For students at West Virginia University School of Medicine, studying anatomy now consists of more than just furiously comparing textbook images to a cadaver. In addition to their traditional dissection-based coursework, they also learn anatomical structures from a living patient using ultrasound technology.
Pioneered by Dr. Joseph Minardi, director of the emergency ultrasound fellowship at the WVU School of Medicine, the MD curriculum has begun integrating ultrasound education into all four years of its program. The class of 2016 was the pilot class to work with ultrasound, beginning the curriculum in the spring of 2013 as part of the gross anatomy course. According to Minardi, the completion of a four-year integrated ultrasound course is still pretty unique amongst programs across the country. “Due to its wide clinical applicability, we have incorporated [ultrasound] as a thread within multiple years and courses, rather than a separate independent course,” he said.
Medical students at WVU have embraced the integration of ultrasound enthusiastically and have been quite impressed with its almost seamless introduction into the usual coursework. Second-year student Benjamin Lasure said that the integration of ultrasound in the curriculum is often a welcome change.
“In our first two years, which lean heavily on antiquated examination methods and material for boards rather than clinical practice, ultrasound was a useful breath of fresh air in terms of applicability and hands-on experience,” Lasure said. “The implementation of ultrasound into the anatomy coursework went extremely well, and the ultrasound component complemented the anatomy course perfectly.”
Students have greatly appreciated the opportunity for another hands-on method of learning the anatomical structures covered in lectures. Ultrasound laboratories with standardized patients are organized to coincide with the material covered in the gross anatomy course, as well as with the material in the pathology course during the second year.
For example, the second block of the anatomy course covers abdominal and cardiac anatomy, so echocardiography and renal ultrasound are just a few of the skills covered in the ultrasound labs concurrently. Students also had the opportunity to work with cardiologists who use echocardiography on a daily basis to hone their cardiac ultrasound skills.
Lasure enjoyed the cardiac ultrasound portion of the second year curriculum the most “due to its intricacy, usefulness and general coolness.”
While some students felt that taking time away from dissections to do ultrasound labs limited their experience in the gross lab, the ultrasound labs have been well-received overall. There has been some difficulty in gathering standardized patients with the structural abnormalities and pathologies encountered in the second-year curriculum. Regardless, many students still value being able to use ultrasound to learn how these pathologies would be diagnosed and managed in a clinical setting.
First-year medical student Jeffrey Matherne said his favorite part of the ultrasound lab has been “interacting with the standardized patients, and actually being able to apply what we have learned in lecture to a real life person.”
“The hands-on experience and practice is invaluable when it comes to learning the art of administering and interpreting an ultrasound examination, because there is a definite learning curve involved,” Matherne said.
Since repetition and practice is one of the keys to successfully developing ultrasound technique, Minardi has pushed for funding to ramp up ultrasound resources at WVU School of Medicine. “We have a great simulation lab, a large pool of ultrasound machines, standardized patients and a very large skills lab. A lot of schools don’t have these resources,” Minardi said. “We teach hands-on skills in very small groups – this year has groups of two students per ultrasound machine.”
Lasure agrees that the availability of ultrasound equipment and opportunities to practice skills has been a huge advantage to the program at WVU. Handheld units are available for students to check out for practice at home. According to Lasure, this gives students “the ability to explore the technology and a chance to develop a familiarity with a tool that will set us apart from our colleagues and will undoubtedly help our patients, before even beginning clerkships.”
As the inaugural class for the ultrasound program begins third-year clerkships in July, students are very excited to begin putting diagnostic skills to use in a clinical setting. “I’m looking forward to beginning clerkships with the ability to help make real-time diagnoses with minimal risks and costs to the patient,” Lasure said. “Ultrasound is an exciting and practical emerging tool in medicine, and in the future I hope to use these skills frequently as part of my practice.”