IU Indianapolis ScholarWorks :: Browsing by Author "Ferre, Robinson M."

Browsing by Author "Ferre, Robinson M."

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A shared point of care ultrasound curriculum for graduate medical education
(Springer Nature, 2024-08-06) Ferre, Robinson M.; Kaine, Joshua C.; Lobo, Daniela; Peterson, Dina; Sarmiento, Elisa; Adame, John; Herbert, Audrey; Wallach, Paul M.; Russell, Frances M.; Emergency Medicine, School of Medicine
Background: Point of care ultrasound (POCUS) education has grown significantly over the past two decades. Like most curricular items, POCUS education is siloed within individual graduate medical education (GME) programs. The purpose of this study was to evaluate the effectiveness of a shared GME POCUS curriculum between five GME programs at a single institution. Methods: Post-graduate-year-1 (PGY-1) residents from emergency medicine (EM), family medicine (FM), internal medicine (IM), combined internal medicine-pediatrics (IM-Peds) and combined emergency medicine-pediatrics (EM-Peds) residency programs were enrolled in a core POCUS curriculum. The curriculum included eleven asynchronous online learning modules and ten hands-on training sessions proctored by sonographers and faculty physicians with POCUS expertise. Data was gathered about the curriculum's effectiveness including participation, pre- and post-curricular surveys, pre- and post-knowledge assessments, and an objective skills assessment. Results: Of the 85 residents enrolled, 61 (72%) participated in the curriculum. Engagement varied between programs, with attendance at hands-on sessions varying the most (EM 100%, EM-Peds 100%, FM 40%, IM 22%, Med-Peds 11%). Pre- and post-knowledge assessment scores improved for all components of the curriculum. Participants felt significantly more confident with image acquisition, anatomy recognition, interpreting images and incorporating POCUS findings into clinical practice (p < 0.001) after completing the curriculum. Conclusion: In this shared GME POCUS curriculum, we found significant improvement in POCUS knowledge, attitudes, and psychomotor skills. This shared approach may be a viable way for other institutions to provide POCUS education broadly to their GME programs.
Acute Heart Failure Assessment: The Role of Focused Emergency Cardiopulmonary Ultrasound in Identification and Early Management
(Wiley, 2015-12) Ferre, Robinson M.; Chioncel, Ovidiu; Pang, Peter S.; Lang, Roberto M.; Gheorghiade, Mihai; Collins, Sean P.; Department of Emergency Medicine, IU School of Medicine
Assessment of Medical Students' Ability to Integrate Point-of-Care Cardiac Ultrasound Into a Case-Based Simulation After a Short Intervention
(Springer Nature, 2022-07-31) Russell, Frances M.; Herbert, Audrey; Peterson, Dina; Wallach, Paul M.; Ferre, Robinson M.; Emergency Medicine, School of Medicine
Introduction: While a large amount of point-of-care ultrasound (POCUS) undergraduate medical education research exists, very little assesses the effectiveness of teaching on the student's ability to utilize POCUS within a clinical context. We set out to assess the ability of pre-clinical (second year) medical students to perform and interpret a parasternal long axis (PSLA) cardiac ultrasound view, and to diagnose a pericardial effusion on POCUS in a simulated patient with hypotension. Methods: This was a prospective study assessing second-year medical students before and after focused cardiac POCUS instruction. Pre-instruction, students completed a pre-assessment and test. They then watched a short video on cardiac ultrasound technique, anatomy, and pathology. Students then participated in 10 minutes of one-on-one hands-on instruction using a simulated patient. Immediately after didactics and hands-on instruction, students in groups of two to four completed a case simulation where they performed a PSLA view, identified pathology, and made a diagnosis. Differences between pre- and post-workshop responses were analyzed using the Chi-square test. Results: We analyzed data on 132 pre-clinical second-year medical students; 126 (95%) had limited to no POCUS experience prior to the workshop. Comparing pre- to post-workshop responses, we found significant improvement in students' ability to identify a pericardial effusion (46% to 69%) (p=0.002) on a PSLA cardiac view. Of the 57 student groups (132 students), 41 (72%) groups were able to adequately obtain a PSLA view on a mannequin using an ultrasound simulator without needing guidance with probe placement or maneuvering. Thirty-five (61%) student groups were able to identify a pericardial effusion and diagnose cardiac tamponade in a simulated patient with hypotension. Conclusion: After short, structured training, pre-clinical medical students, novice to cardiac POCUS, showed improved knowledge with identifying a pericardial effusion on an ultrasound image. The majority of students were able to obtain a PSLA view and diagnose cardiac tamponade in a hypotensive patient during a during a case-based simulation.
