Why SonoStuff.com?

Three reasons:

As a co-director of technology enabled active learning (TEAL) at the UC Davis school of medicine I incorporate important technologies into the medical curriculum, which has primarily been point of care ultrasound (POCUS). Ultrasound is an incredible medical education tool and curriculum integration tool. It can be used to teach, reinforce, and expand lessons in anatomy, physiology, pathology, physical exam, and the list goes on.

I knew there was a better way to teach medical students thaschick_photo_1n standing in front of the classroom and giving a lecture. Student’s need to learn hands-on, spatial reasoning, and critical thinking skills to become excellent physicians. Teaching clinically relevant topics with ultrasound in small groups with individualized instruction
is the best strategy. I needed to flip the classroom.

I started by creating online lectures for an introduction to ultrasound lecture, thoracic anatomy, and abdominal anatomy:

Introduction to Ultrasound, POCUS

FAST Focused Assessment of Sonography in Trauma Part 1

FAST Focused Assessment of Sonography in Trauma Part 2

Aorta Exam AAA POCUS

Introduction in Cardiac Ultrasound POCUS

Topics quickly grew in scope and depth. I initially housed my lectures on YouTube and emailed them out to students before the ultrasound laboratory sessions. However, I wanted a platform that allowed for improved organization and showcasing. I needed a single oschick_photo_2nline resource they could go to to find those materials I was making specific to their medical curriculum.

https://www.youtube.com/channel/UCOhSjAZJnKpo8pP7ypvKDsw

Around the same time, during a weekly ultrasound quality assurance session in my emergency department I realized we were reviewing hundreds of scans each month and the reviewers were the only ones benefiting educationally from the process. Many cases were unique and important for education and patient care.

We began providing more feedback to our emergency sonographers and I decided I could use the same software I was using to develop material for the school of schick_photo_3medicine to highlight the most significant contributions to POCUS in our department every week. I quickly realized I needed a resource to house all these videos, one that anyone in my department could refer to when needed. The most efficient and creative method was to start a blog. I was discussing the project and possible names for the blog with colleagues and Dr. Sarah Medeiros said, “sounds like it’s a bunch of ultrasound stuff”. https://sonostuff.com was born.

I owe a great deal to free and open access to medical education or FOAMed. I was hungry for more POCUS education in residency and the ultrasoundpodcast.com came to the rescue. I became a local expert as a resident and even traveled to Tanzania to teach POCUS.

schick_photo_4I primarily began www.SonoStuff.com to organize and share with my department of emergency medicine and school of medicine, but it grew into a contribution to the growing body of amazing education resources that is FOAMed. I now use it as a resource in my global development work along with the many other FOAMed resources.

The work we all do in FOAMed, including AIUM’s the Scan, are an incredible and necessary resource. I have read the textbooks and attended the lectures, but I would not be where I am without FOAMed. I know all or most of those contributing to FOAMed do it out of love for education and patient care, without reimbursement or time off. Thank you to the many high-quality contributors and I am proud to play a small part in the FOAMed movement.schick_photo_5

Michael Schick, DO, MA, is Assistant Professor of Emergency Medicine at UC Davis Medical Center and Co-Director of Technology Enabled Active Learning, UC Davis School of Medicine. He is creator of www.sonostuff.com and can be reached on Twitter: ultrasoundstuff.

Interdisciplinary Education and Training in MSK Ultrasound

In my primary specialty of occupational medicine there is a need for practical education in musculoskeletal ultrasound for both diagnostic evaluation and therapeutic interventional guidance. Incorporation of this into education has begun recently and is continuing in the specialty. A wide variety of specialties are represented in occupational medicine, including many specialists who move into the field after a mid-career transition.

Interestingly, over the last few years clinicians have approached me and asked me to help them learn musculoskeletal ultrasound from many different disciplines outside of occupational medicine. These have included emergency medicine, orthopedics, rheumatology, sports medicine, family medicine, radiology, palliative care, and physical medicine and rehabilitation. When inquiring into why these clinicians are seeking training in this modality it seems that the consistent answer is thdr-sayeedat medical students are graduating and insisting on using ultrasound in their residency training. It would seem that many of our medical students are learning ultrasound at a rate that will outpace attending physician knowledge, exposure, and experience. Indeed, when teaching ultrasound to many of the medical students at West Virginia University as part of their medical education, I was astounded to see how proficient they were at using the machine, the transducer, and correctly identifying both normal and pathologic anatomy. It’s my understanding that many universities have included medical ultrasound into the academic curricula as a bridge to their respective gross anatomy courses and in their general clinical medical education.

Ultrasound is a modality utilized by many medical specialties for various indications. Several specialties outside of radiology, including the ones above, utilize ultrasound. Increasingly, residency programs are integrating ultrasound into their ACGME-accredited curriculum and, importantly, medical students are also learning the benefits of using the modality. It seems clear that despite the number of pitfalls, hurdles, and difficulties using ultrasound, the modality has proven to be an asset in clinical settings and has become a permanent fixture in hospital and clinical settings. The benefits of utilizing ultrasound have been well documented across many academic medical journals. I believe that medicine, as a whole, has done well to embrace the modality, however, there seems to be another vital step to take in the education arena to more fully integrate the modality into our patient’s care.

