Assessment in Ultrasound Education: A Tapestry of Approaches

Matthew R. Lohse, MD, FACEP
Ultrasound Director and EUS Fellowship Director at Baylor Scott & White-Temple Medical Center and Co-Director of the POCUS curriculum thread for Baylor College of Medicine-Temple campus.
Jodi Jones, MD FACEP, FPD-AEMUS
Associate Professor; Interim Division Chief, Emergency Ultrasound and Simulation; Section Chief, Clinical Ultrasound; Fellowship Director, Clinical Ultrasound; Associate Director,  EM Ultrasound Residency Education; Department of Emergency Medicine UT Southwestern Medical Center
Emily Lovallo, MD
University of Pittsburgh School of Medicine, Associate Professor of Emergency Medicine, Director of Ultrasound Services, UPP Emergency Medicine, Director of Ultrasound Education, disclosures: Exo, Inc and Exo Iris
Dan Mirsch, DO, FACEP
University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, SUNY, Assistant Professor of Emergency Medicine, Director of the Behling Simulation Center and Wendt Clinical Competency Center, Director of Student Ultrasound Education, Department of Emergency Medicine, Division of Point of Care Ultrasound, disclosures: 20% owner of BlockHeads LLC

The recent ACEP Ultrasound Section Medical Student Education meeting provided a vibrant platform for subcommittee members to delve into the dynamic world of ultrasound-based assessments and curriculum models. The session, moderated by Dr. Matt Lohse of Baylor College of Medicine, showcased a diverse range of perspectives and experiences from educators across the country.

Spotlight on Diverse Educational Models:

• Full Integration at the University of Pennsylvania: Wilma Chan shared how their curriculum weaves ultrasound training seamlessly throughout all four years, employing structured teaching in both preclinical and clinical settings.
• Primarily Integrated Model at Ohio State University: Creagh Boulger highlighted their approach, which features ultrasound touchpoints across all four years, with a focus on targeted "ground schools" and assessments tailored to specific clinical rotations.
• Extracurricular POCUS Certificate Program at the University of Pittsburgh: Emily Lovallo detailed their innovative program, offering workshops, OSCEs, and an asynchronous curriculum for motivated clerkship students.
• Bedside Teaching and Electives at UT Southwestern: Jodi Jones discussed their approach, which relies on individualized bedside teaching and electives due to smaller class sizes.

Pearls of Wisdom:

• Defining Competency: There's no one-size-fits-all answer. Competency hinges on the specific application of ultrasound being assessed (e.g. RUSH, EFAST) and the learner's stage of training.
• Assessment Strategies: A blend of standardized assessments, individualized feedback, and hands-on learning offers a comprehensive evaluation approach.
• Faculty Engagement: Recruiting and retaining passionate faculty is vital, and can be achieved through a combination of volunteerism, hourly compensation, and the strategic involvement of trainees, residents, and fellows.
• The "Quiz Effect": Wilma Chan shared a powerful insight: simply labeling an ungraded assessment as a "quiz" significantly boosted student preparedness and engagement. The perception of higher stakes associated with an assessment has a clear impact on student performance.

Navigating the Gray Areas: Challenges and Opportunities

The discussion also unearthed the complexities of defining and assessing ultrasound competency. The variability in student experiences and the evolving landscape of medical education necessitate ongoing adaptation and innovation. Faculty recruitment and retention emerged as another crucial challenge, highlighting the need for institutional fiscal support and recognition.

Key Takeaways for Directors:

• Embrace Diversity: Explore diverse curriculum models to find the best fit for your institution's resources and needs.
• Standardize When Possible: Implement standardized assessments where feasible, while recognizing the value of individualized feedback and hands-on learning.
• Invest in Faculty: Foster a supportive environment for faculty involved in ultrasound education, recognizing their contributions and offering opportunities for professional development.
• Think Outside the Box: Consider innovative approaches like self-scanning with remote image review to optimize resources and enhance learning.

The Future of Ultrasound Education: A Collaborative Endeavor

As ultrasound continues to revolutionize medical practice, the ACEP Ultrasound Section Medical Student Education subcommittee serves as a reminder of the importance of collaboration and knowledge-sharing among educators. By embracing diverse perspectives and innovative strategies, we can equip the next generation of physicians with the skills they need to harness the power of ultrasound at the point of care.

Articles on this topic

1. Hoppmann RA, Mladenovic J, Melniker L, Badea R, Blaivas M, Montorfano M, et al. International consensus conference recommendations on ultrasound education for undergraduate medical students. Ultrasound J. 2022;14(1):31.
2. Russell FM, Zakeri B, Herbert A, Ferre RM, Leiser A, Wallach PM. The State of Point-of-Care Ultrasound Training in Undergraduate Medical Education: Findings From a National Survey. Acad Med. 2022;97(5):723-727.
3. Bahner DP, Goldman E, Way D, Royall NA, Liu YT. The state of ultrasound education in U.S. medical schools: results of a national survey. Acad Med. 2014;89(12):1681-6.