When Dr. Peter Steinmetz took on the task of ensuring McGill University’s medical school graduates would be proficient in the use of point-of-care ultrasound, he faced numerous challenges, not the least of which was the fact that the undergraduate medical school curriculum was already full.
Dr. Steinmetz’s first step was to convince the curriculum implementation committee that ultrasound is essential for future clinicians. “Ultrasound is performed by clinicians worldwide, and is an ideal adjunct to teaching anatomy and conducting physical examinations,” explains Dr. Steinmetz. “You need to show how your medical students will effectively learn the skills to use POCUS as a helpful clinical tool.”
Here are Dr. Steinmetz's top tips for how to integrate ultrasound and develop faculty support in a four-year undergraduate program.
1. Explain how earlier POCUS training provides better clinical results
Medical studies indicate that medical students are more accurate at identifying cardiac pathology and better at identifying pleural effusion when using POCUS. It’s better to teach POCUS skills to students in medical school instead of waiting for the residency portion of their ultrasound training.
2. Prove that teaching POCUS does not increase training load
The medical curriculum at McGill is designed around answering focused clinical questions. Since ultrasound helps clinicians gather supplemental clinical information, we were able to show that integrating POCUS skills into specific clinical areas of the curriculum was an enhancement to the curriculum design. Therefore, no additional time needed to be added for teaching POCUS
3. Develop the right infrastructure for program viability
At McGill, the solution was to access an existing simulation centre at university, and furnish it with 8 POCUS systems purchased with the help of a benefactor’s donation. Be proactive in seeking out stakeholders in the University community and ensure they’re committed to supporting an infrastructure for POCUS teaching (systems, simulation centre, CME, etc).
4. Have enough budget to hire qualified POCUS instructors and staff
Budget enough resources to have excellent POCUS instructors. Build a sustainable/regenerative team of instructors – certified instructors & “near peer” teachers/residents. Good recruits often come from to Emergency Medicine and Family Medicine, where POCUS is already a standard of care.
5. Be ready to back up your POCUS initiatives with hard data
Master the literature on safety and improved clinical outcomes with POCUS. Know all relevant literature on who’s teaching, why, how, whether it improves medical student’s accuracy, etc.
6. Focus on using POCUS to enhance students’ clinical skills
A POCUS curriculum should be tailored to the rest of the undergraduate curriculum. Make it realistic and focused. Have clearly defined objectives for pre-course content, evaluative techniques, textbook, videos, etc. All materials should be aligned and integrated with each other.
7. Continually look for ways to improve POCUS training
Determine whether students are benefiting from the course, and whether they are acquiring and retaining the skills set forth. Don’t shy away from implementing necessary changes that are guided by solid feedback.
Watch Dr. Steinmetz's webinar, "A Four-Year Undergraduate Ultrasound Curriculum."
As we get ready for this year's annual World Congress of Ultrasound in Medical Education, we'll be working with the WCUME team to help providers and medical students learn how to incorporate the power of ultrasound into their clinical practice. Check out more of Dr. Steinmetz's thoughts on ultrasound in his Sonosite webinar on how to start and integrate ultrasound into an already-full curriculum, and outline ways to develop faculty and resources to support an ultrasound curriculum in a four-year undergraduate program.
