGN chapter activities including journal club articles, hands on workshop (example EMG), celebration/cause events (example ALS walk). In addition, a free neurology clinic was introduced. Activities were planned in consultation with office of medical education, and were organized during ‘down times’. Data on student enrollment, activities successfully carried out, students interested in neurology residency, number of neurology-related research projects with student involvement were collected prior to changes and compared to values after changes were introduced.Results: Post intervention, student engagement in neurology activities and projects increased significantly. There were also significantly more students engaged in neurology related research projects and significantly more students reported interest in neurology. However, a similar increase in applications to neurology residency was not yet observed.Conclusions: An open chapter with early engagement and involvement of first and second year medical students, creating a variety of chapter activities with greater hands on involvement, planned in conjunction with office of medical education has reinvigorated our SIGN chapter.


CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S104-S105
Author(s):  
A. V. Seto

Introduction: Teamwork skills are essential in emergency presentations. When training medical students to manage acute care cases, simulation is frequently the educational tool. However, simulation content is often medically-focused, and post-simulation debriefs may not prioritize discussion of teamwork skills, as time is limited. Furthermore, debriefing both medical and teamwork aspects of a case may add to the learners cognitive load. This innovation uses an escape game as a non-clinical simulation to gamify teamwork skills training, with a focus on the collaborator CanMEDS role. In the entertainment industry, escape games are activities where teams solve a series of puzzles together to ultimately escape a room. Methods: 2 groups of 5 second-year medical students piloted the escape game, created within a simulation theatre, designed to surface teamwork competencies under the four University of Calgary Team Scheme domains (adapted from CIHCs National Interprofessional Competency Framework and TeamSTEPPS): Leadership/Membership, Communication, Situation Monitoring, and Collaborative Decision-Making/Mutual Support. During the game, facilitators noted examples of students strengths and challenges in demonstrating teamwork competencies. Post-game, a debrief and written reflective exercise enabled students to analyze successes and challenges in demonstrating teamwork competencies, propose solutions to teamwork challenges, and write 3 goals to improve teamwork skills. All competencies listed under each Team Scheme domain represented themes used in a thematic analysis to uncover students reported teamwork challenges. Results: Each escape game is a 30-minute teamwork activity where 5 students collaborate to complete 8 puzzles, which do not require medical knowledge, in order to win. Briefing is scheduled for 15-minutes, whereas post-game debriefing and reflection is 45-minutes. Conclusion: Escape games can highlight strengths and challenges in teamwork and collaboration amongst second-year medical students. Every competency under the Team Scheme domains was highlighted by the escape game pilots, touching on both strengths and challenges, for which students demonstrated, debriefed, and reflected upon. Students self-documented teamwork challenges include issues surrounding task-focused, closed-loop communication, and frequent reassessments. Advantages of this innovation include its use as a learning progression towards acute care simulations, portability and affordability, potential interprofessional use, and customizability. Additional training time may be required to orient facilitators to this atypical simulation. The escape game will launch in MDCN490 for second-year medical students and is scheduled prior to their acute care simulations. Further teamwork challenges identified at that time will help inform teamwork curriculum development for year 3.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bela Turk ◽  
Sebastian Ertl ◽  
Guoruey Wong ◽  
Patricia P. Wadowski ◽  
Henriette Löffler-Stastka

Abstract Background Case-Based Learning (CBL) has seen widespread implementation in undergraduate education since the early 1920s. Ample data has shown CBL to be an enjoyable and motivational didactic tool, and effective in assisting the expansion of declarative and procedural knowledge in academia. Although a plethora of studies apply multiple choice questions (MCQs) in their investigation, few studies measure CBL or case-based blended learning (CBBL)-mediated changes in students’ procedural knowledge in practice or employ comparison or control groups in isolating causal relationships. Methods Utilizing the flexibilities of an e-learning platform, a CBBL framework consisting of a) anonymized patient cases, b) case-related textbook material and online e-CBL modules, and c) simulated patient (SP) contact seminars, was developed and implemented in multiple medical fields for undergraduate medical education. Additionally, other fields saw a solo implementation of e-CBL in the same format. E- cases were constructed according to the criteria of Bloom’s taxonomy. In this study, Objective Structured Clinical Examination (OSCE) results from 1886 medical students were analyzed in total, stratified into the following groups: medical students in 2013 (n = 619) before CBBL implementation, and after CBBL implementation in 2015 (n = 624) and 2016 (n = 643). Results A significant improvement (adjusted p = .002) of the mean OSCE score by 1.02 points was seen between 2013 and 2015 (min = 0, max = 25). Conclusion E-Case-Based Learning is an effective tool in improving performance outcomes and may provide a sustainable learning platform for many fields of medicine in future.


