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Sonography and hypotension: a change to critical problem solving in undergraduate medical educationAmini, Richard, Stolz, Lori A, Hernandez, Nicholas C, Gaskin, Kevin, Baker, Nicola, Sanders, Arthur Barry, Adhikari, Srikar 14 January 2016 (has links)
UA Open Access Publishing Fund / Study objectives: Multiple curricula have been designed to teach medical students the basics
of ultrasound; however, few focus on critical problem-solving. The objective of this study is to
determine whether a theme-based ultrasound teaching session, dedicated to the use of ultrasound
in the management of the hypotensive patient, can impact medical students’ ultrasound education
and provide critical problem-solving exercises.
Methods: This was a cross-sectional study using an innovative approach to train 3rd year
medical students during a 1-day ultrasound training session. The students received a 1-hour
didactic session on basic ultrasound physics and knobology and were also provided with YouTube
hyperlinks, and links to smart phone educational applications, which demonstrated a variety
of bedside ultrasound techniques. In small group sessions, students learned how to evaluate
patients for pathology associated with hypotension. A knowledge assessment questionnaire was
administered at the end of the session and again 3 months later. Student knowledge was also
assessed using different clinical scenarios with multiple-choice questions.
Results: One hundred and three 3rd year medical students participated in this study. Appropriate
type of ultrasound was selected and accurate diagnosis was made in different hypotension clinical
scenarios: pulmonary embolism, 81% (95% CI, 73%–89%); abdominal aortic aneurysm,
100%; and pneumothorax, 89% (95% CI, 82%–95%). The average confidence level in performing
ultrasound-guided central line placement was 7/10, focused assessment with sonography
for trauma was 8/10, inferior vena cava assessment was 8/10, evaluation for abdominal aortic
aneurysm was 8/10, assessment for deep vein thrombus was 8/10, and cardiac ultrasound for
contractility and overall function was 7/10. Student performance in the knowledge assessment
portion of the questionnaire was an average of 74% (SD =11%) at the end of workshop and
74% (SD =12%) 3 months later (P=0.00).
Conclusion: At our institution, we successfully integrated ultrasound and critical problemsolving
instruction, as part of a 1-day workshop for undergraduate medical education
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