Beyond Bones: Assessing Whether Ultrasound‐Aided Instruction and Practice Improve Unassisted Soft Tissue Palpation Skills of First‐Year Medical Students

Objectives Our purpose was to determine whether ultrasound (US)‐aided instruction and practice on musculoskeletal anatomy would improve first‐year medical students’ ability to locate and identify specific soft tissue structures by unaided palpation in the upper and lower extremities of healthy human...

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Veröffentlicht in:Journal of ultrasound in medicine 2019-08, Vol.38 (8), p.2047-2055
Hauptverfasser: Walrod, Bryant J., Boucher, Laura C., Conroy, Mark J., McCamey, Kendra L., Hartz, Clinton A., Way, David P., Jonesco, Michael A., Albrechta, Steven, Bockbrader, Marcia, Bahner, David P.
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container_end_page 2055
container_issue 8
container_start_page 2047
container_title Journal of ultrasound in medicine
container_volume 38
creator Walrod, Bryant J.
Boucher, Laura C.
Conroy, Mark J.
McCamey, Kendra L.
Hartz, Clinton A.
Way, David P.
Jonesco, Michael A.
Albrechta, Steven
Bockbrader, Marcia
Bahner, David P.
description Objectives Our purpose was to determine whether ultrasound (US)‐aided instruction and practice on musculoskeletal anatomy would improve first‐year medical students’ ability to locate and identify specific soft tissue structures by unaided palpation in the upper and lower extremities of healthy human models. Methods This study was a randomized crossover design with 49 first‐year medical students randomly assigned to 1 of 2 groups. Each group was provided expert instruction and hands‐on practice using US to scan and study soft tissue structures. During session 1, group A learned the anatomy of the upper extremities, whereas group B learned the lower. Students were then tested on their proficiency in locating 4 soft tissue structures (2 upper and 2 lower extremities) through palpation of a human model. During session 2, group A learned lower extremities, and group B learned upper. At the end of session 2, students repeated the assessment. Results After the first instructional session, neither group performed significantly better on identifying and locating the soft tissue landmarks they learned aided by US. After the second instructional session, however, scores for both groups increased approximately 20 percentage points, indicating that both groups performed significantly better on palpating and identifying both the upper and lower extremity soft tissue landmarks (Cohen d = 0.89 and 0.82, respectively). Conclusions Time and practice viewing soft tissue structures with US assistance seems to have a “palpation‐with‐eyes” effect that improves students’ abilities to correctly locate, palpate, and identify limb‐specific soft tissue structures once the US assistance is removed.
doi_str_mv 10.1002/jum.14894
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Methods This study was a randomized crossover design with 49 first‐year medical students randomly assigned to 1 of 2 groups. Each group was provided expert instruction and hands‐on practice using US to scan and study soft tissue structures. During session 1, group A learned the anatomy of the upper extremities, whereas group B learned the lower. Students were then tested on their proficiency in locating 4 soft tissue structures (2 upper and 2 lower extremities) through palpation of a human model. During session 2, group A learned lower extremities, and group B learned upper. At the end of session 2, students repeated the assessment. Results After the first instructional session, neither group performed significantly better on identifying and locating the soft tissue landmarks they learned aided by US. After the second instructional session, however, scores for both groups increased approximately 20 percentage points, indicating that both groups performed significantly better on palpating and identifying both the upper and lower extremity soft tissue landmarks (Cohen d = 0.89 and 0.82, respectively). Conclusions Time and practice viewing soft tissue structures with US assistance seems to have a “palpation‐with‐eyes” effect that improves students’ abilities to correctly locate, palpate, and identify limb‐specific soft tissue structures once the US assistance is removed.</description><identifier>ISSN: 0278-4297</identifier><identifier>EISSN: 1550-9613</identifier><identifier>DOI: 10.1002/jum.14894</identifier><identifier>PMID: 30561028</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Clinical Competence - statistics &amp; numerical data ; Cross-Over Studies ; Curriculum ; Education, Medical, Undergraduate - methods ; Extremities - anatomy &amp; histology ; Humans ; musculoskeletal system ; Musculoskeletal System - anatomy &amp; histology ; Palpation - methods ; Physical Examination ; regional anatomy ; Students, Medical ; Ultrasonography - methods ; ultrasound ; undergraduate medical education</subject><ispartof>Journal of ultrasound in medicine, 2019-08, Vol.38 (8), p.2047-2055</ispartof><rights>2018 by the American Institute of Ultrasound in Medicine</rights><rights>2018 by the American Institute of Ultrasound in Medicine.