Ultrasound Curricula of Student Education in Europe: Summary of the Experience

Abstract

Background Despite the increasing role of ultrasound, structured ultrasound teaching is only slowly being integrated into the curricula of medical schools and universities all over Europe.

Aim To survey the current situation at European universities regarding the integration of ultrasound in student medical education and to report on models of student ultrasound training from selected European universities.

Methods A questionnaire survey focusing on the implementation of curricular ultrasound education was sent out to the 28 presidents of the national ultrasound societies of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), who were asked to distribute the questionnaires to the medical universities of their countries.

Results Overall, 53 questionnaires were returned from 46 universities in 17 European countries. In most of the universities (40/46 universities, 87%), the theoretical background of ultrasound is taught. However, in only a minority of universities is ultrasound integrated in anatomy courses (8/46 universities, 17%) or basic science courses (16/46 universities, 35%). Practical skills in ultrasound are taught in 56% of the universities (26/46 universities) and tested in a practical exam in seven of the responding universities (15%). The number of hours in which ultrasound was taught ranged from one to 58 (mean, seven). The respondents reported that lack of time and limited faculty funding were major hurdles.

Conclusion According to our survey, only a minority of European universities has integrated ultrasound into the preclinical curriculum thus far. Future EFSUMB initiatives will continue to promote the introduction of ultrasound as an integrative part of the core curriculum of student medical education, and the preparation of proper teaching material.

