Date of Award

January 2017

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Rachel Liu

Abstract

Point-of-care ultrasound (POCUS) is being adopted by an increasing number of medical schools as a powerful teaching modality in which hands-on training in POCUS is integrated with or used as an adjunct to the existing undergraduate medical curriculum, particularly during the pre-clinical years. In 2013, the Yale School of Medicine (YSM) introduced a novel longitudinal POCUS curriculum as an optional elective offered to incoming first-year medical students who applied to participate in this elective in addition to the standard YSM curriculum; due to capacity limits, enrollment was by lottery. The goal of this study was to evaluate whether participation in the POCUS elective improved students’ performance in other areas of the YSM curriculum. To test this, we conducted a retrospective cohort study comparing mean scores on existing standardized assessments used in the YSM curriculum (including anatomy and physiology exams, clinical skills assessments, and board exams) between students in the POCUS elective and a randomly-selected control group of peer students who had applied for the POCUS elective but were not selected by lottery. For students in the POCUS cohort from the Classes of 2017 and 2018 (n=34), we observed a statistically-significant increase in mean physical exam score on a standardized clinical skills assessment compared to students in the control cohort (n=34) (mean score 89.2±1.0 vs 85.7±1.3, P=0.04); there was no difference in mean history-taking or communication skills scores. In a subgroup analysis of the Class of 2017, for students in the POCUS cohort (n=17) there was a trend towards increased mean score on the first anatomy exam (115.4 vs 108.4, P=0.07) and second physiology exam (67.9 vs 63.7, P=0.05) compared to controls; this increase approached but did not reach statistical significance. There was no difference in mean score on pathology exams or board exams. To further characterize the impact of the POCUS elective, we conducted a cross-sectional survey of students in the POCUS cohort; the results indicate strong support for POCUS education among enrolled students, and the score comparisons in our study suggest that implementation of a POCUS curriculum can objectively improve students’ physical exam skills and may improve their early understanding of anatomy and physiology on existing assessments.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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