Designing a multi-disciplinary undergraduate medical school ultrasonography curriculum

Main Article Content

Elliot Stansfield
Michael Y Woo
Ron Tam
Debra Pugh
Matthew McInnes
Stanley Hamstra

Abstract

Objectives: Although there is increasing demand for physicians from various specialties to be trained in ultrasonography (US), it is currently not being taught at most Canadian undergraduate medical schools in a comprehensive manner. The purpose of this study was to develop objectives to form the foundation of a comprehensive undergraduate US curriculum.
Methods: After completing an environmental assessment, which included a review of our current undergraduate objectives, a literature review was performed to identify published undergraduate US objectives. Using this information, a preliminary list of objectives was developed. The list was distributed electronically to 12 content experts from 10 disciplines and, using a two-round modified Delphi process, consensus about the inclusion of educational objectives was obtained. An a priori consensus criterion of 75% agreement was used to determine objectives that would be included in the curriculum. Objectives that met consensus in the first round of the survey were excluded from second round evaluation.
Results: Review of our undergraduate curriculum revealed that there were already 10 objectives relating to US. Combining existing objectives with those found during the literature review, an initial list of 79 objectives was produced. Sixteen of these were approved during the first Delphi round, while the remaining 63 objectives required rating during a second round. A final list of 25 objectives was produced.
Conclusions: Using a modified Delphi process, physicians from diverse backgrounds reflecting current and future use of US developed 25 multi-disciplinary objectives for a comprehensive undergraduate medical school US curriculum.

 

RÉSUMÉ

Objectifs: Bien qu’on demande de plus en plus que les médecins de diverses disciplines suivent une formation en échographie, cette méthode d’exploration n’est pas encore enseignée de façon exhaustive dans la plupart des programmes d’études de premier cycle des facultés de médecine canadiennes. Le but de cette étude est d’élaborer des objectifs qui serviront de fondation à la création d’un programme d’enseignement de l’échographie au premier cycle.
Méthodes: Après avoir terminé une analyse de contexte qui incluait une revue de nos objectifs d’apprentissage actuels, une revue de la littérature a été effectuée afin de faire ressortir les objectifs publiés pour l’enseignement de l’échographie au premier cycle de médecine. Avec cette information, une liste préliminaire d’objectifs a ensuite été élaborée. La liste a été envoyée électroniquement à 12 experts de contenu dans 10 disciplines différentes. Utilisant un processus de Delphi modifié en deux étapes, un consensus a été établi pour l’inclusion des objectifs d’apprentissage. Un consensus à priori de 75 % approuvant les objectifs a été utilisé pour choisir ceux qui seraient inclus dans le cursus. Les objectifs qui avaient satisfait au consensus lors de la première étape ont été exclus des évaluations lors de la deuxième étape.
Résultats: La revue de notre programme d’études de premier cycle a démontré qu’il y avait déjà dix objectifs portant sur l’échographie. En combinant les objectifs actuels et ceux qui ont été relevés lors de la revue de la littérature, une liste initiale de 79 objectifs a été produite. Seize de ces objectifs ont été approuvés lors du premier tour Delphi. Les 63 autres objectifs ont dû être évalués dans le cadre du deuxième tour. Une liste finale de 25 objectifs a été produite.
Conclusion: À l’aide d’un processus de Delphi modifié, des médecins provenant de diverses disciplines reflétant l’utilisation courante et éventuelle de l’échographie ont élaboré 25 objectifs multidisciplinaires pour offrir un programme complet de formation en échographie dans le cursus du programme de premier cycle de médecine.

Article Details

Section
Research

References

1. Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011 Feb 24;364(8):749-57

2. Duck FA. Hazards, risks and safety of diagnostic ultrasound. Med Eng Phys. 2008 Dec;30(10):1338-48.

3. Kendall JL, Hoffenberg SR, Smith RS. History of emergency and critical care ultrasound: The evolution of a new imaging paradigm. Crit Care Med. 2007 May;35(5 Suppl):S126-30.

4. Wong I, Jayatilleke T, Kendall R, Atkinson P. Feasibility of a focused ultrasound training programme for medical undergraduate students. Clin Teach. 2011 Mar;8(1):3-7.

5. Gogalniceanu P, Sheena Y, Kashef E, Purkayastha S, Darzi A, Paraskeva P. Is basic emergency ultrasound training feasible as part of standard undergraduate medical education? J Surg Educ. 2010 May-Jun;67(3):152-6.

6. Tshibwabwa ET, Groves HM, Levine MA. Teaching musculoskeletal ultrasound in the undergraduate medical curriculum. Med Educ. 2007 May;41(5):517-8.

7. Tshibwabwa ET, Groves HM. Integration of ultrasound in the education programme in anatomy. Med Educ. 2005 Nov;39(11):1148.

8. Teichgraber UK, Meyer JM, Poulsen Nautrup C, von Rautenfeld DB. Ultrasound anatomy: A practical teaching system in human gross anatomy. Med Educ. 1996 Jul;30(4):296-8.

9. Hoppmann RA, Riley R, Fletcher S, Howe D, Poston MB, Rao V, et al. First world congress on ultrasound in medical education hosted by the university
of south carolina school of medicine. J S C Med Assoc. 2011 Oct;107(5):189-90.

10. Hoppmann RA, Rao VV, Poston MB, Howe DB, Hunt PS, Fowler SD, et al. An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience.
Crit Ultrasound J. 2011 Apr;3(1):1-12.

11. U of O, faculty of medicine, MD program curriculum objectives: [Internet].: University of Ottawa; 2012 [updated November 12, 2012; cited June 6,2012]. Available from: http://www.med.uottawa.ca/Students/MD/assets/documents/pre_clerkship/unit_2_english_weekly_objectives_report.pdf.

12. Keeney S, Hasson F, McKenna H. Consulting the oracle: Ten lessons from using the delphi technique in nursing research. J Adv Nurs. 2006 Jan;53(2):205-12.

13. Rao S, van Holsbeeck L, Musial JL, Parker A, Bouffard JA, Bridge P, et al. A pilot study of comprehensive ultrasound education at the wayne state university school of medicine: A pioneer year review. J Ultrasound Med. 2008 May;27(5):745-9.

14. Hasson F, Keeney S, McKenna H. Research guidelines for the delphi survey technique. J Adv Nurs. 2000 Oct;32(4):1008-15.

15. Penciner R, Langhan T, Lee R, McEwen J, Woods RA, Bandiera G. Using a delphi process to establish consensus on emergency medicine clerkship
competencies. Med Teach. 2011;33(6):e333-9. 16. Paes P, Wee B. A delphi study to develop the association for palliative medicine
consensus syllabus for undergraduate palliative medicine in Great Britain and Ireland. Palliat Med. 2008 Jun;22(4):360-4.

17. CDC coffee break: Using likert scales in evaluation of survey work [Internet]. Atlanta, Georgia: Center for Disease Control and Prevention; 2012 [updated
February 14, 2012; cited February 9, 2013]. Available from: http://www.cdc.gov/dhdsp/pubs/docs/CB_February_14_2012.pdf.

18. Walley T, Webb DJ. Developing a core curriculum in clinical pharmacology and therapeutics: A delphi study. Br J Clin Pharmacol. 1997 Aug;44(2):167-70.

19. Kizawa Y, Tsuneto S, Tamba K, Takamiya Y, Morita T, Bito S, et al. Development of a nationwide consensus syllabus of palliative medicine for undergraduate
medical education in japan: A modified delphi method. Palliat Med. 2011 Sep 15.