Design and implementation of a basic and global point of care ultrasound (POCUS) certification curriculum for emergency medicine faculty
(Springer, 2022-02-19) Russell, Frances M.; Kennedy, Sarah K.; Rood, Loren K.; Nti, Benjamin; Herbert, Audrey; Rutz, Matt A.; Palmer, Megan; Ferre, Robinson M.; Emergency Medicine, School of Medicine
Point of care ultrasound (POCUS) use in the emergency department is associated with improved patient outcomes and increased patient satisfaction. When used for procedural guidance, it has been shown to increase first pass success and decrease complications. As of 2012, ultrasound has been identified as a core skill required for graduating emergency medicine (EM) residents. Despite this, only a minority of EM faculty who trained prior to 2008 are credentialed in POCUS. Half of all EM training programs in the United States have less than 50% of their faculty credentialed to perform and teach POCUS to learners. As the use of POCUS continues to grow in medicine, it is especially important to have a pathway for faculty to attain competence and become credentialed in POCUS. The goal of this paper was to outline an implementation process of a curriculum designed to credential EM faculty in POCUS.
Development and implementation of a point of care ultrasound curriculum at a multi-site institution
(Springer, 2021-02-21) Russell, Frances M.; Herbert, Audrey; Ferre, Robinson M.; Zakeri, Bita; Echeverria, Valerie; Peterson, Dina; Wallach, Paul; Emergency Medicine, School of Medicine
In 2014, over 60% of medical schools were incorporating point of care ultrasound (POCUS) into their curriculum. Today, over 6 years later, many more schools are teaching POCUS or are in the planning stages of implementing a POCUS curriculum. In 2019, the AAMC reported that 53 schools or over one-third of US medical schools have multi-site campuses for undergraduate medical education. Implementation of a POCUS educational initiative at a multi-site campus presents unique challenges for teaching a uniform curriculum statewide. This article will discuss the POCUS curriculum and implementation process at a large multi-site institution.
Gamification of POCUS: Are Students Learning?
(Department of Emergency Medicine, School of Medicine, University of California, Irvine, 2023-02-22) Russell, Frances M.; Lobo, Daniela; Herbert, Audrey; Kaine, Joshua; Pallansch, Jenna; Soriano, Pamela; Adame, J. D.; Ferre, Robinson M.; Emergency Medicine, School of Medicine
Introduction: While gamification of point-of-care ultrasound (POCUS) is well received by learners, little is known about the knowledge gained from material taught during these events. We set out to determine whether a POCUS gamification event improved knowledge of interpretation and clinical integration of POCUS. Methods: This was a prospective observational study of fourth-year medical students who participated in a 2.5-hour POCUS gamification event consisting of eight objective-oriented stations. Each station had one to three learning objectives associated with the content taught. Students completed a pre-assessment; they then participated in the gamification event in groups of three to five per station and subsequently completed a post-assessment. Differences between pre- and post-session responses were matched and analyzed using Wilcoxon signed-rank test and Fisher's exact test. Results: We analyzed data from 265 students with matched pre- and post-event responses; 217 (82%) students reported no to little prior POCUS experience. Most students were going into internal medicine (16%) and pediatrics (11%). Knowledge assessment scores significantly improved from pre- to post-workshop, 68% vs 78% (P=0.04). Self-reported comfort with image acquisition, interpretation, and clinical integration all significantly improved from pre- to post-gamification event (P<0.001). Conclusion: In this study we found that gamification of POCUS, with clear learning objectives, led to improved student knowledge of POCUS interpretation, clinical integration, and self-reported comfort with POCUS.
