Medical Science Educator

, Volume 27, Issue 2, pp 273–280 | Cite as

Medical Student Perception of the Impact of Early Ultrasonography Education on Experiences during Clinical Rotations

  • Kyle Zoll
  • Peter KondrashovEmail author
  • Vanessa Pazdernik
  • Derek Beatty
  • Mattie Arseneaux
  • Tahani Atieh
  • Tatyana Kondrashova
Original Research


Teaching medical students ultrasonography has a positive impact on their confidence in its use. The study institution has integrated ultrasonography education into the first 2 years of its 4-year curriculum. The first-year ultrasonography course taught students how to use ultrasound equipment and identify a number of structures in the neck, abdomen, pelvis, chest, and extremities. A pass/fail elective course during second year provided more opportunities to practice ultrasonography skills and use ultrasonography training models for guided procedures. The objective of this study was to investigate student perception of early ultrasonography education as related to their experience during clinical rotations. After completing third-year rotations, students were surveyed on their perception of how ultrasonography training impacted their clinical decision-making abilities, how often they engaged in ultrasonography activities, the obstacles that prevented them from using ultrasonography, and the specialties in which they used ultrasonography most. Eighty-five students from the class of 2015 and 162 students from the class of 2016 participated. Students agreed ultrasonography training aided their clinical decision-making abilities (P<.001) and their ultrasonography skills were used during third-year rotations (P<.001). Many students experienced at least 1 obstacle, most commonly lack of permission. Ultrasonography was used most during obstetrics and gynecology rotations. Despite obstacles, ultrasonography was used in a variety of specialties. These results support the inclusion of ultrasonography in the medical school curriculum to improve clinical decision-making skills and promote the development of ultrasonography skills.


Ultrasonography Undergraduate medical education Clinical rotations Clinical skills 



The authors thank Deborah Goggin, MA, Scientific Writer, at A.T. Still University for help with manuscript preparation.

Compliance with Ethical Standards


The current study had no funding sources.

Conflict of Interest

The authors declare that they have no financial disclosures or conflicts of interest.


