Teaching Jugular Venous Pressure (JVP) Ultrasound: Methods That Improved Medical Students’ Knowledge and Confidence in Performing JVP Assessment

Badar Patel,1,2 Mary W Montgomery,1 Dana G Callahan,1 Hannah X Chen,1 Nora Y Osman,1 Eden Engel-Rebitzer,1,2 Stephen R Pelletier,3 Helen M Shields1 1Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA; 2Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA; 3Office of Medical Education, Harvard Medical School, Boston, MA, USACorrespondence: Helen M Shields, Department of Medicine, Brigham and Women’s Hospital, 75 Francis St, Boston, MA, 02115, USA, Tel +1 (617) 678-6077, Email [email protected]: Jugular venous pressure ultrasound (JVP US) augments the physical examination by allowing direct visualization of the jugular vein. While JVP US offers diagnostic advantages, there is limited literature describing methods for teaching JVP US to medical students. We describe methods by which medical students were trained to use JVP US as part of volume status assessment. We aimed to increase student knowledge as well as demonstrate students’ ability to apply bedside JVP US skills through this workshop.Patients and Methods: Ninety-one medical students completing a sub-internship in internal medicine participated in this study. All students received a brief didactic workshop on dyspnea, an overview of JVP US, and then a hands-on bedside practice session with JVP US on two volunteer patients. Students participated in the study by completing a pre-survey and post-survey which aimed to assess both knowledge and confidence.Results: After completing the JVP US training program, students demonstrated increased knowledge in multiple assessed survey questions. Additionally, they were more confident in their ability to distinguish the jugular vein from the carotid artery using color and pulse wave doppler (Pre- 2.67 to Post- 4.62; p < 0.001). Finally, students believed that JVP US added confidence to their estimation of JVP when added to the physical examination (Pre- 3.88 to Post- 4.64; p < 0.001).Conclusion: In this single-arm, non-randomized study, after a didactic workshop and structured bedside JVP US practice session, student surveys showed an increase in knowledge and self-reported confidence in the usage of JVP US as a complement to the physical examination for patients with dyspnea.Keywords: ultrasound, jugular venous pressure, medical education, bedside teaching, dyspnea, volunteer patients