Piloting a Graduate Medical Education Point-of-Care Ultrasound Curriculum
(Springer Nature, 2022-07-23) Ferre, Robinson M.; Russell, Frances M.; Peterson, Dina; Zakeri, Bita; Herbert, Audrey; Nti, Benjamin; Goldman, Mitchell; Wilcox, James G.; Wallach, Paul M.; Emergency Medicine, School of Medicine
Objective: As point-of-care ultrasound (POCUS) use grows, training in graduate medical education (GME) is increasingly needed. We piloted a multispecialty GME POCUS curriculum and assessed feasibility, knowledge, and comfort with performing POCUS exams. Methods: Residents were selected from the following residency programs: internal medicine, family medicine, emergency medicine, and a combined internal medicine/pediatrics program. Didactics occurred through an online curriculum that consisted of five modules: physics and machine operation, cardiac, lung, soft tissue, and extended focused sonography in trauma applications. Residents completed a pre- and post-curriculum questionnaire, as well as knowledge assessments before and after each module. One-hour hands-on training sessions were held for each module. Differences between pre- and post-participation questionnaire responses were analyzed using the Wilcoxon rank sum. Results: Of the 24 residents selected, 21 (86%) were post-graduate year two or three, and 16 (65%) were from the internal medicine program. Eighteen (67%) residents reported limited prior POCUS experience. All pre- to post-knowledge assessment scores increased (p<0.05). Statistically significant increases pre- to post-curriculum were found for frequency of POCUS use (p = 0.003), comfort in using POCUS for assessing for abdominal aortic aneurysm, soft tissue abscess detection, undifferentiated hypotension and dyspnea, cardiac arrest and heart failure (p<0.025); and competency in machine use, acquiring and interpreting images and incorporating POCUS into clinical practice (p<0.001). All participants felt the skills learned during this curriculum were essential to their future practice. Conclusions: In this pilot, we found using a combination of online and hands-on training to be feasible, with improvement in residents’ knowledge, comfort, and use of POCUS.
Piloting a Graduate Medical Education Point-of-Care Ultrasound Curriculum
(Springer, 2022-07) Ferre, Robinson M.; Russell, Frances M.; Peterson, Dina; Zakeri, Bita; Herbert, Audrey; Nti, Benjamin; Goldman, Mitchell; Wilcox, James G.; Wallach, Paul M.; Radiology & Imaging Sciences, School of Medicine
Objective As point-of-care ultrasound (POCUS) use grows, training in graduate medical education (GME) is increasingly needed. We piloted a multispecialty GME POCUS curriculum and assessed feasibility, knowledge, and comfort with performing POCUS exams. Methods Residents were selected from the following residency programs: internal medicine, family medicine, emergency medicine, and a combined internal medicine/pediatrics program. Didactics occurred through an online curriculum that consisted of five modules: physics and machine operation, cardiac, lung, soft tissue, and extended focused sonography in trauma applications. Residents completed a pre- and post-curriculum questionnaire, as well as knowledge assessments before and after each module. One-hour hands-on training sessions were held for each module. Differences between pre- and post-participation questionnaire responses were analyzed using the Wilcoxon rank sum. Results Of the 24 residents selected, 21 (86%) were post-graduate year two or three, and 16 (65%) were from the internal medicine program. Eighteen (67%) residents reported limited prior POCUS experience. All pre- to post-knowledge assessment scores increased (p<0.05). Statistically significant increases pre- to post-curriculum were found for frequency of POCUS use (p = 0.003), comfort in using POCUS for assessing for abdominal aortic aneurysm, soft tissue abscess detection, undifferentiated hypotension and dyspnea, cardiac arrest and heart failure (p<0.025); and competency in machine use, acquiring and interpreting images and incorporating POCUS into clinical practice (p<0.001). All participants felt the skills learned during this curriculum were essential to their future practice. Conclusions In this pilot, we found using a combination of online and hands-on training to be feasible, with improvement in residents' knowledge, comfort, and use of POCUS.
