Integration of ultrasonography training into undergraduate medical education: catch up with professional needs

Objective Ultrasonography (US) has become the first-line imaging modality even for physicians who are not imaging specialists. The progress has not yet been sufficiently considered in medical education. The aim was to develop a curriculum that integrates US as a compulsory part into medical education directly from the start, to build up professional competencies toward residency. Methods Development was based on Kern’s six-step approach to identify problems, specify needs, define goals, outline strategies, and propose methods. Results The proposed curriculum follows a spiral course within which students should pass through four levels of training with increasing complexity. Students will be asked to independently prepare for courses by using learning videos. On the first training level, US should be closely linked to anatomy and physiology courses. Competency-centered courses should be held in small groups. On the second level, in the third year of education, students will apply point-of-care ultrasonography concerning multiple medical disciplines. On the third level, they will select a compulsory course in a specialty of their choice, held at five consecutive dates. From then on, US will be conducted in patients. Finally, during the final year, students are expected to use US under pro-active supervision with a large degree of independence and confidence. Throughout the curriculum, the discipline of radiology combines vertically with foundational sciences and horizontally with other medical specialties. Conclusion The conceptual proposal for a longitudinal US curriculum presented here has been developed by radiologists to equip students with competencies needed for contemporary patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s13244-022-01296-3.


Integration of Ultrasonography Training into Undergraduate Medical Education: Catch up With Professional Needs
Content Table 1 Literature Review on Established Ultrasonography Curricula Table 2 Entrustable Professional Activity: Focused Assessment with Sonography for Trauma (FAST)     • Direct, pro-active supervision (level 2) for entry into sub-internship.
• Indirect, reactive supervision (level 3) for entry into residency * A teaching unit equals 45 minutes † Maximum group size of 6 learners per supervisor ‡ According to Ten Cate [13]: level 2: the learner is allowed to execute the EPA with direct, pro-active supervision, present in the room; level 3: the learner is allowed to carry out the EPA without a supervisor in the room, but quickly available if needed * A teaching unit equals 45 minutes † Maximum group size of 6 learners per supervisor ‡ According to Ten Cate [13]: level 2: the learner is allowed to execute the EPA with direct, pro-active supervision, present in the room; level 3: the learner is allowed to carry out the EPA without a supervisor in the room, but quickly available if needed Supplemental • Direct, pro-active supervision (level 2) for entry into sub-internship.
• Indirect, reactive supervision (level 3) for entry into residency ‡ According to Ten Cate [13]: level 2: the learner is allowed to execute the EPA with direct, pro-active supervision, present in the room; level 3: the learner is allowed to carry out the EPA without a supervisor in the room, but quickly available if needed Supplemental Table 5 Entrustable professional activity: focused sonography abdomen

Title
Abdominal ultrasonography scanning

Specification and limitations
Performing and interpreting abdominal ultrasonography to detect or rule out pathological organ alterations and free fluid. • Direct, pro-active supervision (level 2) for entry into sub-internship.
• Indirect, reactive supervision (level 3) for entry into residency * A teaching unit equals 45 minutes † Maximum group size of 6 learners per supervisor ‡ According to Ten Cate [13]: level 2: the learner is allowed to execute the EPA with direct, pro-active supervision, present in the room; level 3: the learner is allowed to carry out the EPA without a supervisor in the room, but quickly available if needed Supplemental • Direct, pro-active supervision (level 2) for entry into sub-internship.
• Indirect, reactive supervision (level 3) for entry into residency * A teaching unit equals 45 minutes † Maximum group size of 6 learners per supervisor ‡ According to Ten Cate [13]: level 2: the learner is allowed to execute the EPA with direct, pro-active supervision, present in the room; level 3: the learner is allowed to carry out the EPA without a supervisor in the room, but quickly available if needed Supplemental • Direct, pro-active supervision (level 2) for entry into sub-internship.
• Indirect, reactive supervision (level 3) for entry into residency * A teaching unit equals 45 minutes † Maximum group size of 6 learners per supervisor ‡ According to Ten Cate [13]: level 2: the learner is allowed to execute the EPA with direct, pro-active supervision, present in the room; level 3: the learner is allowed to carry out the EPA without a supervisor in the room, but quickly available if needed