Ultrasound Education in the Post-COVID Era

In his book, The Innovator’s Dilemma, Clayton Christensen discusses the idea of disruptive technology. This market force that challenges industry norms can create new opportunities but also requires traditional market fixtures to adapt in order to maintain effectiveness.

Point-of-care Ultrasound (POCUS) has emerged as a disruptive technology in medical imaging. It relies heavily on education, both for new learners and also for those continuing to advance their knowledge base as skilled sonologists. As ultrasound technology improves and the scope of POCUS expands, two important facets of ultrasound education are collaboration and innovation. 

Ultrasound has traditionally been confined to specific rooms within the house of medicine. However, POCUS has grown to include a variety of specialties. Emergency medicine, critical care, hospital medicine, outpatient clinics, and even surgical specialties have all benefitted from “Ultrasound First” and the diagnostic specificity of ultrasound. But just as every disruptive technology creates challenges for traditional users, the democratization of ultrasound has required new users and traditional imaging specialties to rethink the imaging paradigm. 

Since each specialty (traditional or new adopter) comes to the table with a unique skillset and expertise, we benefit from collaboration. In the same way that a rising tide lifts all boats, cross-departmental collaboration allows for a broader understanding of the interplay between a patient’s anatomy, physiology, and ultrasound findings. 

In our institution, we have sought to use ultrasound as a tool to build bridges between departments. We have brought sonologists from various specialties together to teach anatomy with ultrasound. We have brought our ED residents to the MICU to scan patients with known pathology and MICU fellows to the ED. We have conducted cross-departmental ED/Radiology case conferences discussing the use of bedside ultrasound and traditional imaging. In each of these examples, we have sought ways to build collaborative relationships with other departments and benefit from each other’s particular perspective and experience. 

Ultrasound proficiency requires a firm foundation of both didactic knowledge and psychomotor skill. There is a significant interdependency between the classroom and the bedside. By restricting access to both spheres, COVID-19 has interrupted our normal way of living and educating and created a number of challenges to continuing ultrasound education. But, like a silver lining behind every dark cloud, the distance that COVID has created physically has drawn us together in unique ways. Distancing, occupancy limits, and virtual interactions have required us to reimagine ways of reaching learners. 

A large part of our continuing ultrasound education is a regular ultrasound lecture series. Virtual education has allowed for more flexibility with attendance. Individuals who traditionally could not attend an in-person lecture due to time or geographical constraints can now participate. We previously included learners from various departments within our institution. However, with virtual lectures, we have included students, residents, fellows, and faculty from other institutions throughout our greater region.

In addition to increasing the participant base, virtual education has allowed us to tap into a broader faculty base. The traditional model of medical education relies on in-person lectures and didactic education. Virtual education opens opportunities to include regional, national, and international experts. Prior to COVID, a visiting lecturer would have to take time away from their personal practice and travel to a particular place. Now, a speaker can attend via Zoom or other platforms. This has allowed us to invite outside experts to our educational forum. And for faculty looking to build an educational portfolio and progress through the academic ranks, virtual education allows for junior faculty to gain experience as visiting lecturers. 

As we emerge from the COVID era, I personally look forward to losing the masks, gathering together again, and seeing the word “virtual” used less ubiquitously in the English lexicon. But our imperative as ultrasound educators is to learn from the ways that COVID has changed our existing models for education and has caused us to adapt to new teaching methods. We should embrace the disruptive technologies of the past year and find ways to blend the advantages of cross-departmental, in-person learning with cross-institutional virtual education. To the extent that we are successful in this endeavor, we will find increased cohesion as a community, improved educational opportunities for our learners, and, ultimately, improved outcomes for our patients. 

Matthew Tabbut, MD, FACEP, is Director of Emergency Ultrasound at MetroHealth Medical Center in Cleveland, Ohio.

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