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ObjectivesDespite the rise of ultrasound in medical education (USMED), multiple barriers impede the implementation of such curricula in medical schools. No studies to date have surveyed individuals who are successfully championing USMED programs. This study aimed to investigate the experiences with ultrasound integration as perceived by active USMED directors across the United States.MethodsIn 2014, all allopathic and osteopathic medical schools in the United States were contacted regarding their status with ultrasound education. For schools with required point-of-care ultrasound curricula, we identified the USMED directors in charge of the ultrasound programs and sent them a 27-question survey. The survey included background information about the directors, ultrasound program details, the barriers directors faced toward implementation, and the directors' attitudes toward ultrasound education.ResultsOne-hundred seventy-three medical schools were contacted, and 48 (27.7%) reported having a formal USMED curriculum. Thirty-six USMED directors responded to the survey. The average number of years of USMED curriculum integration was 2.8 years (SD, 2.9). Mandatory ultrasound curricula had most commonly been implemented into years 1 and 2 of medical school (71.4% and 62.9%, respectively). The most common barriers faced by these directors when implementing their ultrasound programs were the lack of funding for faculty/ equipment (52.9%) and lack of time in current medical curricula (50.0%).ConclusionsFinancial commitments and the full schedules of medical schools are the current prevailing roadblocks to implementation of ultrasound education. Experiences drawn from current USMED directors in this study may be used to help programs starting their own curricula.

The early diagnosis of necrotizing fasciitis is often ambiguous. Computed tomography and magnetic resonance imaging, while sensitive and specific modalities, are often time consuming or unavailable. We present a case of necrotizing fasciitis that was rapidly diagnosed using bedside ultrasound evaluating for subcutaneous thickening, air, and fascial fluid (STAFF). We propose the STAFF ultrasound exam may be beneficial in the rapid evaluation of unstable patients with consideration of necrotizing fasciitis, in a similar fashion to the current use of a focused assessment with sonography for trauma exam in the setting of trauma. [West J Emerg Med. 2014;15(1):111–113.]

The author presents his views on concept of developing a point-of-care ultrasound contest for medical students.

Purpose: Ultrasound (US) guidance during renal access and mass biopsy reduces radiation exposure, but can be technically challenging. A needle guidance system might simplify these procedures. The purpose of this randomized crossover trial was to compare conventional and computer-assisted US needle guidance systems for renal access and mass biopsy. Materials and Methods: Seventy-one subjects were randomized to perform renal access or mass biopsy on a phantom using conventional and computer-assisted US guidance in a crossover study design. The primary outcome was success rate including subgroup analysis by experience level. Secondary outcomes included total procedure time, time to hit target, number of course corrections, and total punctures. In addition, subjective preferences of participants were also collected. Results: Procedure success rate was higher with the computer-assisted US than with conventional US for both novice (98.0% (48/49) vs 81.6% (40/49); p < 0.001) and experienced US users (100% (22/22) vs 81.8% (18/22); p < 0.001). Computer-assisted US significantly shortened the total procedure time (94.0 seconds vs 192.9 seconds; p ≤ 0.001), time required to hit the target (62.5 seconds vs 121.6 seconds; p ≤ 0.001), and the number of course corrections (0.56 vs 2.89; p < 0.001) compared with conventional US. Computer-assisted US did not significantly reduce the number of needle punctures (1.75 vs 2.39; p = 0.132). Seventy-three percent of subjects preferred the computer-assisted US system. Conclusion: A computer-assisted needle guidance system increases effective US targeting for renal access and mass biopsy for novice and experienced users. [ABSTRACT FROM AUTHOR]

The utility of point of care ultrasound training during medical school is becoming more and more evident. At the Loma Linda University School of Medicine, we have formally integrated ultrasound education into the curriculum of all four years. Exposure begins in the first few months of Year 1 and takes form in a variety of educational mediums through Year 4. Whether students receive training through mandatory sessions during physical diagnosis courses or extracurricular workshops provided through the Ultrasound Interest Group-the experience equips learners of at all different skill levels with the confidence to apply what they have learned to patient care. The successful integration of ultrasound training into the medical curriculum can be attributed to progressive administration, devoted faculty and eager students. The perspective of medical students during the integration process is described in this paper. [ABSTRACT FROM AUTHOR]

Objectives: Lung ultrasound (LUS) plays an increasing role in diagnosis and monitoring of interstitial lung disease (ILD). Connective tissue disorders (CTD) frequently cause ILD, and often presents symptomatically after irreversible fibrosis has ensued. As point-of-care musculoskeletal ultrasound (US) is commonly utilised by rheumatologists, translating this US expertise towards LUS places the rheumatologist in a position to screen for ILD. However, a standardised curriculum for the rheumatology community is lacking. The aim of this study is to determine the effectiveness of a formalised lung US training course for rheumatologists., Methods: Four rheumatology fellows and four board-certified rheumatologists participated in a 4-hour training session. Pre-course, post-course and 6-month follow-up surveys evaluated perceptions towards previous US experience, training, clinical utility and attitudes toward lung US. Didactics explained the protocols utilised in ILD evaluation. Evaluation of knowledge in US physiology, lung anatomy, artifact and pathology recognition were done through written exams before, after training, and at 6 months and through a practical exam using live models and simulation., Results: Temporally there was overall improvement in written test scores. Improvement was noted in overall practical skill score following training course (17.4% vs. 92.9%, p<0.001), in written test scores 49.3% vs. 72.5% p<0.001), and pathology identification (26.5% vs. 79.6%, p<0.001). Six-month follow assessments were similar to post-test results revealing similar written scores (70.6%) and practical scores (89.7%)., Conclusions: This formalised lung ultrasound training course was effective in improving skills and knowledge of rheumatology specialists.