Quantitative Assessment of Skill Acquisition by Medical Students After Bedside Ultrasound Instruction
Peter Steinmetz MD1,2,3*, Sharon Oleskevich PhD3, and John Lewis1 MD
1Department of Family Medicine, 捆绑SM社区, Canada
2Arnold and Blema Steinberg Medical Simulation Centre, 捆绑SM社区
3St. Mary鈥檚 Research Centre, St. Mary鈥檚 Hospital Centre-捆绑SM社区, Montreal, Canada
Undergraduate teaching of bedside ultrasound improves a medical student鈥檚 knowledge of basic anatomy and physiology, and diagnostic accuracy. Here we assess skill acquisition in the new undergraduate bedside ultrasound course at 捆绑SM社区, the first comprehensive four-year undergraduate ultrasound course in Canada. The course textbook, objectives, and evaluations were aligned to maximize skill acquisition. Course objectives and pre-course reading material were distributed to Year 1 medical students (n=195) prior to six clinically based one-hour practical teaching modules evenly spaced during the academic year (approach to dyspnea, hypotension, rule-out AAA, rule-out free abdominal fluid, kidney injury, swollen leg). The bedside ultrasound course was evaluated using a quantitative assessment of student skills and student perspectives. Skill acquisition was evaluated by the students鈥� ability to meet course objectives (n=6-8 objectives per module centered on image generation and interpretation) and rated using anonymous evaluation forms containing a Likert-type rating scale with four categories (strongly disagree, disagree, agree, strongly agree). Evaluation forms were completed by instructors (n=8) and students (n=126-195) immediately following each teaching module. According to instructor evaluations, the mean percentage of students assigned a scale of 鈥榮trongly agree鈥� or 鈥榓gree鈥� for their ability to successfully meet all objectives in all modules was 98 卤 0.4% (Strongly agree = 52 卤 3%, Agree = 46 卤 3%). According to student self-evaluations, the mean percentage of students assigned a scale of 鈥榮trongly agree鈥� was significantly greater than the percentage assigned by instructors for all modules (mean of 86 卤 2% versus 52 卤 3%; P<0.0001). Skill acquisition for the dyspnea module was retained after 8 months with 91 卤 2% of students assigned a scale of 鈥榮trongly agree鈥� or 鈥榓gree鈥�. A high percentage of students agreed that bedside ultrasound improved their understanding of anatomy for all modules (mean=95 卤 0.01%). Acquisition of bedside ultrasound skills in first-year medical students was excellent for all modules, suggesting that course objectives were set at an achievable level for the teaching time alloted. Student self-evaluations indicated an over-estimate of skill acquisition, concurrent with previous reports of over-confidence in self-assessments. Skills were retained by academic year鈥檚 end and students consistently reported an improved understanding of basic anatomy following completion of this new undergraduate course in bedside ultrasound.
