Learning Community Curriculum: Outcomes of Point of Care Ultrasound Curriculum

Abstract

Introduction: In Fall 2020, the John A. Burns School of Medicine (JABSOM) implemented Learning Communities (LC) for medical students. LC consists of small groups of faculty and students who work together throughout all 4 years of medical school. LC’s main aim is to foster a supportive learning environment and provide an opportunity for students to practice their clinical skills. During these hands-on practice sessions, students receive valuable feedback from their faculty mentors and collaborate with their peers to build their repertoire of clinical knowledge. Recognizing the importance of point-of-care ultrasound (POCUS) in clinical practice, JABSOM leveraged the potential of small group learning environments within the LC framework to introduce a comprehensive POCUS curriculum. Ultrasound in clinical application has expanded over the past decades1-3. Ultrasound is a critical skill that will be important for practicing physicians as it is listed as a training guideline in a number of residency specialties. POCUS training in medical school will allow JABSOM graduates to be prepared for many residency specialties. The launch of the LC POCUS curriculum started with the fourth-year medical students in 2020 and gradually incorporated different components of the curriculum starting from the MS1 year. Currently, the POCUS curriculum includes organ-specific ultrasounds that correlate with its respective course (i.e. cardiac ultrasound during the student’s MD2 cardiac unit) and ultimately culminates in “Sono-Games” as a POCUS challenge. This challenge utilizes an interactive game-like framework, promoting a fun learning experience where students apply their POCUS skills they learned through both LC and their clerkship years.

Objectives: The objective study was to assess the usefulness and effectiveness of the LC POCUS curriculum, and further, whether it enhanced the students’ confidence in their understanding and usage of POCUS including organ specific and eFAST (Extended Focused Assessment with Sonography in Trauma) skills.

Methods: The methods of this study involved distribution of anonymous surveys to medical students following the completion of each preclinical unit. The surveys consisted of 5 point likert scale questions to measure the perceived impact of the organ specific, eFAST and sonogames workshops in helping them to understand POCUS.

Results: Data was analyzed from 2 academic years of 2021-2022 and 2022-2023. Notably 96.4% of students in MD1 felt that the LC session was a useful introduction to POCUS (n=112), 93.1% MD2 students felt the cardiac US session was useful (n=135), 90.4% MD3 students felt the renal US session was useful (n=115), 84.3% of MS3s felt the session improved their confidence in performing an eFAST exam (n=64) and 88.0% of MS4s reported Sono Games was useful to help them review POCUS (n=50).

Discussion: The implementation of a POCUS curriculum in JABSOM’s learning community small group framework has yielded positive outcomes for medical students. The results indicate overall positive response regarding LC POCUS sessions, with students finding them useful for learning organ-specific ultrasounds. Notably, 84.3% of MS3s reported increased confidence in performing an eFAST exam, showing the broader applicability of POCUS training. Positive feedback from the MS4s on Sono Games highlight the continued impact of the LC POCUS curriculum, reinforcing POCUS skills through engaging game-based activities. In the future, it would be interesting to expand this study and ask JABSOM graduates whether they found this new addition to the curriculum helpful while in residency, especially since they would have used POCUS more extensively in the real-world setting on patients. Increasing POCUS use throughout clinical rotations would also be another valuable addition to the current POCUS curriculum. For example, medical students could use POCUS to help triage patients as well as collect additional information on the patient’s they are seeing, particularly in their OBGYN and emergency medicine rotations where POCUS is used more heavily. In addition, incorporating POCUS assessments within each unit would be valuable in determining strengths and weaknesses of the curriculum. For instance, POCUS could be incorporated in standardized patient scenarios and end-of-unit clinical skills exams. These methods would allow us to evaluate the competency of the students’ POCUS skills and could further assess the efficacy of this new curriculum addition. In conclusion, integrating the POCUS curriculum within Learning Communities at JABSOM has proven valuable for medical education, with consistent positive feedback across academic years supporting its success.