Currently, most education models for teaching ultrasound, whether it is for residents or medical students, involves grouping like kind together. Emergency residents learn it in the emergency medicine didactics. Physical medicine and rehabilitation (PM&R) residents learn it from demonstrations in their own didactics, and so on. Perhaps approaching the curriculum from a more inclusive perspective, however, would be more beneficial for residents and fellows. I, personally, had experience teaching an integrated musculoskeletal course at West Virginia University. The idea, admittedly, was born out of necessity. Physicians experienced in ultrasound from sports medicine, emergency medicine and occupational medicine created and executed a curriculum to teach musculoskeletal ultrasound and invited residents from other specialties. The interest we were able to garner quite frankly surprised me. Although the curriculum was targeted to occupational medicine residents the interest in using musculoskeletal ultrasound was widespread. Residents from specialties like emergency medicine, radiology, family medicine, internal medicine, and orthopedics attended our sessions.

While the course was a success, introducing an integrated curriculum across medical specialties posed a new set of challenges. My specialty was able to use dedicated didactic time for the education but many other specialties have disparate educational time. Many residents could not make all of the sessions and many more could not make any sessions because of fixed residency schedules. This makes coordination very difficult. As I have pondered this over the last few months I believe that educational leaders should begin to form structured educational collaborative time for activities like education in musculoskeletal ultrasound. Each discipline will be able to contribute to teaching to ensure high quality evidence-based curriculum for residents learning ultrasound. Each discipline has their individual strengths and collaboration ensures coordination and even learning amongst instructors. Integrating medicine has been a goal of thought leaders in medicine at the very highest levels and can be replicated for the instruction and training of our resident physicians.

Another option is to allow residents to attend the American Institute of Ultrasound in Medicine’s annual conference where interdisciplinary education in ultrasound occurs. This conference even has a day for collegial competition among medical students and schools. In fact, the courses are created to encourage engagement in the education and training of clinicians at all levels of training. The overall goal is to advance the education and training in this modality and hope that education leaders begin to encourage collaboration in a much larger scale thus achieving integrated medical care that provides a building block to lead to high quality evidence-based medical care for our patients, families, and communities.

What other areas of ultrasound education have room to grow? How would you recommend making changes? Do you have any stories from your own education to share? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Yusef Sayeed, MD, MPH, MEng, CPH, is a Fellow at Deuk Spine Institute, Melbourne, FL.

The Spirit of Collaboration – A Tribute to Carmine M. Valente, PhD, CAE

Are you aware of the depth and breadth of engagement activities at the AIUM? Most likely, our flagship enterprises, such as the JUM and the convention, as well as the 18 (and growing!) communities immediately come to mind. And for almost 20 years, AIUM CEO Carmine M. Valente, PhD, CAE, has been at the heart of it all. As we close out 2016, we say goodbye to a leader, a catalyst, and a friend. While Carmine has set his focus on new adventures in retirement, it’s interesting to note how much the AIUM has grown during his tenure.

Back in 1997, the AIUM had 8 communities, known in those days as sections. There were 2 types of practice accreditation – OB/GYN and abdominal/gecarmneral. There are now 12. The EER, in its infancy, had $47,000 in its coffers. Over time, 8 practice guidelines have grown to 31 practice parameters; training guidelines have expanded from 1 to 12; and the number of societies that have worked with us to develop these tools has expanded exponentially.

This growth is a result of a theme Carmine has instilled throughout his tenure—collaboration. Carmine is often heard declaring “It makes no sense for the AIUM to develop [fill in the blank] without looking outward. The more stakeholders at the table, the stronger the result.” The imaging community recognized this as early as 2007, when RT Image recognized Carmine as one of radiology’s 25 most influential movers and shakers. “Dr. Valente has been a key element in facilitating and coordinating these and other important activities that continue to grow both the AIUM and interest in the ultrasound arena.”

Over time, Carmine has partnered with 10 of AIUM’s 31 presidents, enabling them to achieve their goals and further the AIUM mission. In the last 12 years, the AIUM has hosted 9 forums on a variety of topics with dozens of participant organizations at each; and all within the framework of collaboration: Compact Ultrasound (2004); Training/Exam Guidelines and Scope of Practice (2006/2008); Patient Safety and Quality: The Role of Ultrasound (2007); Point-of-Care Use of Ultrasound (2010); Ultrasound First & Beyond Ultrasound First: Quality Imaging (2012 & 2016); and Ultrasound in Medical Education (2014 & 2015).

In October 2016, the AIUM’s Board of Governors established the Carmine M. Valente, PhD, CAE Distinguished Service Award to memorialize and recognize significant contributions to the AIUM and the ultrasound community as a whole by furthering the multidisciplinary nature and collaborative efforts of the organization. Its first presentation will occur at the 2017 AIUM Annual Convention in Orlando, Florida.

For those who visit the AIUM Headquarters, you will see that the AIUM’s primary conference area has been dedicated as an enduring reminder of Carmine’s Spirit of Collaboration. This space will serve as a center for informing, educating, inspiring, and entertaining, and instill a growing sense of belief and pride in our ability to advance the safe and effective use of ultrasound in medicine.

Today, it is endemic of the AIUM’s culture to ask “Who else should be at the table?” whenever a project is discussed. And for that, we thank you, Carmine.

The spirit of collaboration is, in Carmine’s immortalized words, “to be continued…”

Do you have a memory, thought, or story to share about Carmine? Comment below and on Twitter: @AIUM_Ultrasound.

Glynis V. Harvey, CAE, is the AIUM’s Chief Executive Officer Designate & Deputy Chief Executive Officer.