Development and Assessment of Simulation-Based Point-of-Care Ultrasound Curriculum in Undergraduate Medical Education

Nancy L Hagood; Monica Klaybor; Romik Srivastava; William McManigle; John Terrill Huggins; Pranav V Shah; Marc E Heincelman; Meghan K Thomas

doi:10.1177/23821205231213754

Development and Assessment of Simulation-Based Point-of-Care Ultrasound Curriculum in Undergraduate Medical Education

J Med Educ Curric Dev. 2023 Nov 9:10:23821205231213754. doi: 10.1177/23821205231213754. eCollection 2023 Jan-Dec.

Authors

Nancy L Hagood¹, Monica Klaybor¹, Romik Srivastava¹, William McManigle^{2

3}, John Terrill Huggins^{2

3}, Pranav V Shah⁴, Marc E Heincelman⁴, Meghan K Thomas⁴

Affiliations

¹ Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
² Division of Pulmonary and Critical Care, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
³ Division of Pulmonary and Critical Care, Department of Medicine, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
⁴ Division of Hospital Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.

Abstract

Objectives: Implementation barriers and lack of standardized point-of-care ultrasound (POCUS) curricula make the development of effective POCUS curricula and methods of assessment challenging. The authors aim to develop a longitudinal POCUS curriculum through staged intervention. In the first stage, the authors hypothesized that the use of high-fidelity ultrasound simulation during the Internal Medicine clerkship would improve POCUS confidence and knowledge among medical students, minimizing the need for trained faculty.

Methods: A quasi-experimental study of third-year students on the Internal Medicine clerkship at a large academic medical center in the United States was performed assessing the efficacy of ultrasound simulation use. The control group consisted of students who received baseline POCUS education during teaching rounds but did not have access to the ultrasound simulator. The experimental group consisted of students who, in addition to baseline POCUS education, had access to a high-fidelity ultrasound simulator throughout the clerkship for a minimum of 1 hour per week. Students in both the control and experimental groups completed a pre- and post-intervention confidence survey and knowledge-based examination.

Results: Eighty-two percent (50/61) of students completed pre- and post-tests, with the control group demonstrating no significant difference in POCUS confidence or knowledge. After exposure to the ultrasound simulator, the experimental group demonstrated statistically significant improvement in POCUS confidence and overall POCUS knowledge (p < .01).

Conclusion: The use of high-fidelity ultrasound simulation can improve POCUS confidence and knowledge among medical students while addressing common barriers to the implementation of a POCUS curriculum. Despite showing statistically significant improvement in overall knowledge, the results did not appear to hold educational significance. Additional POCUS educational methods are necessary to overcome cognitive bias and potential overconfidence. The next stage of curriculum development will include resident-led POCUS workshops to supplement simulation.

Keywords: curriculum development; simulation; ultrasound; undergraduate medical education.