Browsing by Author "Lobo, Daniela"

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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.
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    Evaluation of Point-of-Care Ultrasound Training for Family Physicians Using Teleultrasound
    (Society of Teachers of Family Medicine, 2023) Russell, Frances M.; Herbert, Audrey; Lobo, Daniela; Ferre, Robinson; Nti, Benjamin K.; Emergency Medicine, School of Medicine
    Background and objectives: The goal of this study was to assess family physicians' change in knowledge and ability to perform abdominal aorta ultrasound after implementation of a novel teleultrasound curriculum. Methods: This was a prospective, observational study conducted at a single academic institution. Family physicians completed a preassessment, test, and objective structured clinical evaluation (OSCE). Physicians then individually completed a standard curriculum consisting of online content and an hour-long, hands-on training session on abdominal aorta ultrasound using teleultrasound technology. Physicians then performed a minimum of 10 independent examinations over a period of 8 weeks. After physicians completed the training curriculum and 10 independent scans, we administered a postassessment, test, and OSCE. We analyzed differences between pre- and postcurriculum responses using Fisher exact and Wilcoxon signed rank tests. Results: Thirteen family physicians completed the curriculum. Comparing pre- to postcurriculum responses, we found significant reductions in barriers to using aorta POCUS and improved confidence in using, obtaining, and interpreting aorta POCUS (P<0.01). Knowledge improved from a median score of 70% to 90% (P<0.01), and OSCE scores improved from a median of 80% to 100% (P=0.012). Overall, 211 aorta ultrasound examinations were independently acquired with a median image quality of 4 (scale 1 to 4). Conclusions: After an 8-week teleultrasound curriculum, family physicians with minimal experience with POCUS showed improved knowledge and psychomotor skill in abdominal aorta POCUS.
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    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.
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    Use of Artificial Intelligence Program to Increase Resident Confidence and POCUS Use at the Bedside
    (2024-04-26) Wilcox, James; Lobo, Daniela; Hernandez, Reuben; Holley, Matthew; Renshaw, Scott
    Introduction: Point of Care Ultrasound (POCUS) education continues to increase in undergraduate and graduate medical education, mostly fueled by clinical usefulness and increasing graduate medical education requirements. Many schools are now teaching POCUS as a core part of the curriculum. However, with the sudden rush of POCUS education, one barrier often identified in the literature is a lack of trained faculty to educate residents and medical students. Study Objective: Our team at the Family Medicine Department recruited an artificial intelligence program developed by Global Ultrasound Institute to assist POCUS instructors with resident ultrasound education. The research project would use AI programming and learning to allow residents to access timely answers to questions at the bedside while on rounds, when a trained POCUS instructor might not always be present. Since POCUS instructors cannot be available for every bedside patient examination in the hospital or residency clinic, this AI program would provide answers to needed bedside questions to give residents more confidence with performing more POCUS evaluations. Methods: We would deploy the AI program for interns who have completed at least 6 months of POCUS training and residents who had completed prior intern POCUS training. This program would be available on smart phone devices for when rounding in adult medicine, pediatrics, OBGYN, and in the outpatient residency clinic. Residents will have 24/7 access to a smart AI who will answer questions about POCUS technique, indications for use, interpretation questions, and many more. The program will give residents a quick and focused answer, as well as access to resources for further study if needed. Resident POCUS use will be tracked with the Butterfly IQ academy, as well as with resident procedure logging. Results: Since this is a very new program and relationship with Global Ultrasound Institute, no results are currently available. We anticipate preliminary results will be available by the presentation date in April. Conclusions: Artificial Intelligence is changing the way medical education is approached in the United States and the world. This particular program will allow residents to have access to timely answers to their POCUS practice questions at the bedside, while on rounds. We anticipate this will allow residents the opportunity to use the ultrasound devices for more cases and scenarios, as well as have improved confidence in their ultrasound acquisition abilities, with the support of the AI Education Assistant.