Embers David, Yedlinsky Nicole T
Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS.
PRiMER. 2023 Nov 27;7:39. doi: 10.22454/PRiMER.2023.183911. eCollection 2023.
Point-of-care ultrasound (POCUS) is becoming more common as a diagnostic and clinical tool. Some medical schools have incorporated POCUS training in their curriculum. A family medicine clerkship during the third year of undergraduate medical education is appropriate for incorporating musculoskeletal (MSK) education. Musculoskeletal ultrasound (MSKUS) is a potential tool for augmenting this teaching.
Third-year undergraduate family medicine clerkship students were given prework related to ultrasound physics, terminology, and sonographic appearance of MSK structures. This was followed by a 2-hour session in the first week of their clerkship covering the shoulder and knee MSK exams, and incorporated hands-on scanning. Students practiced MSK exams during their 8-week clerkship and POCUS was available in clinic. They were administered a postsession survey to rate the MSKUS curriculum. Objective, structured clinical exam (OSCE) testing, including performance evaluation of the knee examination during the final clerkship week, was compared to prior-year OSCE scores.
Third-year medical students felt the use of MSKUS was helpful and enhanced overall understanding of MSK exams. We did not see an improvement in OSCE scores. Students reported a desire for more POCUS training.
POCUS is a powerful tool within the clinical and academic setting. We were able to develop a curriculum using MSKUS to augment teaching the shoulder and knee exams to third-year family medicine clerkship students. While we did not see an improvement in OSCE scores evaluating the performance of a knee exam, students reported greater understanding of the exams with the MSKUS instruction added. Students desire more POCUS training in the undergraduate medical curriculum.
即时超声检查（POCUS）作为一种诊断和临床工具正变得越来越普遍。一些医学院校已将POCUS培训纳入其课程体系。本科医学教育第三年的家庭医学实习适合纳入肌肉骨骼（MSK）教育。肌肉骨骼超声（MSKUS）是加强这一教学的潜在工具。
本科三年级家庭医学实习学生接受了与超声物理学、术语以及MSK结构的超声表现相关的预习作业。随后，在实习的第一周进行了为期2小时的课程，内容涵盖肩部和膝部的MSK检查，并包括实践扫描。学生们在为期8周的实习期间练习MSK检查，且诊所提供POCUS检查。对他们进行了课后调查以评估MSKUS课程。将客观结构化临床考试（OSCE）测试，包括在实习最后一周对膝关节检查的表现评估，与上一年的OSCE分数进行比较。
三年级医学生认为MSKUS的使用很有帮助，并增强了对MSK检查的整体理解。我们未观察到OSCE分数有所提高。学生们表示希望获得更多的POCUS培训。
POCUS在临床和学术环境中是一种强大的工具。我们能够开发出一门使用MSKUS的课程，以加强对本科三年级家庭医学实习学生进行肩部和膝部检查的教学。虽然我们在评估膝关节检查表现的OSCE分数上未看到提高，但学生们报告称，增加了MSKUS指导后，对这些检查有了更深入的理解。学生们希望在本科医学课程中获得更多的POCUS培训。
