Why Teach Ultrasound?

Sonosorority on ultrasound teaching rounds: (left to right) Michelle Nasal, Grace Rodriguez, Jessica Everett, Erin Wendell, and Tatiana Thema, with Creagh T. Boulger, MD.

Early in my career, I recall my choice to pursue my academicniche in ultrasound and more specifically ultrasound education being questioned. “Why would you do that?” “How are you going to get promoted?” “This is just a fad!”. For a moment I paused wondering if I should heed this advice. Was I making a mistake? I am happy I did not dwell on that moment because I would not be where I am, I would not have gotten promoted, I would not have touched so many learners, met so many amazing people, and helped so many patients.

One of my first patients as a doctor illustrates why I teach ultrasound. I was a brand-new doctor maybe 10 days under my belt. I walked in the room of my patient. They were in clear discomfort, I was nervous. I pushed on their abdomen. Unsure, I walked out to my supervisors and said: “I think I have an acute abdomen in bed 10.” We paged surgery and were ordering other imaging when my now-mentor, Dave Bahner, suggested we do a FAST exam. This was before the ultrasound invasion in medical school and my only exposure to ultrasound was limited and in OB and the trauma bay. He immediately noted significant free fluid and presumed rupture of a neobladder. The patient went promptly to the OR. This opened my eyes and sparked the passion for ultrasound that has fueled my career. I could use this machine to look inside and help patients on the outside.

So why teach ultrasound and who should you teach?

I teach ultrasound because…

It enables me to bring 2-dimensional anatomy to life. One of my greatest joys is showing a new medical student, undergrad, or high school student their own heart beating right in front of them and see the awe in their eyes.

It makes complicated concepts simple. I recall the challenge in medical school of the preclinical years 1 and 2. Understanding systole, diastole, cardiac valves, and flow. On paper, these are complicated and merely rote memorization. Watching these events occur on ultrasound in real time and how they are altered by simple maneuvers such as Valsalva or squatting truly aids in full understanding of the concepts.

Ultrasound is always relevant. One of my favorite courses to teach is ‘The Approach to Undifferentiated Shock’. This is attended by all fourth-year medical students. By the fourth year in medical school, many students are distracted by interviews and matching and have already chosen their respective fields. I love this course because as a teacher, I get one last chance to show them the light, or rather sound, and how it could help them if they encounter a patient in shock. I ask each of them their field of choice and if they see ultrasound having a role in their career. Many will nod affirmatively to appease me but by the end of the course, they are asking if we can teach them more ultrasound before they graduate. Ultrasound helps me connect and let them know how we use ultrasound to understand the causes of shock and how to manage these patients. This ability to break down silos and demonstrate how useful it can be across many specialties that care for patients is one of my favorite aspects of teaching bedside ultrasound.

Innovation

Ultrasound is such an exciting new tool and developed into a new field. New probes, technology, and applications are always evolving and changing how we use it to care for patients.

Ultrasound education is equally as exciting and dynamic. Because of challenges such as limited curricular time and tight budgets we have gotten creative to teach ultrasound. Ultrasound education has led the way with new concepts such as remote instruction, flipped classroom, near-peer training, learning through modeling, and gaming.

Mentorship

I have been fortunate to be blessed with amazing mentors who have given me amazing opportunities. The ultrasound community is small and welcoming, as well as young, fresh, and innovative. One of the greatest joys of teaching ultrasound has been the relationships I have made. I have found wonderful mentors but also been able to be a mentor. To watch my students turn into fellowship directors, division heads, and national speakers has been one of the greatest rewards. I have seen that hard work, loving what you do, and helping others learn ultrasound is a winning strategy for me and possibly you too.

Clinical Excellence

I make myself endlessly available to my learners and that offer does not end at graduation. More so than any award I have ever gotten, the greatest accomplishments of my career are the notes, emails, and texts saying thank you: ultrasound saved my patient last night. Those clinical wins where a patient benefits from a bedside ultrasound make every late night of lecture prep worth it.

So, why teach ultrasound? Ultrasound is the future of medicine and medical education. Get involved!

Why do you teach ultrasound? What do you value most about teaching the next generation of ultrasound users? Comment below, or, AIUM members, continue the conversation on Connect, the AIUM’s online community. 

Creagh Boulger, MD, RDMS, FACEP, is Assistant Professor, Assistant Director of Ultrasound, and Assistant Fellowship Director of Emergency Ultrasound at Ohio State University Wexner Medical Center.

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