  1. 1.
    Bernard S, Richardson C, Hamann CR, Lee S, Dinh VA. Head and neck ultrasound education—a multimodal educational approach in the predoctoral setting: a pilot study. J Ultrasound Med. 2015;34:1437–43. doi: 10.7863/ultra.34.8.1437.CrossRefGoogle Scholar
  2. 2.
    Griksaitis MJ, Scott MP, Finn GM. Twelve tips for teaching with ultrasound in the undergraduate curriculum. Med Teach. 2014;36:19–24. doi: 10.3109/0142159x.2013.847909.CrossRefGoogle Scholar
  3. 3.
    Hoppmann R, Cook T, Hunt P, et al. Ultrasound in medical education: a vertical curriculum at the University of South Carolina School of Medicine. J S C Med Assoc. 2006;102:330–4.Google Scholar
  4. 4.
    Kondrashov P, Johnson JC, Boehm K, Rice D, Kondrashova T. Impact of the clinical ultrasound elective course on retention of anatomical knowledge by second-year medical students in preparation for board exams. Clin Anat. 2015;28:156–63. doi: 10.1002/ca.22494.CrossRefGoogle Scholar
  5. 5.
    Arya R, Morrison T, Zumwalt A, Shaffer K. Making education effective and fun. Acad Radiol. 2013;20:1311–8. doi: 10.1016/j.acra.2013.07.012.CrossRefGoogle Scholar
  6. 6.
    Brown B, Adhikari S, Marx J, Lander L, Todd GL. Introduction of ultrasound into gross anatomy curriculum: perceptions of medical students. J Emerg Med. 2012;43:1098–102. doi: 10.1016/j.jemermed.2012.01.041.CrossRefGoogle Scholar
  7. 7.
    Swamy M, Searle RF. Anatomy teaching with portable ultrasound to medical students. BMC Med Educ. 2012;12:99. doi: 10.1186/1472-6920-12-99.CrossRefGoogle Scholar
  8. 8.
    Teichgräber UKM, Meyer JMA, Nautrup CP, von Rautenfeld DB. Ultrasound anatomy: a practical teaching system in human gross anatomy. Med Educ. 1996;30:296–8. doi: 10.1111/j.1365-2923.1996.tb00832.x.CrossRefGoogle Scholar
  9. 9.
    Kobal SL, Trento L, Baharami S, et al. Comparison of effectiveness of hand-carried ultrasound to bedside cardiovascular physical examination. Am J Cardiol. 2005;96:1002–6. doi: 10.1016/j.amjcard.2005.05.060.CrossRefGoogle Scholar
  10. 10.
    Song S, Burleson PD, Passo S, et al. Cardiac structure and function in humans: a new cardiovascular physiology laboratory. Adv Physiol Educ. 2009;33:221–9. doi: 10.1152/advan.00032.2009.CrossRefGoogle Scholar
  11. 11.
    Brunner M, Moeslinger T, Spieckermann PG. Echocardiography for teaching cardiac physiology in practical student courses. Am J Phys. 1995;268:S2–9.Google Scholar
  12. 12.
    Lavranos G, Koliaki C, Briasoulis A, Nikolaou A, Stefanadis C. Effectiveness of current teaching methods in cardiology: the SKILLS (medical students knowledge integration of lower level clinical skills) study. Hippokratia. 2013;17:34–7.Google Scholar
  13. 13.
    Raupach T, Hanneforth N, Anders S, Pukrop T,  Th J ten Cate O, Harendza S. Impact of teaching and assessment format on electrocardiogram interpretation skills. Med Educ. 2010;44:731–40. doi: 10.1111/j.1365-2923.2010.03687.x.
  14. 14.
    Kondrashova T, Sexton W, Baer R, Kondrashov P. Integration of didactic knowledge with procedural skill: learning cardiac electrophysiology and electrocardiography using ultrasound. Med Sci Educ. 2015;25:141–7. doi: 10.1007/s40670-015-0119-5.CrossRefGoogle Scholar
  15. 15.
    Shapiro RS, Ko PP, Jacobson S. A pilot project to study the use of ultrasonography for teaching physical examination to medical students. Comput Biol Med. 2002;32:403–9. doi: 10.1016/S0010-4825(02)00033-1.CrossRefGoogle Scholar
  16. 16.
    Barloon TJ, Brown BP, Abu-Yousef MM, Ferguson KJ, Schweiger GD, Erkonen WE, Schuldt SS. Teaching physical examination of the adult liver with use of real-time sonography. Acad Radiol. 1998;5:101–3.CrossRefGoogle Scholar
  17. 17.
    Hoppmann R, Hunt P, Louis H, Keisler B, Richeson N, Rao V, Stacy J. Howe D (2011) medical student identification of knee effusion by ultrasound. ISRN Rheumatol. 2011a; doi: 10.5402/2011/874596.Google Scholar
  18. 18.
    Brennan JM, Blair JE, Goonewardena S, et al. A comparison by medicine residents of physical examination versus hand-carried ultrasound for estimation of right atrial pressure. Am J Cardiol. 2007;99:1614–6. doi: 10.1016/j.amjcard.2007.01.037.CrossRefGoogle Scholar
  19. 19.
    Kelm DJ, Ratelle JT, Azeem N, Bonnes SL, Halvorsen AJ, Oxentenko AS, Bhagra A. Longitudinal ultrasound curriculum improves long-term retention among internal medicine residents. J Grad Med Educ. 7:454–7. doi: 10.4300/JGME-14-00284.1.
  20. 20.
    Rao S, van Holsbeeck L, Musial JL, Parker A, Bouffard JA, Bridge P, Jackson M, Dulchavsky SA. A pilot study of comprehensive ultrasound education at the Wayne State University School of Medicine: a pioneer year review. J Ultrasound Med. 2008;27:745–9.CrossRefGoogle Scholar
  21. 21.
    Hoppmann RA, Rao VV, Poston MB, et al. An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience. Crit Ultrasound J. 2011b;3:1–12. doi: 10.1007/s13089-011-0052-9.CrossRefGoogle Scholar
  22. 22.
    Syperda VA, Trivedi PN, Melo LC, Freeman ML, Ledermann EJ, Smith TM, Alben JO. Ultrasonography in preclinical education: a pilot study. J Am Osteopath Assoc. 2008;108:601–5.Google Scholar
  23. 23.
    Cantisani V, Dietrich CF, Badea R, et al. EFSUMB statement on medical student education in ultrasound [short version]. Ultraschall Med. 2016;37:100–2. doi: 10.1055/s-0035-1566959.CrossRefGoogle Scholar
  24. 24.
    Sullivan GM, Artino AR. Analyzing and interpreting data from Likert-type scales. J Grad Med Educ. 2013;5:541–2. doi: 10.4300/JGME-5-4-18.CrossRefGoogle Scholar
  25. 25.
    Cook T, Hunt P, Hoppman R. Emergency medicine leads the way for training medical students in clinician-based ultrasound: a radical paradigm shift in patient imaging. Acad Emerg Med. 2007;14:558–61. doi: 10.1197/j.aem.2007.04.003.CrossRefGoogle Scholar
  26. 26.
    Fox JC, Schlang JR, Maldonado G, Lotfipour S, Clayman RV. Proactive medicine: the "UCI 30," an ultrasound-based clinical initiative from the University of California, Irvine. Acad Med. 2014;89:984–9. doi: 10.1097/ACM.0000000000000292.CrossRefGoogle Scholar
  27. 27.
    Hoppmann R, Blaivas M, Elbarbary M. Better medical education and health care through point-of-care ultrasound. Acad Med. 2012;87:134. doi: 10.1097/ACM.0b013e31823f0e8f.CrossRefGoogle Scholar
  28. 28.
    Jeppesen KM, Bahner DP. Teaching bedside sonography using peer mentoring: a prospective randomized trial. J Ultrasound Med. 2012;31:455–9.CrossRefGoogle Scholar
  29. 29.
    Mouratev G, Howe D, Hoppmann R, et al. Teaching medical students ultrasound to measure liver size: comparison with experienced clinicians using physical examination alone. Teach Learn Med. 2013;25:84–8. doi: 10.1080/10401334.2012.741535.CrossRefGoogle Scholar
  30. 30.
    Rosenkrantz AB, Bilal NH, Hughes DR, Duszak R. National specialty trends in billable diagnostic ultrasound in the ED: analysis of Medicare claims data. Am J Emerg Med. 2014;32:1470–5. doi: 10.1016/j.ajem.2014.09.002.CrossRefGoogle Scholar
  31. 31.
    Yoo MC, Villegas L, Jones DB. Basic ultrasound curriculum for medical students: validation of content and phantom. J Laparoendosc Adv Surg Tech A. 2004;14:374–9. doi: 10.1089/lap.2004.14.374.CrossRefGoogle Scholar

Copyright information

© International Association of Medical Science Educators 2017

Authors and Affiliations

  1. 1.Anatomy Department, Kirksville College of Osteopathic MedicineA.T. Still UniversityKirksvilleUSA
  2. 2.Research SupportA.T. Still UniversityKirksvilleUSA
  3. 3.Department of Family Medicine, Preventive Medicine, and Community Health, Kirksville College of Osteopathic MedicineA.T. Still UniversityKirksvilleUSA

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