Overview:
This is an elective rotation spanning 2 to 4 weeks for residents who wish to deepen their understanding and skill in bedside ultrasound techniques in addition to the longitudinal training they already receive in residency. PGY2 and PGY3 residents may choose a 2-4 week elective time. The rotation occurs at Memorial Hospital, in E. Blair Warner Family Medicine Center, the Memorial Residency Ultrasound Simulation Lab, and in independent study.
Prior to starting the rotation, residents will identify 2-3 ultrasound examinations to focus on during the rotation. Residents will complete didactic content asynchronously using an online learning management system that will include video lecture series, ultrasound case studies, and pre-/post- tests for the resident’s self-identified areas of interest. Residents will learn the procedural ultrasound skills through a combination of self-guided simulation, supervised clinical practice, and independent scanning with faculty oversight on stored images. The preceptors for this rotation are the Memorial Ultrasound Faculty and precepting physicians in Memorial Hospital.
Goals:
At the end of this rotation, the resident will have improved knowledge and skills in Point-of-Care Ultrasound examinations appropriate to their future practice.
POCUS: Options for Focused Practice
- Lung Ultrasound
- Vascular Ultrasound (AAA, IVC, DVT)
- Soft Tissue Ultrasound (abscesses, masses, locating foreign bodies, etc)
- Ultrasound Guided Procedures (thoracentesis, paracentesis, arthtrocentesis, line placement)
- The RUSH Exam (Rapid Ultrasound in Shock and Hypotension)
- Obstetrical Ultrasound
- Musculoskeletal Ultrasound
- Other
Objectives:
By the end of the ultrasound elective, residents will be able to perform the following skills in their identified area of focused study:
- Utilize settings of gain, zoom, focus, depth, and to correctly optimize and obtain ultrasound images in their chosen focus areas.
- Choose the correct probe for each type of ultrasound examination learned.
- Utilize the AIUM’s ultrasound guidelines to obtain and document the ultrasound images required to complete each type of ultrasound examination.
- Identify normal ultrasound anatomy of the chosen focus areas.
- Recognize ultrasound findings of commonly encountered ultrasound pathology specific to the chosen focus areas.
- Accurately document ultrasound findings in the patient chart and bill for bedside examinations.
- Correctly utilize ultrasound examination findings to make clinical decisions.
Implementation:
Educational Methods
- Online didactic content including:
- Video Lecture Series
- Ultrasound Case-Based Studies
- Pre/Post Tests
- Ultrasound Simulation
- Supervised Clinical Ultrasound Examinations
- Independent Bedside Ultrasound Practice with faculty review and feedback of stored images.
Resident Responsibilities
- Contact the rotation director 2 weeks before the start of your elective to design and coordinate your schedule for the elective.
- Choose 2-3 ultrasound examinations to learn during the elective. If you successfully complete all requirements for the 2-3 exams chosen early in the rotation, you may choose to add another ultrasound focus area, but this is not required.
- Aim for a minimum of 20 bedside ultrasounds for each chosen ultrasound focus area.
- Continue outpatient clinic per your regular schedule.
- Complete assigned online ultrasound lectures, pre- and post- test, case-based clinical studies, and simulator modules.
- Log all ultrasound procedures in New Innovations and submit them to the elective’s supervising faculty for review.
- At the end of the rotation, complete a one-on-one ultrasound skill assessment with the supervising faculty or your rotation preceptor.
Resources
- Medaphor Scantrainer Ultrasound Simulator
- Schoology Online Learning Management System
- Personal Butterfly and Smartphone
- Video lecture modules online and on your smartphone through Butterfly
Methods of Evaluation:
- An End-of-Rotation Evaluation
- Standardized Image Review
- Online Pre- and Post-test.
- Case-Based Ultrasound Simulation.
- Resident evaluation of the elective experience.
ACGME Milestones:
PC 1: Care of the acutely ill patient
PC 4: Ongoing care of patients with undifferentiated signs, symptoms or health concerns
PC 5: Management of procedural care
MK 2: Critical thinking and decision making
PBL 2: Reflective practice and commitment to personal growth
Prof 3: Self-awareness and help-seeking behaviors
