Expectations and Outcomes for the Development of an

Expectations and Outcomes for the Development of an Ultrasound Curriculum in a Resource-limited Environment R Berkowitz MD, JW Mangan MD, G Rose MD, K Cramer MD, T Saul MD, S Siadecki MD, R Sunderwirth MD, K Chhaganlal MD, S Buttar MD Introduction Emergency medicine physicians from developed countries are increasingly traveling to resource-limited countries to teach courses and establish new programs. Point-of-care US is a particularly valuable tool in these settings and demand for learning this skill is growing. Objective The objective was to evaluate curriculum choices when entering an unfamiliar medical environment. Questions posed included: 1) Could we design appropriate didactics without preforming a formal needs assessment? 2) Would surveying trainees before the course be instructive? Methods Demographics Future specialty # of students Medicine Surgery Pediatrics Ob/Gyn Cardiology Neurosurgery Public health 4 2 5 5 2 1 1 Access to machine Previous instruction Results # of students Hands-on teaching Lectures 17 Assigned reading 4 Other 0 12 # of students Yes No 16 4 Results • Overall, instructors accurately identified the diseases perceived by students as most prevalent and deadly A group of physicians traveled to Beira, Mozambique to teach a three-day course in point-of-care US for 20 fifthyear medical students, and to spend time as observers in the university hospital. • Instructors rated FASH, OB, and IV access as the most useful US modalities before the course, and thoracic and procedural guidance highest after the course. The curriculum was based on twelve lecture topics followed by hands-on practice. • Students rated cardiac and late OB highest before the course. Afterwards, answers were more evenly distributed, but one month later, they again favored cardiac and OB. Instructors and students were surveyed before and after the course. Students were again surveyed 1 month after course completion. • No students rated IV access or procedural guidance highly at any time. 33% recommended adding transcranial US. Conclusions Based on limited research of the local epidemiology and medical system, instructors designed a course for medical students that was well-received. However, based on survey results, the curriculum could have been improved by several changes: less focus on IV access and soft tissue/musculoskeletal evaluation, more emphasis of transcranial applications. Students’ input before training may be worth considering.