A Pilot Study of the Feasibility and Efficicacy of Teaching Cardiac Ultrasound to Large Groups of Medical Students

Background: Teaching cardiac ultrasound to medical students in a brief course is a challenge. We aim to evaluate the feasibility of teaching large groups of medical students the acquisition and interpretation of cardiac ultrasound imaging by operating a pocket ultrasound device (PUD).

Methods: Thirty one, 4^th year medical students participated in the study. The training consisted of 4 hours of frontal lectures on basic ultrasound, cardiac ultrasound anatomy, imaging acquisition and observation of teaching-cases as well as 4 hours of hands-on training. Students were encouraged to use PUD for self practice during their 8-week internal medicine rotation. Finally, the students’ proficiency in acquisition of ultrasound images and their ability to recognize normal and pathological cardiac states were evaluated by means of a written exam and a 6-minutes practical test.

Results: Sixteen out of 27 (59%) students were able to demonstrate all the main ultrasound views (parasternal, apical and sub costal views) within a 6-minute test. The most obtainable view was the parasternal long-axis view (89%) and the least obtainable view was the sub-costal view (58%). Ninety-seven percent of students correctly differentiated normal from severely reduced LV function, 100% differentiated normal from severely hypokinetic RV, all the students differentiated normal from rheumatic mitral valve, 88% recognized normal from calcified aortic valve and 95% identified the presence of pericardial effusion. Twenty-six % of the students diagnosed bicuspid aortic valve and recognized a dilated inferior vena cava in 52% of the cases.

Conclusions: Large scale instruction of medical students in cardiac ultrasound during the first clinical years is feasible. A short training in cardiac ultrasound, comprised of frontal lectures, hands-on sessions and self-practice, allows medical students to be proficient in the diagnosis of a limited number of cardiac states. Acquisition of ultrasound images is more difficult and probably requires longer practice.