Introducing Ultrasound to students – Is it useful or is it just “fashion”?

For more than 50 years, physicians have been introduced to the amazing world of ultrasound and learned how to use the features of this imaging technique in daily practice. It is a real-time imaging technique, very accessible, very well accepted by the patients, without irradiation, a problem-solving investigation that can be useful in almost any medical specialty. The development of new applications and the continuing improvement of this technique and of the machines made ultrasound one of the most dynamic fields in medicine.

However, it is still an operator dependent method, and the physicians need training and experience in performing it. But when these are achieved, it becomes an extension of our hands and minds for a proper patient diagnosis and management.

The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and The World Federation for Ultrasound in Medicine and Biology (WFUMB), together with other national and international ultrasound societies, advocate for thorough training in ultrasound and on the role of implementing professional standards in this medical field as well. Thus, recommendations for minimal training in different branches of ultrasound [1] and also professional standards for performing and reporting ultrasound examinations by different ultrasound examiners [2] have been issued. All societies acknowledge the importance of quality training for achieving the requested standards which are mandatory for good medical practice in ultrasound and promote integrated education programs in ultrasonography.

For those who are using it, ultrasound is an essential tool in the diagnostic algorithm, an acquired skill, like anamnesis or the physical exam. And from here arises the question, when would be best to start learning ultrasound? Should one wait until one is already specialized in a specific medical field or is the technique useful for one’s general training as medical doctor? Should we start training in ultrasound during undergraduate medical school? Is it useful for the students to learn ultrasound, or it is just a “modern trend”?

The answer is that training should definitely start as soon as possible. But which are the advantages for the students in learning ultrasound during medical school?

First of all, ultrasound can be used as an additional learning tool for the study of anatomy, since it allows real-time visualization of anatomic structures and their reports, similar to dissection techniques [3] [4]. It is also easier to learn ultrasound anatomy at the same time, rather than to refresh your anatomical knowledge when you start studying ultrasound, sometimes many years later after medical school. Most students are excited by the possibility of seeing the anatomical elements they learn about in real life; thus they will be able to understand the ultrasound images relatively easily, and will be able to integrate the recently studied information in another perspective. Moreover, the method can be used to improve the physical examination skills of students, helping them to a better understanding of the regional anatomy and to confirm immediately the physical findings [5] [6].

Ultrasound also offers the students a stable point in the diagnostic algorithm, along with the anamnesis and the physical examination, facilitating understanding of physiology and of specific pathologies [7]. Another important advantage is that ultrasound offers an additional element of orientation on possible diagnoses and the need for further investigations necessary to establish a positive diagnosis. The possibility to visualize by themselves some of this information brings a better understanding and more in-depth learning.

Teaching ultrasound requires the use of classic methods, such as didactic presentations, case presentations, video marathons, with mandatory hands-on training, and probably the use of modern techniques – such as simulators and virtual reality. Different educational approaches, such as intensive short period workshops or longer more dissipated courses, both centered on hands-on training, seem to have similar learning outcomes [8], proving the importance of practical exercise in ultrasound medical training.

This is why when asked, the students who studied ultrasound are enthusiastic and have a highly favorable impression on the usefulness of this technique.

This positive perception and the continuous increase of favorable published data regarding the usefulness of implementing ultrasound during medical school, has led to a widespread worldwide trend of introducing ultrasound into university curriculum. Both EFSUMB [9] and WFUMB [10] [11] addressed this issue in position papers that advocate for the systematic use of ultrasound as an educational tool in modern medical school.

However, the university surveys carried out show that achieving this goal is difficult and there is high heterogeneity in implementation among universities [12]. Only a limited number of universities have integrated ultrasound into their curriculum, the lack of time and limited faculty funding being the major barriers.

Some of the current data, controversies and difficulties in implementing ultrasound in the medical university curriculum are summarized by Dietrich et al. [13] in a comprehensive review included in this Ultraschall in der Medizin issue. Answers to practical questions, such as how to use ultrasound in studentsʼ training, how ultrasound should be taught and by whom, which ultrasound devices to use, which would be the ideal course structure – are presented, based on international recommendations. The authors conclude that studentsʼ undergraduate ultrasound education is very important, and an integrated curriculum is needed. Modern teaching methods should be used – blended learning, peer-to-peer teaching and simulation – but the central role should be reserved for the hands-on sessions.

In conclusion, introduction of ultrasound into undergraduate curricula is proved to be useful and, even if currently there is no unitary view on how to best implement it, we should continue to promote the rightful place of ultrasound as an integrative part of the medical university core curriculum.

Prof. Alina Popescu

Prof. Ioan Sporea

Dr. Roxana Șirli

• References

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Publication History

Article published online:
01 August 2024