Hand- held Ultrasound Scanners in Medical Education: A Systematic Review
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Background: Ultrasound imaging devices are becoming popular in clinical and teaching settings, but there is no systematic information on their use in medical education. We conducted a systematic review of hand-held ultrasound (HHU) devices in undergraduate medical education to delineate their role, significance, and limitations. Methods: We searched Cochrane, PubMed, Embase, and Medline using the strategy: [(Hand-held OR Portable OR Pocket OR “Point of Care Systems”) AND Ultrasound] AND (Education OR Training OR Undergraduate OR “Medical Students” OR “Medical School”). We retained 12 articles focusing on undergraduate medical education. We summarised the patterns of HHU use, pooled and estimated sensitivity, and specificity of HHU for detection of left ventricular dysfunction. Results: Features reported were heterogeneous: training time (1–25 hours), number of students involved (1-an entire cohort), number of subjects scanned (27–211), and type of learning (self-directed vs. traditional lectures + hands-on sessions). Most studies reported cardiac HHU examinations, but other anatomical areas were examined, e.g. abdomen and thyroid. Pooled sensitivity 0.88 [95% confidence interval (CI) 0.83–0.92] and specificity 0.86 (95% CI 0.81–0.90) were high for the detection of left ventricular systolic dysfunction by students. Conclusion: Data on HHU devices in medical education are scarce and incomplete, but following training students can achieve high diagnostic accuracy, albeit in a limited number of (mainly cardiac) pathologies. There is no consensus on protocols best-suited to the educational needs of medical students, nor data on long-term impact, decay in proficiency or on the financial implications of deploying HHU in this setting.
Abstract
Background: Ultrasound imaging devices are becoming popular in clinical and teaching settings, but there is no systematic information on their use in medical education. We conducted a systematic review of hand-held ultrasound (HHU) devices in undergraduate medical education to delineate their role, significance, and limitations. Methods: We searched Cochrane, PubMed, Embase, and Medline using the strategy: [(Hand-held OR Portable OR Pocket OR “Point of Care Systems”) AND Ultrasound] AND (Education OR Training OR Undergraduate OR “Medical Students” OR “Medical School”). We retained 12 articles focusing on undergraduate medical education. We summarised the patterns of HHU use, pooled and estimated sensitivity, and specificity of HHU for detection of left ventricular dysfunction. Results: Features reported were heterogeneous: training time (1–25 hours), number of students involved (1-an entire cohort), number of subjects scanned (27–211), and type of learning (self-directed vs. traditional lectures + hands-on sessions). Most studies reported cardiac HHU examinations, but other anatomical areas were examined, e.g. abdomen and thyroid. Pooled sensitivity 0.88 [95% confidence interval (CI) 0.83–0.92] and specificity 0.86 (95% CI 0.81–0.90) were high for the detection of left ventricular systolic dysfunction by students. Conclusion: Data on HHU devices in medical education are scarce and incomplete, but following training students can achieve high diagnostic accuracy, albeit in a limited number of (mainly cardiac) pathologies. There is no consensus on protocols best-suited to the educational needs of medical students, nor data on long-term impact, decay in proficiency or on the financial implications of deploying HHU in this setting.
