Assessing the use of cardiac ultrasound as an adjunct to physiology education at the medical school level

At Midwestern University-Glendale, hands-on point-of-care ultrasound (POCUS) training is integrated throughout the 4-year medical curriculum. The core physiology courses are completed by all first-year osteopathic medical students [Arizona College of Osteopathic Medicine (AZCOM)] and podiatric medical students [Arizona College of Podiatric Medicine (AZPOD)]. We hypothesized that the incorporation of a cardiac ultrasound workshop would enhance students' perceived confidence in their understanding of cardiac physiology and increase students' perceived confidence to perform cardiac POCUS scans and, additionally, that student perceived confidence in either area of cardiac physiology or POCUS may affect either or both of these metrics. The study utilized brief pre- and postworkshop surveys, administered on paper; questions assessed confidence in cardiac physiology and ultrasound principles and perceived gains in understanding and practical skills measuring cardiac output (CO), velocity time integral (VTI), measurement of aortic diameter, and E-point septal separation (EPSS). Additionally, all student participant-captured images were evaluated by a clinical faculty expert in ultrasound instruction using a grading rubric based on image clarity and anatomical and measurement accuracy. The pre- and postsurvey analyses demonstrated <i>1</i>) significantly increased confidence in basic ultrasound machine use and <i>2</i>) significantly increased confidence in obtaining the parasternal long axis (PLAX) view, integral to measuring CO, VTI, and EPSS, and that <i>3</i>) participants with lower baseline confidence in physiology showed greater overall gains in confidence in obtaining the PLAX view and <i>4</i>) participants with higher prior POCUS confidence reported significantly higher subjective learning in cardiac physiology. Average scores for all images assessed fell into the "fair" category for image clarity and anatomical and measurement accuracy. Our findings offer evidence of and meaningful insights into the educational value of integrating POCUS-based learning experiences within medical physiology courses.<b>NEW & NOTEWORTHY</b> This study assesses the utility of cardiac ultrasound workshops within a medical physiology course. Students were surveyed; stratifying respondents into high- and low-prior confidence groups, we demonstrate which students may benefit the most from hands-on ultrasound workshops. Additionally, students' technical skill proficiency in POCUS was assessed and evaluated from images of cardiac anatomical structures and corresponding physiological measurements. The large experimental group utilized (291 surveys) yields increased sensitivity and supports significant findings.