Key words

ultrasound - methods & techniques - guideline - teaching

Publikationsverlauf

Eingereicht: 03. Januar 2020
Eingereicht: 11. Mai 2020

Angenommen: 13. Mai 2020

Artikel online veröffentlicht:
31. August 2020

• References

• 1 Cantisani V, Dietrich CF, Badea R, Dudea S, Prosch H, Cerezo E, Nuernberg D. et al. EFSUMB statement on medical student education in ultrasound [short version]. Ultraschall Med 2016; 37: 100-102
• 2 Cantisani V, Dietrich CF, Badea R, Dudea S, Prosch H, Cerezo E, Nuernberg D. et al. EFSUMB Statement on Medical Student Education in Ultrasound [long version]. Ultrasound Int Open 2016; 2: E2-E7
• 3 Dietrich CF, Hoffmann B, Abramowicz J, Badea R, Braden B, Cantisani V, Chammas MC. et al. Medical Student Ultrasound Education: A WFUMB Position Paper, Part I. Ultrasound Med Biol 2019; 45: 271-281
• 4 Dinh VA, Fu JY, Lu S, Chiem A, Fox JC, Blaivas M. Integration of Ultrasound in Medical Education at United States Medical Schools: A National Survey of Directors' Experiences. J Ultrasound Med 2016; 35: 413-419
• 5 Baltarowich OH, Di Salvo DN, Scoutt LM, Brown DL, Cox CW, DiPietro MA, Glazer DI. et al. National ultrasound curriculum for medical students. Ultrasound Q 2014; 30: 13-19
• 6 Dinh VA, Lakoff D, Hess J, Bahner DP, Hoppmann R, Blaivas M, Pellerito JS. et al. Medical Student Core Clinical Ultrasound Milestones: A Consensus Among Directors in the United States. J Ultrasound Med 2016; 35: 421-434
• 7 Chiem AT, Soucy Z, Dinh VA, Chilstrom M, Gharahbaghian L, Shah V, Medak A. et al. Integration of Ultrasound in Undergraduate Medical Education at the California Medical Schools: A Discussion of Common Challenges and Strategies From the UMeCali Experience. J Ultrasound Med 2016; 35: 221-233
• 8 Heinzow HS, Friederichs H, Lenz P, Schmedt A, Becker JC, Hengst K, Marschall B. et al. Teaching ultrasound in a curricular course according to certified EFSUMB standards during undergraduate medical education: a prospective study. BMC Med Educ 2013; 13: 84
• 9 Wakefield RJ, Weerasinghe A, Tung P, Smith L, Pickering J, Msimanga T, Arora M. et al. The development of a pragmatic, clinically driven ultrasound curriculum in a UK medical school. Med Teach 2018; 40: 600-606
• 10 Bahner DP, Adkins EJ, Hughes D, Barrie M, Boulger CT, Royall NA. Integrated medical school ultrasound: Development of an ultrasound vertical curriculum. Crit Ultrasound J 2013; 5: 6
• 11 Celebi N, Griewatz J, Malek NP, Krieg S, Kuehnl T, Muller R, Pauluschke-Frohlich J. et al. Development and implementation of a comprehensive ultrasound curriculum for undergraduate medical students - a feasibility study. BMC Med Educ 2019; 19: 170
• 12 Wilson SP, Mefford JM, Lahham S, Lotfipour S, Subeh M, Maldonado G, Spann S. et al. Implementation of a 4-Year Point-of-Care Ultrasound Curriculum in a Liaison Committee on Medical Education-Accredited US Medical School. J Ultrasound Med 2017; 36: 321-325
• 13 Tarique U, Tang B, Singh M, Kulasegaram KM, Ailon J. Ultrasound Curricula in Undergraduate Medical Education: A Scoping Review. J Ultrasound Med 2018; 37: 69-82
• 14 Davis JJ, Wessner CE, Potts J, Au AK, Pohl CA, Fields JM. Ultrasonography in Undergraduate Medical Education: A Systematic Review. J Ultrasound Med 2018; 37: 2667-2679
• 15 Mircea PA, Badea R, Fodor D, Buzoianu AD. Using ultrasonography as a teaching support tool in undergraduate medical education – time to reach a decision. Med Ultrason 2012; 14: 211-216
• 16 So S, Patel RM, Orebaugh SL. Ultrasound imaging in medical student education: Impact on learning anatomy and physical diagnosis. Anat. Sci Educ 2017; 10: 176-189
• 17 Patel SG, Benninger B, Mirjalili SA. Integrating ultrasound into modern medical curricula. Clin Anat 2017; 30: 452-460
• 18 Walrod BJ, Schroeder A, Conroy MJ, Boucher LC, Bockbrader M, Way DP, McCamey KL. et al. Does Ultrasound-Enhanced Instruction of Musculoskeletal Anatomy Improve Physical Examination Skills of First-Year Medical Students?. J Ultrasound Med 2018; 37: 225-232
• 19 Luetmer MT, Cloud BA, Youdas JW, Pawlina W, Lachman N. Simulating the multi-disciplinary care team approach: Enhancing student understanding of anatomy through an ultrasound-anchored interprofessional session. Anat Sci Educ 2018; 11: 94-99
• 20 Danielle F. Royer, Seeing with Sound: How Ultrasound Is Changing the Way We Look at Anatomy. In: Rea PM, Ed. Biomedical Visualisation, Vol. 2. Cham: Springer Nature Switzerland; 2019: 1–11
