Key result
A 60-minute didactic and hands-on ultrasound skills session significantly increased fourth-year medical students' knowledge test scores on volume assessment in shock from 45.6% to 66.4%.
Why the study?
Does a one-hour educational session improve knowledge of ultrasound for volume assessment in fourth-year medical students?
Observational (n=83)
No
Does a one-hour educational session improve knowledge of ultrasound for volume assessment in fourth-year medical students?
A one-hour educational session significantly improved fourth-year medical students' knowledge regarding the use of ultrasound and echocardiography for volume assessment in shock.
Answers are grounded in this paper and cite their sources.
Brief training may improve student ultrasound knowledge for shock assessment; leaves open clinical skill translation and RCT validation.
Objective Shock is a common emergency condition with high morbidity and mortality, and judicious fluid resuscitation can significantly affect outcomes. The use of a bedside echocardiogram and evaluation of the inferior vena cava (IVC) via ultrasound (US) for collapsibility can predict volume status. Additionally, the Association of American Medical Colleges (AAMC) Entrustable Professional Activities (EPA) 10 states that residents need to be able to address a patient with a critical illness, including hypotension, on Day 1 of residency. Existing literature revealed no published curriculum to teach medical students these skills. We aimed to determine the effectiveness of an educational intervention to teach fourth-year medical students how to utilize IVC US measurement and echocardiography to assist in volume assessment of patients presenting with shock. Methods Students participated in an hour session on the first day of the emergency medicine (EM) clerkship. Didactic effectiveness was evaluated by comparing results on a pre-test and post-test. The test was administered to residents and attendings during the first week of the academic year to gain evidence for content validity. Students also responded to a survey to evaluate learner satisfaction. Results The average score on the validation test was 68.4% (standard deviation (SD): 21.6%, number (n) = 38) for residents and attendings, and 47.4% (SD: 19.4, n = 13) for interns. Students scored an average of 45.6% (SD: 23.6, n = 83) on the pre-test and 66.4% (SD: 22.1 n = 72) on the post-test, p < 0.01 (degrees of freedom (df) = 153, t = 5.7), Cohen's d = 0.92. The satisfaction survey showed 97.6% of students felt the session was worthwhile, 96.4% would recommend it to other students, and 83.1% felt it taught new information. Conclusion These results show that the educational intervention provides a significant increase in knowledge regarding volume assessment and the use of echocardiogram and IVC US. Additionally, students rated the course highly and felt that it provided information not otherwise taught in medical school. This curriculum addresses the AAMC EPA 10, as it increases students' readiness to address hypotension and could add significant value to the medical school curriculum.
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Kukulski et al. (2018) conducted an observational in Fourth-year medical students (n=83). Didactic and hands-on ultrasound skills session vs. Pre-intervention baseline was evaluated on Difference in knowledge test scores between pre- and post-tests (Cohen's d 0.92, p=<0.01). A 60-minute didactic and hands-on ultrasound skills session significantly increased fourth-year medical students' knowledge test scores on volume assessment in shock from 45.6% to 66.4%.
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