Abstract:

Introduction: The use of ultrasound (US) technologies by a variety of specialties, coupled with its diverse array of applicability, cost effectiveness, and ease of operability make it an ideal technology for the early years of medical education. We have intertwined US imaging into the Human Anatomy Course that was part of a coordinated system-based curriculum. This approach is based on the concept that the students learn anatomy, relationships, and functions in conjunction with US imaging. This will enable the student to appreciate the relationships of the same structures in real time. This project was designed to bridge the gap between knowledge attained through traditional cadaveric teaching and clinical medicine.
Curriculum Design: Anatomy was taught in a coordinated curriculum simultaneously with the other basic sciences. Laboratories were supplemented by active learning sessions through the use of US on live humans. Students were divided into 4 groups of 40 with a student to instructor ratio of 8:1. Instruction was conducted by attendings and residents in Emergency Medicine, Internal Medicine, Obstetrics and Gynecology, simulation fellows, an US technician, basic science faculty, and a senior medical student. Students received a 2-hour US orientation, which included physics, nomenclature, “knobology”, and capabilities. Each session consisted of a 15-minute slide presentation followed by hands on scanning. Students used 5 different probes and used M- & B-modes, and Color Doppler and were required to demonstrate specific structures for each module to the proctor.
Topics were coordinated with the gross anatomy lecture and laboratory schedule. Topics were chosen for their significance in medical practice and the echogenic properties of the structures. They included the cardiovascular and respiratory systems, the hepato-biliary complex, the spleen, urologic structures, and the female reproductive system. Each session included images of the relevant common pathology. Active participation in the sessions was mandatory and accounted for 2% of the course grade. Proper US technique and the ability to identify anatomical structures on live models were utilized to assess student knowledge.
Discussion: Introduction of US at a very early stage in medical education is a viable and logical mechanism to correlate anatomic structures and function. As non radiological disciplines continue to incorporate US into residency curricula, this teaching module becomes vital in undergraduate medical education. We observed a clear improvement in student ability to transform knowledge from identification of structures to live demonstration. This experience enabled student to translate conceptual knowledge gained in textbooks, atlases and dissection sessions into real life experiences encountered by health professionals in their daily practice.
Conclusion: In an era of medicine where cost is an increasing factor in the way clinicians practice, US technologies are a logical extension of the physical exam. The portability and quality of the imaging technologies have allowed for the greater incorporation of these technologies into many different medical specialties. Students were very satisfied with the US portion of the anatomy class in an end of year questionnaire. US helps bridge the basic science years by demonstrating the applicability of basic science knowledge in the clinical years.

Keywords:

Anatomy curriculum, Ultrasound, Educational advances.