Ultrasonography is an incredibly useful tool in medicine, particularly in emergency departments. It usually takes under a minute for an ultrasonography tool to assess whether a critically injured patient has time for a CT scan or needs to be rushed directly to the operating room. As the technology advances, it gets cheaper, more portable, and more powerful. Since it uses sound waves, an ultrasound doesn’t put the patient at risk for radiation.

Despite its usefulness, ultrasound education for medical students often is limited. Fewer than half of U.S. medical schools give students the option to perform hands-on ultrasound examinations. Significantly fewer have it fully integrated into the required curriculum or offer preclinical ultrasound electives, says David Resuehr, Ph.D., assistant professor in the Department of Cell, Development and Integrative Biology.

Wanting to ensure UAB provides the highest-quality medical instruction, Resuehr teamed up with colleagues from across UAB to develop high-quality ultrasound instruction programming for interested students. The result was a week-long special topics course, STP 2233 Introduction to Ultrasound in Anatomy, in which about a dozen second-year medical students learn the basics of ultrasound technology and technique beginning with the physics behind it and culminating in identifying pathological processes.

“Understanding how complex three-dimensional anatomical structures translate to grayscale ultrasound images is very helpful for students to gain a deeper understanding of the anatomy and physiology they’re studying,” Resuehr says.

Interprofessional Partnerships

Resuehr developed STP 2233 in 2014 with faculty and staff from the Department of Emergency Medicine and the Office of Interprofessional Simulation for Innovative Clinical Practice (OIPS). The course provides students with a unique opportunity to learn foundational knowledge about emergency medicine ultrasounds, and it gives them hands-on practice with high-fidelity ultrasound simulators and standardized patients. They also shadow physicians in the emergency department.

“Scanning live emergency department patients with active pathophysiology is vital to helping them understand. It shows how a two-dimensional gray image can help them understand what is happening with the patient in front of them and help them make better decisions regarding that patient’s care in real time,” says Luke Burleson, M.D., an assistant professor in the Department of Emergency Medicine who co-directs STP 2233 with Resuehr.

Each August, medical students have the chance to learn more about ultrasound technology and experience its value as an educational and clinical tool.

“We are all working toward one common goal: giving students the best medical education,” Resuehr says. “We want to give students a solid foundation on how to effectively provide and interpret ultrasound scans so they can to provide better patient care as future physicians.”

A Step Ahead

While ultrasound technology is becoming cheaper, machines are still relatively expensive, Resuehr says. He notes finding time and funding for training programs are barriers to incorporating ultrasound education into the medical school curriculum.

At UAB, Resuehr collaborates with the Department of Engineering and several clinicians on projects involving homemade ultrasound phantoms. He partnered with OIPS, which has purchased ultrasound machines for student practice for high-fidelity ultrasound simulations. OIPS also trains practicing clinicians to improve their use of ultrasound technology. Resuehr has helped them develop training materials for practicing clinicians, says OIPS Director Marjorie Lee White, M.D.

“Ultrasound is an incredibly important part of patient care,” White says. “We serve as a host site for ultrasound training and partner with experts like Dr. Resuehr to make sure all our learners across the spectrum—everyone from medical and physician’s assistant students to residents, nurse practitioners, and other health care practitioners—develop ultrasound skills.”

Adopting the simulation model to train students and clinicians has given UAB an advantage in the field of ultrasound education because it enables the learners to benefit from interprofessional partnerships across relevant fields and access technology that is specific for their use.

Students benefit because they train with the right people and technology, and patients benefit because their practitioners have the right expertise, White says.

Sharing Knowledge

UAB students trained in ultrasound technology will have a head start when they begin practicing, Resuehr says. He started STP 2233 several years ago to create a curriculum-based place to get that instruction. He also hosts independent sessions for students interested in the OIPS.

“Not every specialty needs it, but everyone who becomes a physician should be able to do basic ultrasound,” he says.

Resuehr has presented his ideas at conferences across the U.S. and Canada. At the World Congress for Ultrasound in Medical Education conference in Montreal, Resuehr and clinicians from other leading institutions recently conducted an interactive, hands-on ultrasound workshop. He often meets other non-clinician anatomists like him and practicing physicians interested in his philosophy who want to learn more about ultrasound education.

“It highlights the fact that many clinicians don’t know how to do ultrasounds. But it shows that everyone realizes the value of it, especially once they’ve gotten their hands on it themselves,” Resuehr says.

By Haley Herfurth