2020 ◽  
Author(s):  
Satoshi Jujo ◽  
Jannet J Lee-Jayaram ◽  
Brandan I Sakka ◽  
Atsushi Nakahira ◽  
Akihisa Kataoka ◽  
...  

Abstract Background Cardiac point-of-care ultrasound (POCUS) training has been integrated into medical school curricula. However, there is no standardized cardiac POCUS training method for medical students. To address this issue, the American Society of Echocardiography (ASE) proposed a framework for medical student cardiac POCUS training. The objective of this pilot study was to develop a medical student cardiac POCUS curriculum with test scoring systems and test the curriculum feasibility for a future definitive study.Methods Based on the ASE-recommended framework, we developed a cardiac POCUS curriculum consisting of a pre-training online module and hands-on training with a hand-held ultrasound (Butterfly iQ). The curriculum learning effects were assessed with a 10-point maximum skill test and a 40-point maximum knowledge test at pre-, immediate post-, and 8-week post-training. To determine the curriculum feasibility, we planned to recruit 6 pre-clinical medical students. We semi-quantitatively evaluated the curriculum feasibility in terms of recruitment rate, follow-up rate 8 weeks after training, instructional design of the curriculum, the effect size (ES) of the test score improvements, and participant satisfaction. Discriminatory ability of the test scoring systems were assessed by comparing the scores of the medical students, medical interns, and experts.Results Six pre-clinical medical students participated in the curriculum. The recruitment rate was 100% (6/6 students) and the follow-up rate 8 weeks after training was 100% (6/6). ESs of skill and knowledge test score differences between pre- and immediate post-, and between pre- and 8-week post-training were large. The students reported high satisfaction with the curriculum. The test scoring systems demonstrated excellent discriminatory ability between the 3 different performance levels.Conclusions This pilot study confirmed the curriculum design as feasible with instructional design modifications including the hands-on training group size, content of the cardiac POCUS lecture, hands-on teaching instructions, and hand-held ultrasound usage. Based on the pilot study findings, we plan to conduct the definitive study with the primary outcome of long-term skill retention 8 weeks after initial training. The definitive study has been registered in ClinicalTrials.gov (Identifier: NCT04083924).


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rohit Gummi ◽  
Ross Smith ◽  
Raghav Govindarajan

Abstract Background Student Interest Group in Neurology (SIGN) chapters across the medical schools in the United States provide opportunities for medical students to participate in clinical, research, and service activities in neurology. Despite these, applicants for the field of neurology have traditionally been low. Methods Following changes were introduced: an open board style SIGN chapter executive committee with greater active engagement of first and second year students. New activities included journal clubs, hands on workshops, celebration/cause events (example ALS walk). In addition, a free neurology clinic was introduced. Activities were planned in consultation with office of medical education, and were organized during ‘down times’. Data on student enrollment, activities successfully carried out, students interested in neurology residency, number of neurology-related research projects with student involvement were collected prior to changes and compared to values after changes were introduced. Results Post intervention, student engagement in neurology activities and projects increased significantly. However, a similar increase in applications to neurology residency was not yet observed. Conclusions An open chapter with early engagement and involvement of first and second year medical students, creating a variety of chapter activities with greater hands on involvement, planned in conjunction with office of medical education has reinvigorated our SIGN chapter.