참고문헌 (32)
- Lapostolle F, "Usefulness of hand-held ultrasound devices in out-ofhospital diagnosis performed by emergency physicians", Am J Emerg Med, 24, pp.237~242 (2006)
- Wright J, "The application of hand-held ultrasound scanner in teaching of telemedicine and rural medicine", Donald Sch J Ultrasound in Obstet Gynecol, 8, pp.87~91 (2014)
- Kobal SL, "Comparison of effectiveness of hand-carried ultrasound to bedside cardiovascular physical examination", Am J Cardiol, 96, pp.1002~1006 (2005)
- Kimura BJ, "Value of a cardiovascular limited ultrasound examination using a handcarried ultrasound device on clinical management in an outpatient medical clinic", Am J Cardiol, 100, pp.321~325 (2007)
- Egan M, "The pocket echocardiograph: a useful new tool?", Eur J Echocardiogr, 9, pp.721~725 (2008)
- Greaves K, "The use of hand-carried ultrasound in the hospital setting--a cost-effective analysis", J Am Soc Echocardiogr, 18, pp.620~625 (2005)
- Otto CM, "Heartbeat: Echo anytime, anywhere by anyone?", Heart, 102, pp.1~2 (2016)
- Estai M, "Best teaching practices in anatomy education: a critical review", Ann Anat, 208, pp.151~157 (2016)
- Baltarowich OH, "National ultrasound curriculum for medical students", Ultrasound Q, 30, pp.13~19 (2014)
- Sweetman GM, "The benefits and limitations of using ultrasonography to supplement anatomical understanding", Anat Sci Educ, 6, pp.141~148 (2013)
- Tshibwabwa ET, "Integration of ultrasound in the education programme in anatomy", Med Educ, 39, pp.1148~ (2005)
- Hammoudi N, "Ultrasound-based teaching of cardiac anatomy and physiology to undergraduate medical students", Arch Cardiovasc Dis, 106, pp.487~491 (2013)
- Sicari R, "The use of pocket-size imaging devices: a position statement of the European Association of Echocardiography", Eur J Echocardiogr, 12, pp.85~87 (2011)
- Cawthorn TR, "Development and evaluation of methodologies for teaching focused cardiac ultrasound skills to medical students", J Am Soc Echocardiogr, 27, pp.302~309 (2014)
- Fox JC, "Proactive medicine: the “UCI 30,” an ultrasound-based clinical initiative from the University of California, Irvine", Acad Med, 89, pp.984~989 (2014)
- Mai TV, "Feasibility of remote real-time guidance of a cardiac examination performed by novices using a pocket-sized ultrasound device", Emerg Med Int, 2013, pp.627230~ (2013)
- Stokke TM, "Brief group training of medical students in focused cardiac ultrasound may improve diagnostic accuracy of physical examination", J Am Soc Echocardiogr, 27, pp.1238~1246 (2014)
- Andersen GN, "Feasibility and accuracy of point-of-care pocket-size ultrasonography performed by medical students", BMC Med Educ, 14, pp.156~ (2014)
- Gogalniceanu P, "Is basic emergency ultrasound training feasible as part of standard undergraduate medical education?", J Surg Educ, 67, pp.152~156 (2010)
- Bonnafy T, "Reliability of the measurement of the abdominal aortic diameter by novice operators using a pocket-sized ultrasound system", Arch Cardiovasc Dis, 106, pp.644~650 (2013)
- Filipiak-Strzecka D, "Pocket-size echocardiograph--a valuable tool for nonexperts or just a portable device for echocardiographers?", Adv Med Sci, 58, pp.67~72 (2013)
- Panoulas VF, "Pocket-size hand-held cardiac ultrasound as an adjunct to clinical examination in the hands of medical students and junior doctors", Eur Heart J Cardiovasc Imaging, 14, pp.323~330 (2013)
- Lewiss RE, "Point-of-care ultrasound education: the increasing role of simulation and multimedia resources", J Ultrasound Med, 33, pp.27~32 (2014)
- Solomon SD, "Point-of-care ultrasound in medical education- -stop listening and look", N Engl J Med, 370, pp.1083~1085 (2014)
- Andreas Seraphim, "Pocket-Sized Echocardiography Devices: One Stop Shop Service?", Journal of Cardiovascular Ultrasound, 24(1), pp.1~6 (2016), 한국심초음파학회[DOI]
- Hothi SS, "Point-of-care cardiac ultrasound in acute medicine--the quick scan", Clin Med (Lond), 14, pp.608~611 (2014)
- Barrett PM, "To truly look inside", Lancet, 387, pp.1268~1269 (2016)
- Mehta M, "Handheld ultrasound versus physical examination in patients referred for transthoracic echocardiography for a suspected cardiac condition", JACC Cardiovasc Imaging, 7, pp.983~990 (2014)
- Chambers JB, "Point-of-care cardiac ultrasound in acute internal medicine: how can it be delivered?", Clin Med (Lond), 15, pp.403~404 (2015)
- Webb EM, "Teaching point of care ultrasound skills in medical school: keeping radiology in the driver’s seat", Acad Radiol, 21, pp.893~901 (2014)
- "Handheld cardiac ultrasound: case series" (2014)[URL]
- Kimura BJ, "Retention of ultrasound skills and training in “point-of-care” cardiac ultrasound", J Am Soc Echocardiogr, 29, pp.992~997 (2016)