Official Proceedings - AIUM

American Institute of Ultrasound in Medicine Proceedings J Ultrasound Med 32(suppl):S1–S134, 20131428470 Ultrasound Knowledge and Image Interpretation Gains byStudents on Emergency Medicine RotationUche Blackstock,* Jaclyn Munson, Nina Yeboah, DemianSzyld Emergency Medicine, Bellevue Hospital/New York UniversityMedical Center, New York, New York USAObjectives—Bedside ultrasound (BUS) competency is consideredintegral to emergency medicine (EM) practice, and EM residenciesrequire BUS training. However, medical students are rarely formallytaught BUS. We sought to develop and evaluate a BUS curriculum formedical students on their EM rotation.Methods—We prospectively enrolled a convenience sample of26 medical students (second year, 8 [30.8%]; third year, 11 [42.3%]; andfourth year, 7 [26.9%]) on their EM rotation. Students completed a 33–multiple-choice question Web-based pretest assessing knowledge ofphysics (Ph; 17 items [51.5%]) and image interpretation (Im; 16 items[49.5%]). On pretest completion, participants viewed video tutorials covering(1) Ph, 2) focused assessment with sonography for trauma, and (3)ultrasound-guided vascular access. Next, participants attended a 3-hourhands-on BUS session covering the tutorial topics. Subsequently, participantscompleted a Web-based posttest, containing identical questions asthe pretest. To validate results, a sample of 15 EM residents took the sameWeb-based posttest (5 postgraduate year 1 [PGY-1, 33.3%]; 3 PGY-2[20%], 5 PGY-3 [33.3%], and 2 PGY-4 [13.3%]) We performed a withingroupanalysis of participants’ pretest and posttest performance and between-groupanalysis as compared to the EM residents.Results—The students’ pretest mean score was 21.6/33 (65.6%;SD, 11.1%) made up of a Ph mean score of 11.5/17 (67.9%; SD, 14.1%)and an Im mean score of 10.1/16 (63.2%; SD, 15.6%). The students’posttest mean score was 28.4/33 (86.3%; SD, 9.35%), with a Ph meanscore of 15.0/17 (88.0%; SD, 10.8%) and an Im mean score of 13.4/16(84.1%; SD, 12.8%), corresponding to an overall effect size of d = 1.7(95% confidence interval [CI], 1.1, 2.3), Ph effect size of d = 1.5 (95% CI,0.9, 2.0), and Im effect size of d = 1.2 (95% CI, 0.7, 1.7). There were nostatistically significant differences between students’ and residents’ posttestscores (P = .47) or in any subcategory (Ph, P = .13; Im, P = .93).Conclusions—A standardized formal curriculum in BUS significantlyimproved medical students’ Ph knowledge and ability to interpretultrasound images. Medical students performed as well as a sampleof EM residents.1540627 Enhancing Third-Year Medical Student Primary CareClerkships With Handheld UltrasoundMary Elizabeth Poston, 1 Duncan Howe, 2 * Victor Rao, 2Richard Hoppmann, 2 Chung Yoon 1 1 Internal Medicine,2Ultrasound Institute, University of South Carolina School ofMedicine, Columbia, South Carolina USAObjectives—Future physicians may be better prepared to providesafer, higher-quality patient care if point-of-care ultrasound (US) isincluded in the medical school curricula. We piloted a handheld US curriculumfor third-year medical students. The primary objective was to determinestudents’ ability to learn to perform and interpret point-of-care USimages of the heart and assess global heart function. Secondary objectivesincluded determining patterns of use (number/types of scans performed,indications for scans, and impact on patient management) and assessingimpact on student learning.Methods—Fifty-four third-year medical students each receivedhandheld US for 22 weeks during the M3 year (8 weeks each for internalmedicine and pediatrics, 6 weeks for family medicine). During the M1and M2 years, these students had previously been taught cardiac and abdominalscanning techniques with laptop US on live patient models. Duringeach clerkship, students received didactic lectures on the use of thedevice and were instructed to view Web-based modules on global heartfunction assessment. Additional Web-based modules on other US-appropriatescans were also available. Students received hands-on instruction atleast once per clerkship using standardized patients. Students were instructedto save at least 1 cardiac and 2 other images and to record thetype, indication, and impact of scans.Results—Students submitted information on patterns of use andpathology evaluated for 305 cardiovascular (heart/inferior vena cava [IVC]),131 abdominal, 97 nonobstetric genitourinary, 9 lung, and 6 obstetric scans.In an end-of-the-year objective structured clinical examination, M3 studentsdemonstrated the ability to obtain images of the heart (parasternal long-axisview) as well as IVC and comment on global heart function and volumestatus. In end-of-year surveys, students stated that their ability to recognize,understand, and manage patient problems improved with US, but lack ofUS-trained faculty to supervise was a major limitation.Conclusions—M3 students with some prior experience canlearn to assess global heart function with handheld US. Students felt thatunderstanding of patient pathology and management was improved. Lackof trained faculty is a barrier to this curriculum.1541489 Cloud Documentation and iPad Telesonography From aTeaching Hospital in the Andes: A Culturally CompetentModel for Obstetric Ultrasound Education, Quality Assurance,and Practice Improvement in Remote EcuadorJohn Rodney, 1 * Erin Dooley, 2 John Simmons, 1 MatthewHorning, 3 Kelly Arnold, 4 William Rodney 2 1 Family Medicine,Texas A&M Health Science Center, Bryan, Texas USA;2Surgical Family Medicine, Obstetrics, Medicos Para la Familia,Memphis, Tennessee USA; 3 Family Medicine, St Luke’sHospital, Ashland, Wisconsin USA; 4 Family Medicine, Universityof Tennessee, Chattanooga, Tennessee USAObjectives—To create and implement a Spanish language–based obstetric ultrasound curriculum and record-keeping system by creatinga cloud-enhanced iPad application as well as a textbook and lectureseries translated into Spanish.Methods—Using AIUM guidelines for obstetric and gynecologicultrasound, we developed a cloud-based iPad application to addressthe educational and data storage needs of a geographically isolated teachinghospital in the mountains of remote Ecuador. After a brief ultrasoundseminar that included Spanish language–based lectures, texts, and demonstrations,the investigators used the iPad application to remotely monitorthe performance and documentation of obstetric ultrasound examinationsby family medicine trainees and physicians over a 6-week period.Results—We successfully addressed the educational and informationmanagement needs of family medicine trainees and physiciansin an isolated Spanish-speaking teaching hospital in remote Ecuador.Conclusions—Cloud-enhanced tablet technology is a feasiblemeans of overcoming geographic and cultural barriers for the purposes ofultrasound education, quality assurance, and practice improvement forfamily medicine trainees and physicians practicing in remote, resourcelimitedlocations.General and Abdominal UltrasoundModerator: Abid Irshad, MD1536712 European Federation of Societies for Ultrasound in Medicineand Biology Guidelines on the Clinical Use of ElastographyDavid Cosgrove, 1 * Christoph Dietrich, 2 Fabio Piscaglia 31Imaging Sciences, Imperial College, London, England; 2 Gastroenterology,S. Orsola-Malpighi, Bologna, Italy; 3 Medicine,Caritas Krankenhaus, Bad Mergentheim, GermanyObjectives—Elastography has emerged as a clinically usefuladdition to conventional ultrasound in many diagnostic applications. How-S65