Ultrasound in the First Two Years of Medical School: Enhanced Anatomical Learning via Clinically Based, Hands‐On Workshops
Authors: Nydam Randall L. , Finch Charles , Simons Erin L.R. , Townsend K.E. Beth , Grow Wade A. 
Published: April 2020

Ultrasound is an increasingly important and ubiquitous medical resource with diagnostic and procedural applications in a wide variety of medical specialties. To increase the competency of our students in the use of ultrasound, the Arizona College of Osteopathic Medicine integrated ultrasound training into multiple courses of the two year (OMS I, OMS II) preclinical curriculum. These include Anatomy (OMS I), Introduction to Clinical Medicine (OMS I, OMS II), Introduction to Clerkship (OMS I, OMS II), Osteopathic Manipulative Medicine (OMS I, OMS II), Physiology (OMS I), and the Ultrasound Elective (OMS II). The most extensive early ultrasound training is a series of eight, clinically based ultrasound workshops in the OMS I anatomy course. The workshops utilize point of care ultrasound (POCUS) techniques for clinical concerns commonly associated with the regional anatomy of each exam unit. These exercises reinforce anatomical orientation, identification, relationships and differences in normal versus abnormal findings. Workshops begin with a clinical case and associated application of ultrasound followed by a demonstration of the exam. Students then scan each other in a supervised, hands‐on, small group setting using both SonoSite machines and Butterfly iQ portable scanners connected to an iPad. Students perform ultrasound examinations associated with lumbar puncture, transthoracic echocardiogram, carpal tunnel, cholecystitis, abdominal aortic aneurysm, FAST, plantar fasciitis, as well as glenohumeral, thyroid, carotid, oral, and ocular assessments. Student learning is evaluated from images and video clips they save, a formative oral quiz at the end of each workshop, and MCQ questions on both written and practical unit exams.To determine student perceptions of the efficacy of the ultrasound workshops each class is administered a survey at the end of the anatomy course. Survey questions assess student perception of the general value of ultrasound in the curriculum and the specific value of ultrasound training in the anatomy course. To date, 99% of respondents identify ultrasound as an important diagnostic tool and 80–90% of respondents felt the ultrasound workshops improved their comprehension of the associated anatomy. 85–95% of respondents felt the ultrasound workshops improved their understanding of regional clinical concerns. Importantly, up to two‐thirds of respondents indicated that they undertook independent investigation of the clinical concerns after the ultrasound workshops.Answers to open response questions showed that students highly value the hands‐on experience and improved understanding anatomical orientation. Students from 2017–2018 are now on clinical rotations and many have reported that their ultrasound skills have been a valuable asset in their clerkships.We are confident that the ultrasound workshops in our anatomy course are an excellent modality to provide superior clinical relevance of anatomy, improved understanding of anatomical organization and function, and gives our students a strong foundation in a technology that will undoubtedly be part of their clinical practice.Support or Funding InformationFunding was provided in part by the HonorHealth Foundation Phoenix General Hospital Osteopathic Endowment Fund.