• 21 Dinh VA, Frederick J, Bartos R, Shankel TM, Werner L. Effects of ultrasound implementation on physical examination learning and teaching during the first year of medical education. J Ultrasound Med 2015; 34: 43-50
• 22 Smith JP, Kendall JL, Royer DF. Improved medical student perception of ultrasound using a paired anatomy teaching assistant and clinician teaching model. Anat Sci Educ 2018; 11: 175-184
• 23 Feilchenfeld Z, Dornan T, Whitehead C, Kuper A. Ultrasound in undergraduate medical education: A systematic and critical review. Med Educ 2017; 51: 366-378
• 24 Jamniczky HA, Cotton D, Paget M, Ramji Q, Lenz R, McLaughlin K, Coderre S. et al. Cognitive load imposed by ultrasound-facilitated teaching does not adversely affect gross anatomy learning outcomes. Anat Sci Educ 2017; 10: 144-151
• 25 Hamza A, Radosa JC, Solomayer EF, Takacs Z, Juhasz-Boess I, Stroder R, Joukhadar R. et al. Introduction of a student tutor-based basic obstetrical ultrasound screening in undergraduate medical education. Arch Gynecol Obstet 2019; 300: 59-66
• 26 Ahn JS, French AJ, Thiessen ME, Kendall JL. Training peer instructors for a combined ultrasound/physical exam curriculum. Teach Learn Med 2014; 26: 292-295
• 27 Rees EL, Quinn PJ, Davies B, Fotheringham V. How does peer teaching compare to faculty teaching? A systematic review and meta-analysis (.). Med Teach 2016; 38: 829-837
• 28 Burgess A, McGregor D, Mellis C. Medical students as peer tutors: A systematic review. BMC Med Educ 2014; 14: 115
• 29 Knobe M, Munker R, Sellei RM, Holschen M, Mooij SC, Schmidt-Rohlfing B, Niethard FU. et al. Peer teaching: A randomised controlled trial using student-teachers to teach musculoskeletal ultrasound. Med Educ 2010; 44: 148-155
• 30 Celebi N, Zwirner K, Lischner U, Bauder M, Ditthard K, Schurger S, Riessen R. et al. Student tutors are able to teach basic sonographic anatomy effectively - a prospective randomized controlled trial. Ultraschall Med 2012; 33: 141-145
• 31 Byrne C, Kahl N, Knight B, Lee M, Morley S, Lahham S, Bingisser R. et al. A prospective evaluation of point of care ultrasound teaching in Switzerland. J Med Ultrasound 2019; 27: 92-96
• 32 Kuhl M, Wagner R, Bauder M, Fenik Y, Riessen R, Lammerding-Koppel M, Gawaz M. et al. Student tutors for hands-on training in focused emergency echocardiography – a randomized controlled trial. BMC Med Educ 2012; 12: 101
• 33 Garcia-Casasola G, Sanchez FJ, Luordo D, Zapata DF, Frias MC, Garrido VV, Martinez JV. et al. Basic abdominal point-of-care ultrasound training in the undergraduate: Students as mentors. J Ultrasound Med 2016; 35: 2483-2489
• 34 Celebi N, Griewatz J, Malek NP, Hoffmann T, Walter C, Muller R, Riessen R. et al. Outcomes of three different ways to train medical students as ultrasound tutors. BMC Med Educ 2019; 19: 125
• 35 Hempel D, Haunhorst S, Sinnathurai S, Seibel A, Recker F, Heringer F, Michels G. et al. Social media to supplement point-of-care ultrasound courses: The "sandwich e-learning" approach. A randomized trial. Crit Ultrasound J 2016; 8: 3
• 36 Hempel D, Sinnathurai S, Haunhorst S, Seibel A, Michels G, Heringer F, Recker F. et al. Influence of case-based e-learning on students' performance in point-of-care ultrasound courses: A randomized trial. Eur J Emerg Med 2016; 23: 298-304
• 37 Ostergaard ML, Ewertsen C, Konge L, Albrecht-Beste E, Bachmann Nielsen M. Simulation-based abdominal ultrasound training – A systematic review. Ultraschall Med 2016; 37: 253-261
• 38 Miller GT, Scerbo MW, Zybak S, Byars DV, Goodmurphy CW, Lattanzio FA, Knapp BJ. et al. Learner improvement from a simulation-enhanced ultrasonography curriculum for first-year medical students. J Ultrasound Med 2017; 36: 609-619
• 39 Shah S, Tohmasi S, Frisch E, Anderson A, Almog R, Lahham S, Bingisser R. et al. A comparison of simulation versus didactics for teaching ultrasound to Swiss medical students. World J Emerg Med 2019; 10: 169-176
• 40 Orr KE, Hamilton SC, Clarke R, Adi MY, Gutteridge C, Suresh P, Freeman SJ. The integration of transabdominal ultrasound simulators into an ultrasound curriculum. Ultrasound 2019; 27: 20-30
• 41 Ostergaard ML, Rue Nielsen K, Albrecht-Beste E, Kjaer Ersboll A, Konge L, Bachmann Nielsen M. Simulator training improves ultrasound scanning performance on patients: a randomized controlled trial. Eur Radiol 2019; 29: 3210-3218