The primary care clinician is faced with a wide variety of clinical scenarios for which bedside ultrasound can assist in diagnoses, therapeutics, management, procedures, and ultimately, improved patient outcomes.
Bedside ultrasound (point-of-care ultrasound) describes the use of a portable ultrasound device by the treating clinician as an adjunct to the physical examination of a patient. Bedside ultrasound is being increasingly integrated into clinical practice and is gaining widespread use across diverse medical specialties, professions, sites, and continents (Moore and Copel, 2011). In Canada, bedside ultrasound is being used by Family Physicians as a screening tool, an adjunct to the clinical assessment, and an aid for visually guided procedures.
Accordingly, more emphasis is being directed to the teaching of bedside ultrasound.
Undergraduates: In October 2013, Dr. Peter Steinmetz, assistant professor in the Department of Family Medicine at McGill University, introduced a problem-based, hands-on bedside ultrasound course for undergraduate medical students, making it the first university in Canada to integrate ultrasound teaching throughout its four-year undergraduate medical school curriculum.
Postgraduates: In February 2014, Dr. Steinmetz co-founded a bedside ultrasound course with Dr. John Lewis for Family Medicine Residents at McGill University, again a first in Canada. The course uses a problem-based approach to improve the bedside ultrasound skills of primary care providers.
CME: Dr. Steinmetz and Dr. Lewis designed the Bedside Ultrasound Course for Primary Care Clinicians in 2013. Over 100 clinicians from across Canada have completed the course in the first year. The course is a problem-based, hands-on two-day course. It allows participants to scan up to thirty different standardized patients in a supervised setting. Participants tailor the course to their clinical reality through their choice of applications. For further information, please contact Fergus Grieve at medsimcentre [at] mcgill.ca
Curriculum: The course textbook, objectives, evaluation forms, and pre- and post-course tests are all aligned to maximize skill acquisition. The textbook, “Bedside Ultrasound-Level 1” by Dr. Steinmetz (A-line Press), and companion online videos express topics simply and clearly. The textbook is also available as an iBook with embedded interactive images and videos. Dr. Steinmetz was awarded a prize in 2015 for this book from the College Québécois des Médecins Famille (Prix d’excellence: Contribution à la formation continue et à la vulgarisation scientifique). The book has also received excellent positive feedback from students, residents, and clinicians.
Courses are held at the Arnold and Blema Steinberg Medical Simulation Centre, in Montreal, Canada. The SIM Centre has 8-10 new state-of-the-art portable ultrasound machines on site at all times and several ultrasound simulators programmed to demonstrate pathology. There is an excellent instructor to learner ratio (1:2) and instructors have extensive expertise in teaching bedside ultrasound. The Residents' comment that this course is one of the highlights of the year!
Annual World Congress of Ultrasound in Medical Education in Montreal, Canada in 2017
The Annual World Congress on bedside ultrasound in medical education will be held in Canada for the first time! Dr. Steinmetz, Dr. Maxime Valois, and Dr. Lewis are co-chairs of the local organizing committee and they have already begun preparations for this exciting event. The year 2017 marks the 375th anniversary of our city and the World Congress will benefit from the vibrancy of planned events during this time.
The use of bedside ultrasound in resource-poor countries is increasing due to the effectiveness, portability, and relative affordability of this technology. Dr. Steinmetz has been invited to teach bedside ultrasound in Asia (Thailand) and in Africa (Rwanda). After visiting seven urban and rural district hospitals in Rwanda with the NGO initiative, Physicians Ultrasound in Resource-limited Environments (PURE), he developed “The HAPPY Baby Screening Tool” to detect high-risk pregnancies by identifying five basic ultrasound signs of a healthy baby prior to delivery.
Dr. Steinmetz, Dr. Sharon Oleskevich (PhD) and their research team of medical students, research scientists, and senior clinicians are investigating the role of bedside ultrasound in telemedicine, undergraduate teaching, and diagnostic accuracy:
1. Brisson, A.M, Steinmetz, P., Oleskevich, S., Lewis, J., Reid, A. (2015) A comparison of telemedicine teaching to in-person teaching for the acquisition of an ultrasound skill – a pilot project. J Telemed Telecare (in press). Click here for abstract #1
2. Steinmetz, P., Oleskevich, S. Lewis, J. (2015) Quantitative assessment of skill acquisition by medical students after bedside ultrasound instruction. Can Med Assoc J (manuscript in progress). Click here for abstract #2
3. Dobrescu, O., Steinmetz, P., Oleskevich, S., Lewis, J. (2015) National survey on undergraduate bedside ultrasound education in Canada (manuscript in progress). Click here for abstract #3
4. Steinmetz, P., Oleskevich, S., Lewis, J., Gruber, D., McCusker, J., (2015) Does bedside ultrasound improve a medical student’s accuracy in diagnosing a pleural effusion? (in progress).