Faculty Bibliography

Background: Although bedside ultrasound (BUS) competency is required for emergency medicine (EM) residents and BUS is an integral part of EM clinical practice, few opportunities exist for medical students to receive formal BUS instruction. Objectives: We developed a BUS simulation-based curriculum for rotating EM medical students consisting of web-based didactics and a hands-on skills session. We hypothesized that the curriculum would adequately prepare students to perform two common EM procedures: a Focused Assessment for Sonography in Trauma (FAST) exam and placement of ultrasound-guided internal jugular central venous access (IJ CVA). Methods: Forty-five medical students (16 2nd yr, 21 3rd yr, 8 4th yr) on an EM rotation were enrolled. Participants viewed three instructional web-based videos about BUS physics, the FAST exam, and BUS-guided IJ CVA. Subsequently, participants attended a 3-hour hands-on BUS simulation-based training session led by a BUS expert, an EM attending physician with > 7 years of BUS experience and > 3,000 completed BUS scans. After the initial training session, the BUS expert observed participants' FAST exams on a live volunteer, while a trained research assistant evaluated participants' IJ CVA skills on an instructional mannequin. Standardized checklists were used for both assessments. A passing score of 70% on each checklist was chosen prior to study initiation. Results: 89.0% (40/45) of participants passed the FAST and 96.0% (43/45) passed the IJ CVA skills assessments. Participants were successful in obtaining most required FAST views, yielding a right upper quadrant mean score of 90.6%, left upper quadrant score of 88.3%, bladder view score of 97.2%, and lung sliding score of 90.6%, but had the most difficulty with the cardiac view (72.2%). 84% (38/45) of participants placed successful IJ CVA within three attempts, with 64.4% (29/45) achieving success on the first attempt. 91% (41/45) avoided inadvertent puncture of the carotid artery. Conclusion: A standardized c!