Author(s):  
Ratih Yulistika Utami ◽  
Oppi Mirzatillah ◽  
Desi Isnayanti ◽  
M. Jalaluddin Assuyuthi Chalil

Background: Basic Clinical Skills (BCS) is one of the learning methods in medical education that acts as an intermediary bridge to apply procedural knowledge and clinical competency for medical students. Medical educators have successfully used many ways to assess students’ abilities, both oral and written. Oral examinations have vast advantages compared to other assessment methods. However, no standardization of questions to be tested becomes an essential issue in the assessment process. A structured oral examination may increase students’ motivation to prepare themselves better to study the material before following BCS training. This study aimed to determine the effect of a structured oral examination on students’ motivation and identify students’ motivation. Methods: This quasi-experimental research used a pretest-posttest design to assess the effect of applying the structured oral examination on students’ motivation. The subject of this study was the third-year medical students that amounted to 109 students. Sample selection was made by total sampling. In this study, the authors used SMQ-II questionnaires to measure the students’ motivation. Results: This research showed significant differences between student motivation on pretest and posttest (p-value of 0,000) after the students were given the structured oral examination at the beginning of basic clinical skills training. It means the structured oral examination affected students’ motivation. Conclusion: The structured oral examination administered for students before entering BCS learning processes had a significant impact on the students’ motivation. The preparation and the regulation of the structured oral examination on the BCS learning processes should be reinforced to motivate the students and make them more skillful


2021 ◽  
Vol 64 (2) ◽  
Author(s):  
Leandra Stringer ◽  
Sarah Cocco ◽  
Alex Jiang ◽  
Ernest Pang Chan ◽  
Frank Myslik ◽  
...  

Background: Prompt Doppler ultrasonography to aid in diagnosis is often key to managing testicular torsion, but there may be delays in access; a faster, more widely available alternative is point-of-care ultrasonography (POCUS). The purpose of this study was to develop and evaluate a scrotal POCUS curriculum for urology and emergency medicine residents. Methods: Content experts in urology, emergency medicine and diagnostic imaging collaborated in a modified Delphi method to design a practical didactic curriculum for scrotal POCUS for the identification of testicular torsion. Training included 3 online video teaching modules and a 1-hour hands-on teaching session with standardized adult patients. We evaluated participants’ competency in scrotal POCUS using a validated scale. We assessed participants’ knowledge, comfort and confidence in performing scrotal POCUS before and after the intervention and at 3 months. Results: Twenty-four urology (n = 12) and emergency medicine (n = 12) residents participated in the curriculum. After hands-on practice, 23 participants (96%) were deemed competent at scrotal POCUS. Pre–post testing showed significant improvement in knowledge (mean score 63% v. 80%, p < 0.001), comfort (mean Likert score 0.6 v. 3.6, p < 0.001) and confidence (mean Likert score 1.0 v. 2.1, p < 0.001) after the intervention. These effects were maintained at the 3-month assessment. Conclusion: The scrotal POCUS curriculum was effective and acceptable to both urology and emergency medicine residents. The findings suggest that scrotal POCUS can be learned effectively through a short hands-on session and didactic instruction.


PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Molly Cohen-Osher ◽  
Theresa A. Davies ◽  
David B. Flynn ◽  
Megan E. Young ◽  
Miriam Hoffman

Introduction: In this age of rapid information expansion, medical education can no longer be taught solely by information acquisition, but rather requires information management and information mastery at both the point of learning as well as at the clinical point of care. We must teach our trainees how to ask, categorize, and answer their own questions—skills required to be a life-long learner. We developed the Finding Information Framework (FIF), a conceptual algorithm as well as web-based tool and app, to guide medical students in asking and categorizing their questions and to link them directly to the most appropriate information resource for their questions. Here we assess the functionality of the FIF following its implementation in the first-year medical school curriculum problem-based learning (PBL) course. Methods: First-year medical students (n=126) utilized the FIF in their longitudinal problem-based learning course discussion groups and completed an anonymous survey. Results: Qualitative and quantative data suggest that the FIF was easy to use (86.5%), supported the course curriculum (80%), and helped students find relevant information to answer their questions (77%) from trusted reliable resources (70%). Qualitative comments also suggest that the FIF is initially a helpful tool during the PBL course but becomes less useful over time as students become more familiar with resources. Conclusion: The FIF assists students in identifying trusted resources and in efficiently and effectively finding answers to questions at the point of learning. These data suggest that students are internalizing the tool’s conceptual algorithm over time, reinforcing the teaching of information management and information mastery. 


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