Point-of-Care Ultrasound Education During a Pandemic: From Webinar to Progressive Dinner- Style Bedside Learning
(Springer Nature, 2022-05-19) Herbert, Audrey; Russell, Frances M.; Zahn, Gregory; Zakeri, Bita; Motzkus, Christine; Wallach, Paul M.; Ferre, Robinson M.; Emergency Medicine, School of Medicine
Objective: Point-of-care ultrasound (POCUS), traditionally, requires the proximity of learners and educators, making POCUS education challenging during the COVID-19 pandemic. We set out to evaluate three alternate approaches to teaching POCUS in UME. Sessions progressed from an online seminar to a remote, interactive simulation to a “progressive dinner” style session, as precautions evolved throughout the pandemic. Methods: This prospective study details a series of three POCUS workshops that were designed to align with prevailing social distancing precautions during the COVID-19 pandemic. Overall, 656 medical students were included. The first and second workshops used web-based conferencing technology with real-time ultrasound imaging, with the second workshop focusing on clinical integration through simulation. As distancing precautions were updated, a novel “progressive dinner” technique was used for the third workshop. Surveys were conducted after each session to obtain feedback on students’ attitudes toward alternative teaching techniques and quantitative and qualitative analyses were used. Results: The initial, remote POCUS workshop was performed for 180 medical students. Ninety-nine (177) percent of students felt the session was “intellectually challenging” and “stimulating.” Ninety-nine percent of students (340/344), after the second workshop, indicated the session was intellectually challenging, stimulating, and a positive learning experience. Students' ability to correctly identify pathologic images increased post-session evaluation from in-session polling. For workshop three, 99% (107/108) of students indicated that the session was “informative.” There was a significant improvement in pre- to post-workshop knowledge regarding image acquisition, interpretation, and clinical integration. Conclusion: While image acquisition skills are best conveyed at the bedside, these modified POCUS teaching techniques developed and delivered in alignment with COVID-19 pandemic restrictions during a series of three workshops were shown to be effective surrogates for traditional teaching approaches when social distancing requirements, a large learner pool, or lack of local expertise exist.
The State of Point-of-Care Ultrasound Training in Undergraduate Medical Education: Findings From a National Survey
(Wolters Kluwer, 2021-11) Russell, Frances M.; Zakeri, Bita; Herbert, Audrey; Ferre, Robinson M.; Leiser, Abraham; Wallach, Paul M.; Emergency Medicine, School of Medicine
Purpose: The primary aim of this study was to evaluate the current state of point-of-care ultrasound (POCUS) integration in undergraduate medical education (UME) at MD-granting medical schools in the United States. Method: In 2020, 154 clinical ultrasound directors and curricular deans at MD-granting medical schools were surveyed. The 25-question survey collected data about school characteristics, barriers to POCUS training implementation, and POCUS curriculum details. Descriptive analysis was conducted using frequency and percentage distributions. Results: One hundred and twenty-two (79%) of 154 schools responded to the survey, of which 36 were multi-campus. Sixty-nine (57%) schools had an approved POCUS curriculum, with 10 (8%) offering a longitudinal 4-year curriculum. For a majority of schools POCUS instruction was required during the first (86%) and second year (68%). Forty-two (61%) schools were teaching fundamentals, diagnostic, and procedural ultrasound. One-hundred and fifteen (94%) schools identified barriers to implementing POCUS training in UME, which included lack of trained faculty (63%), lack of time in current curricula (54%), and lack of equipment (44%). Seven (6%) schools identified no barriers. Conclusions: Over half of the responding medical schools in the United States had integrated POCUS instruction into their UME curricula. Despite this, a very small portion had a longitudinal curriculum and multiple barriers existed for implementation, with the most common being lack of trained faculty. The data from this study can be used by schools planning to add or expand POCUS instruction within their current curricula.

Browsing by Author "Ferre, Robinson M."

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