Training the Next Generation of Doctors in Ultrasound
Dr. Laleh Gharahbaghian explains an ultrasound technique to medical student attendees at last year's UltraFest symposium, a free, all-day educational program for medical students sponsored by Stanford's emergency medicine department.
Stanford Medicine hosted the second annual UltraFest on October 18, a free, hands-on training session exclusively for medical students. This year's event drew 300 students from throughout California, who learned the value of ultrasound in medicine, regardless of the specialty they choose.
"UltraFest is an event that allows medical students to come for free to learn about a tool that can enhance their education about anatomy, physiology and pathology and how it can affect patient care and diagnosis," says Laleh Gharahbaghian, MD, clinical associate professor of surgery in emergency medicine and co-director of UltraFest. "It's a peak into what the future of medicine is going to look like at the bedside, whether it's in an outpatient clinic or an inpatient setting."
Organized by Emergency Medicine faculty and medical students, the hands-on teaching sessions and simulation exercises were led by over 30 Stanford faculty from multiple specialties, including emergency medicine, cardiology, Ob/Gyn, surgery, anesthesia, radiology, critical care and primary care. Students could try ultrasound techniques in a number of different applications, and take part in realistic simulation training sessions using high-fidelity mannequins.
"Our hope is that students will walk away from UltraFest with an interest in ultrasound, and how it can change the way they engage in patient care," says William White, a fifth year medical student at Stanford who helped organize the event. A second goal of the program, he says, is to give students some proficiency with the tool, regardless of their learning level.
Something new at this year's UltraFest, simulation training, was inspired by Nikita Joshi, MD, a clinical instructor in the division of Emergency Medicine, who is interested in using disruptive technologies in medical education. "Medical simulation is a great way of learning," she says. "It's experiential. You can perform procedures and get results. But it's also safe because your patient is a mannequin."
In small groups, attendees at UltraFest were able to care for a "patient" from beginning to end in Crisis Resource Management drills using ultrasound-based simulation scenarios. The UltraFest simulation lab gave students already proficient in ultrasound a reason to come back to practice their skills in a realistic patient care setting.
"Ultrasound helps solidify some of the things we learn in the classroom," says Brian Cheung, a third year medical student at Stanford, who was also one of the event organizers. "It's one thing to learn something in a classroom, but to practice it in a more realistic setting helps to solidify a lot of concepts."
Reinventing medical education
The event was open to medical students from all schools, not just Stanford, because many schools do not offer ultrasound training as part of their medical school curriculum, says Gharahbaghian. Incorporating ultrasound training into medical school education is a trending topic in medicine. Several institutions have included ultrasound into their medical school curriculum, and it has been shown to help medical students learn anatomy, physiology and pathology in a way that no textbook could really ever do, says Gharahbaghian.
At Stanford, ultrasound training is currently offered as an elective in the emergency medicine rotation, and it is introduced to all students in their core anatomy classes and patient-doctor sessions. The School of Medicine is working to incorporate more ultrasound training into its regular medical school curriculum in the coming years. Gharahbaghian, who directs the emergency medicine ultrasound program and fellowship, is working with Viveta Lobo, MD, who leads ultrasound education for Stanford's medical school students, to develop the curriculum.
Stanford has always been at the forefront of medicine and innovative education, says Gharahbaghian, "So it's no surprise Stanford would want to have bedside ultrasound as an educational tool for its students."
The future of medicine
Ultrasound at the bedside by physicians is a common practice of emergency medicine, critical care and trauma, but it is still underutilized in many areas of medicine, says Lobo. Physicians tend to go to other modalities first, she says, such as CT scans and MRI, but ultrasound is radiation-free, quicker, safer and more cost effective.
"It's a scan we do from head to toe, and skin to bone, and everything in between," says Gharabhaghian. "It allows you to see what's happening in a patient in a dynamic process as it's going on over time, which is very different than many of the other imaging modalities we use."
In five to ten years, Gharabhaghian predicts every physician will have a bedside ultrasound in his or her pocket. While it won't replace the stethoscope, she says, it will be as prevalent.
"We're trying to promote something that's free so we can address our goal, which is to train physicians for the way medicine will be practiced in the future," says Joshi. "And medicine will be practiced in the future with ultrasound."