An Idea Whose Time Has Come

By all accounts, French writer Victor Hugo wasn’t talking about ultrasound in medical education when he wrote these words. But fast forward a little more than two centuries and they seem more than fitting.

Med_Ed_Forum_Logo-blueRecent years have seen a reformation of medical school education, something many have argued is long overdue given the changes in medicine and medical practice in the last two decades. Multiple medical schools are actively changing their curricula and many are incorporating novel educational strategies to teach medical students more efficiently and to focus on less esoteric topics. In perhaps a perfect storm during this same period the accuracy of the physical examination is being questioned more than ever while over reliance on imaging and increased radiation exposure are being linked to increased costs and future mortality. Ultrasound has long been proposed by advocates as a critical tool to help address these concerns but in medical education especially, it may be an ideal tool for future physicians.

Ultrasound as taught in a point-of-care setting, or performed at the bedside, can be incorporated into almost every clinical specialty. Its uses range from procedure guidance to focused diagnostic applications allowing accurate bedside diagnosis of multiple disease states. In addition, it is proving to be an excellent adjunct in teaching basic science topics such as anatomy and physiology. Recent literature, representing just the proverbial tip of the iceberg, suggests that ultrasound is superior to the physical examination even if that exam is done by an expert. Additionally, ultrasound helps novices, known as medical students, better learn the basics needed for all medical professions. Given all of this information it is imperative to have a national conversation regarding ultrasound integration into medical school education.

It is with this backdrop that last year, the AIUM and the Society of Ultrasound in Medical Education (SUSME) convened a conference to discuss the state of ultrasound in medical education and to ultimately craft a roadmap for its integration. Forty-two medical schools, 64 attendees, and 13 faculty gathered in New York City to begin this work.

At the outset, it was clear that the level of integration varied among medical schools, with some being fully integrated, some just starting, and others still exploring. But this fact led credence to the need for this event which started with a series of discussions and presentations covering a variety of topics. Ultrasound education leaders discussed how to get started, how to overcome pitfalls and barriers, and where to find support and funding. Many corresponding resources can be found on the AIUM’s MedEd Portal.

Participants then had a hands-on scanning experience with simulation and live models that was designed to show how and where they could integrate medical ultrasound education. This was followed by roundtable discussions during which participants could share their experiences, ask questions, and focus on next steps.

One of the highlights of the event was the students’ perspective. A number of students shared how medical ultrasound education helped them develop confidence and a skill that could be used for them to teach attendings, other students and practitioners across the world.  Their enthusiasm and energy definitely created a positive and exciting atmosphere.

The participants came away with a shared understanding that it makes sense to prepare the next generation of clinicians and physicians with the skills and understanding of how and when to use medical ultrasound. However, challenges remain.

Multiple barriers exist and many Deans, associate Deans and other tasked with curricula development are not familiar with current point of care ultrasound use.  Additional barriers such as when, where and how to integrate ultrasound into a 4-year curriculum may appear to be unsurmountable, yet have been solved in multiple medical schools already. The collection and efficient distribution of this knowledge is seen as critical to the further spread of ultrasound in medical education and the unprecedented bringing together of multiple basic science and clinical educators.

This event was the first step in opening up the discussion and sharing common resources, challenges and solutions. The second Ultrasound in Medical Education Forum is scheduled to take place May 31-June 1 at the University of California, Irvine. The event is by invitation, but if you know someone who might be interested, please forward their contact information to Glynis Harvey at gharvey@aium.org.

If you are associated with a medical school, how have you integrated ultrasound? If you are a student, what do you think about teaching ultrasound in your classes? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Steven R. Goldstein, MD, is AIUM’s Immediate Past President.

* The 2014 event was underwritten by industry partners and a grant from the Endowment for Education and Research.

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