Ultrasound Training in the Emergency Medicine Clerkship

Abstract

Introduction: The curriculum in most emergency medicine (EM) clerkships includes very little formalized training in point-of-care ultrasound. Medical schools have begun to implement ultrasound training in the pre-clinical curriculum, and the EM clerkship is an appropriate place to build upon this training. The objectives are (1) to evaluate the effectiveness of implementing a focused ultrasound curriculum within an established EM clerkship and (2) to obtain feedback from medical students regarding the program.

Methods: We conducted a prospective cohort study of medical students during an EM clerkship year from July 1, 2011, to June 30, 2012. Participants included fourth-year medical students (n=45) enrolled in the EM clerkship at our institution. The students underwent a structured program focused on the focused assessment with sonography for trauma exam and ultrasound-guided vascular access. At the conclusion of the rotation, they took a 10-item multiple choice test assessing knowledge and image interpretation skills. A cohort of EM residents (n=20) also took the multiple choice test but did not participate in the training with the students. We used an independent samples t-test to examine differences in test scores between the groups.

Results: The medical students in the ultrasound training program scored significantly higher on the multiple-choice test than the EM residents, t(63)=2.3, p<0.05. The feedback from the students indicated that 82.8% were using ultrasound on their current rotations and the majority (55.2%) felt that the one-on-one scanning shift was the most valuable aspect of the curriculum.

Discussion: Our study demonstrates support for an ultrasound training program for medical students in the EM clerkship. After completing the training, students were able to perform similarly to EM residents on a knowledge-based exam.

Figure 1

Medical students’ identified specialty of interest. EM, emergency medicine

Figure 2

Test scores of medical students and residents.