Lyon Matthew, Kriegel David, Lockett Elizabeth, Best Graciela, Seymore Dayna, Kuchinski Ann Marie, Etheridge Rebecca, Wallach Paul
Center for Ultrasound Education, Medical College of Georgia at Augusta University, CJ3101, 1120 15th Street, Augusta, GA 30912 USA.
Department of Family Medicine, Augusta University, 1120 15th Street, Augusta, GA 30912 USA.
Med Sci Educ. 2019 May 21;29(3):795-801. doi: 10.1007/s40670-019-00743-z. eCollection 2019 Sep.
While point of care ultrasound (POCUS) integration into clinical clerkships provides unique educational experiences for students, there are barriers to implementation, particularly in a distributed campus medical school model in clerkships where the faculty do not often perform POCUS, like family medicine (FM). The objective of this paper is to describe the implementation and evaluation of a POCUS curriculum in an FM core clinical clerkship in a state-wide medical school campus model.
Seventeen Philips Lumify Ultrasound Systems were used in 20 clerkship sites with the requirement that students obtain abdominal aortic and inferior vena cava (IVC) images on patients evaluated during their rotation. Images were de-identified, transmitted to a university cloud-based storage account, and scored by medical school ultrasound faculty.
Students were able to obtain adequate images of the aorta and IVC without direct ultrasound-trained faculty at the performance site. Of the 183 students, 119 (65%) were able to successfully submit images for scoring with failure to upload to the cloud-based storage account as the most common reason students were unsuccessful (42%). The majority of students (62%) scored in the top quartile of image quality scoring with the percentage of those scoring in the top quartile improving during the academic year from 57% in the first four rotations to 67% in the last four rotations.
Barriers to implementation of a POCUS curriculum into a FM clerkship in a distributed campus medical school model can be challenging due to equipment availability and issues around the successful transmission of images. These challenges can be overcome however with sufficient attention to implementation design that includes equipment sharing protocols and technical options that enhance the ease of image transmission.
虽然将床旁超声（POCUS）纳入临床实习为学生提供了独特的教育体验，但在实施过程中存在障碍，特别是在分布式校园医学院模式的实习中，像家庭医学（FM）这样的科室，教员并不经常进行POCUS操作。本文的目的是描述在全州医学院校园模式的FM核心临床实习中POCUS课程的实施和评估情况。
在20个实习地点使用了17台飞利浦Lumify超声系统，要求学生在轮转期间对患者进行评估时获取腹主动脉和下腔静脉（IVC）图像。图像进行了去标识化处理，传输到大学基于云的存储账户，并由医学院超声教员进行评分。
学生能够在操作现场没有直接接受过超声培训的教员的情况下，获取足够的主动脉和IVC图像。在183名学生中，119名（65%）能够成功提交图像进行评分，未能上传到基于云的存储账户是学生未成功的最常见原因（42%）。大多数学生（62%）在图像质量评分中处于前四分位，在学年期间，处于前四分位的学生比例从最初四轮的57%提高到最后四轮的67%。
在分布式校园医学院模式下，将POCUS课程纳入FM实习的实施障碍可能具有挑战性，这是由于设备可用性以及图像成功传输方面的问题。然而，通过充分关注实施设计，包括设备共享协议和提高图像传输便利性的技术选项，这些挑战是可以克服的。
