Sink or Swim? Modifying POCUS Medical Education Curriculum During the Coronavirus Pandemic

Modifying a point-of-care ultrasound (POCUS) medical education curriculum initially designed for 4-year matriculation into a 3-year experience is undoubtedly challenging. This 1-year shortening, combined with the added constraints of mandated social distancing guidelines of the coronavirus pandemic, caused us to search for concrete answers to these new directives that would lead us to either sink or swim in this new ocean of learning.

Claude Bernard, a 19th-century French physiologist, remarked that “it is what we think we know already that often prevents us from learning.” This educational concept was true with our efforts to modify a successful ultrasound in medical education curriculum and transform it into a case-based learning approach for a condensed 18-month pre-clerkship ultrasound curriculum.

How we had conducted ultrasound labs previously would have to be revisited, revised, and revamped to transform the curriculum successfully.

Planning began to modify the ultrasound curriculum for the 18-month pre-clerkship experience approximately 2 years before the pandemic was even on the horizon. In-person meetings were held with fellow faculty to discuss and debate the patient-centered learning course’s mission and goals and where the ultrasound curriculum would be housed. Our discussions took place with ease, and ideas for collaboration easily flowed. Plans were made for in-person, hands-on scanning where students scanned each other, volunteers, or standardized patients, without giving any thought to the physical contact.

There was no thought to the exam rooms’ square footage or how students would enter and exit the ultrasound center. Live introductory lectures at the onset of each lab were planned for 25–30 students to introduce the case and review the scanning techniques and logistics for each lab session. The planning included no discussion of online learning or simulated scanning for students from a remote location. Ultrasound instruction would proceed into the new curriculum with a slight modification to how ultrasound content had been previously delivered.

Then, while finalizing our plans for a start date of August 2020, all in-person instruction was suspended for our institution. It was mid-March, and we had a nearly solidified sketch of the ultrasound lab logistics and learning methods for the inaugural class of the 3-year medical school and the 18-month pre-clerkship curriculum.

Nevertheless, that suddenly changed, and the uncertainty of instructing anyone in-person to do any part of the curriculum was up for discussion. The faculty was mandated to work from home away from the ultrasound center with its hand-held systems, full-size ultrasound machines, and simulation capabilities. Student interactions were reduced to phone calls, emails, and video interactions within online course offerings as each student cohort was scattered throughout the 159 counties of our state.

Learning to conduct curriculum meetings through online platforms filled our days. Trying to accomplish fully online ultrasound electives with a plethora of students and revamp the new ultrasound curriculum within the changing coronavirus guidelines stayed on our minds as we struggled through the spring and early summer.

Nevertheless, we made it!

When the inaugural class of the new pre-clerkship curriculum began, we laid out a plan to keep students, staff, and faculty safe through the 3W’s: wearing a mask, watching physical distance, and hand washing.

Facilities management personnel had surveyed our ultrasound exam rooms and learning spaces and posted how many students could be in each room. Hand sanitation stations and masks were made available for students as they entered the ultrasound center. Signage and arrows were erected to direct students in and out of the ultrasound center in a one-way fashion. An online meeting platform was set up in each exam room for students to hear live instruction before beginning the lab. Instructors utilized a laser point at each room’s door to direct student scanning and maintain social distancing. Students used hand-held ultrasound equipment with image transfer capabilities to obtain images needed to complete their online case-based ultrasound assignments. Although these safety measures were not visualized in our early curriculum planning meetings, the ultrasound curriculum was successfully delivered!

While we did not meet the goal of remote hands-on ultrasound instruction for all ultrasound labs during the pandemic, we learned to conduct in-person ultrasound scanning labs safely and effectively within a new accelerated medical school curriculum. The constraints and trials of a global pandemic did not preclude us from putting aside what we already knew and navigating a new course into the future!

Headshot photograph of the post author, Rebecca J. Etheridge. She is shown in front of a gray background wearing a blue suit jacket and has shoulder-length red-brown hair.

Rebecca J. Etheridge, EdD, RDMS, is an assistant professor at the Medical College of Georgia at Augusta University.

Interested in learning more about ultrasound education? Check out the following posts from the Scan:

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