10 Jul Implementation Of Point Of Care Ultrasonography Disciplin In A Brazilian Medical School: 6-Month Experience.
Ana Luisa Vieira, Rayan Ferreira, Pedro Campos, Pedro Henrique Cunha, Matheus Belo, Marcus Bastos, Jose Pazeli Jr
The teaching of point of care ultrasonography (POCUS) in medical education has been recognized as one of the best initiatives to improve the quality of medical education.
However, in Brazil, POCUS is still a timid initiative among our medical schools.
To present our six-month experience of implementing POCUS in a Brazilian medical school and the level of competence acquired and degree of satisfaction of the students.
Fifty-five ninth-grade medical students took theoretical lectures of the following subjects: POCUS philosophy, physical principles of ultrasound (US) and adjustments of the machine, ultrasonographic artifacts, US of the airways, large cervical vessels, lung, heart, inferior vena cava, aorta, US in trauma patients (FAST) and central venous access puncture guided by US.
Supervision sessions of ultrasound hands-on about the same topics were done in human models, as well as, commercial and handmade phantoms.
The evaluation of competence and satisfaction acquired was performed through:
1) multiple choice test (pre and post training) with 30 questions, sixteen of them including US videos;
2) objective structured clinical examinations (OSCE), with simulation of traumatic abdominal case (FAST exam) in human model and projection of images of real trauma patient;
3) Likert Scale questionnaire for evaluation of satisfaction regarding the discipline.
Average scoring in the theoretical pretest was 13.9 points (range 9 to 26) and 24.6 points in the post-test (range 17 to 29), an improvement of 76%.
In the OSCE, 100% of the students made a correct choice of transducer to do the abdominal exam and 69% of them acquired all FAST windows.
The projected images of hepatorenal, splenorenal, suprapubic and subcostal windows were correctly interpreted, respectively, in 97.2%, 63.8%, 50% and 47.2% of the time.
The score 5 on Likert Scale (“totally agree”) was obtained in 92.5% for the sentences “POCUS’s teaching enhances the student’s knowledge of physical examination”; in 96.2% for the sentence “POCUS improves clinical decisions in approaching the patient”; in 74% for phrase “US initiatives increases student’s interest in staying at the patient bedside”; and in 77.7% for the sentence “the student exposed to POCUS training has better medical education than the others”.
These first 6 months of teaching POCUS to undergraduate students in our institution show that they achieved high level of performance in theoretical and practical tests.
In addition, most students believe that teaching POCUS improves the quality of medical education and propitiate a higher opportunity to interact with the patient.