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3914-b1c310c0df3a2e8abb6e04840d95a4015fd746dee99875ded68ccfcaa43e82a53</citedby><cites>FETCH-LOGICAL-c3914-b1c310c0df3a2e8abb6e04840d95a4015fd746dee99875ded68ccfcaa43e82a53</cites><orcidid>0000-0002-1896-3425</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjum.14894$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjum.14894$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30561028$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walrod, Bryant J.</creatorcontrib><creatorcontrib>Boucher, Laura C.</creatorcontrib><creatorcontrib>Conroy, Mark J.</creatorcontrib><creatorcontrib>McCamey, Kendra L.</creatorcontrib><creatorcontrib>Hartz, Clinton A.</creatorcontrib><creatorcontrib>Way, David P.</creatorcontrib><creatorcontrib>Jonesco, Michael A.</creatorcontrib><creatorcontrib>Albrechta, Steven</creatorcontrib><creatorcontrib>Bockbrader, Marcia</creatorcontrib><creatorcontrib>Bahner, David P.</creatorcontrib><title>Beyond Bones: Assessing Whether Ultrasound‐Aided Instruction and Practice Improve Unassisted Soft Tissue Palpation Skills of First‐Year Medical Students</title><title>Journal of ultrasound in medicine</title><addtitle>J Ultrasound Med</addtitle><description>Objectives Our purpose was to determine whether ultrasound (US)‐aided instruction and practice on musculoskeletal anatomy would improve first‐year medical students’ ability to locate and identify specific soft tissue structures by unaided palpation in the upper and lower extremities of healthy human models. Methods This study was a randomized crossover design with 49 first‐year medical students randomly assigned to 1 of 2 groups. Each group was provided expert instruction and hands‐on practice using US to scan and study soft tissue structures. During session 1, group A learned the anatomy of the upper extremities, whereas group B learned the lower. Students were then tested on their proficiency in locating 4 soft tissue structures (2 upper and 2 lower extremities) through palpation of a human model. During session 2, group A learned lower extremities, and group B learned upper. At the end of session 2, students repeated the assessment. Results After the first instructional session, neither group performed significantly better on identifying and locating the soft tissue landmarks they learned aided by US. After the second instructional session, however, scores for both groups increased approximately 20 percentage points, indicating that both groups performed significantly better on palpating and identifying both the upper and lower extremity soft tissue landmarks (Cohen d = 0.89 and 0.82, respectively). Conclusions Time and practice viewing soft tissue structures with US assistance seems to have a “palpation‐with‐eyes” effect that improves students’ abilities to correctly locate, palpate, and identify limb‐specific soft tissue structures once the US assistance is removed.</description><subject>Clinical Competence - statistics &amp; numerical data</subject><subject>Cross-Over Studies</subject><subject>Curriculum</subject><subject>Education, Medical, Undergraduate - methods</subject><subject>Extremities - anatomy &amp; histology</subject><subject>Humans</subject><subject>musculoskeletal system</subject><subject>Musculoskeletal System - anatomy &amp; histology</subject><subject>Palpation - methods</subject><subject>Physical Examination</subject><subject>regional anatomy</subject><subject>Students, Medical</subject><subject>Ultrasonography - methods</subject><subject>ultrasound</subject><subject>undergraduate medical education</subject><issn>0278-4297</issn><issn>1550-9613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFu1DAQhi0EokvhwAsgH-GQ1nbsxOG2rWi7qBWVtivEKfLaE-riJFuPQ7U3HoEH6NPxJJhu4cZpNNI3n2bmJ-Q1ZwecMXF4M_UHXOpGPiEzrhQrmoqXT8mMiVoXUjT1HnmBeJNRxmv5nOyVTFWcCT0j90ewHQdHj8YB8D2dIwKiH77Sz9eQriHSVUjR4DgN7tePn3PvwNHFgClONvlxoCbPXkaTGwt00W_i-B3oajBZgimzy7FL9MojTkAvTdiYh6nlNx8C0rGjJz5iyuYvYCK9AOetCXSZJgdDwpfkWWcCwqvHuk9WJx-ujs-K80-ni-P5eWHLhstizW3JmWWuK40AbdbrCpjUkrlGGcm46lwtKwfQNLpW-YJKW9tZY2QJWhhV7pO3O29e_3YCTG3v0UIIZoBxwlZwpYVkQomMvtuhNo6IEbp2E31v4rblrP0TRpvDaB_CyOybR-207sH9I_9-PwOHO-DOB9j-39R-XF3slL8B2XSZHw</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Walrod, Bryant J.</creator><creator>Boucher, Laura C.</creator><creator>Conroy, Mark J.</creator><creator>McCamey, Kendra L.</creator><creator>Hartz, Clinton A.</creator><creator>Way, David P.</creator><creator>Jonesco, Michael A.</creator><creator>Albrechta, Steven</creator><creator>Bockbrader, Marcia</creator><creator>Bahner, David P.</creator><general>John Wiley &amp; 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histology</topic><topic>Humans</topic><topic>musculoskeletal system</topic><topic>Musculoskeletal System - anatomy &amp; histology</topic><topic>Palpation - methods</topic><topic>Physical Examination</topic><topic>regional anatomy</topic><topic>Students, Medical</topic><topic>Ultrasonography - methods</topic><topic>ultrasound</topic><topic>undergraduate medical education</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walrod, Bryant J.</creatorcontrib><creatorcontrib>Boucher, Laura C.</creatorcontrib><creatorcontrib>Conroy, Mark J.</creatorcontrib><creatorcontrib>McCamey, Kendra L.</creatorcontrib><creatorcontrib>Hartz, Clinton A.</creatorcontrib><creatorcontrib>Way, David P.</creatorcontrib><creatorcontrib>Jonesco, Michael A.</creatorcontrib><creatorcontrib>Albrechta, Steven</creatorcontrib><creatorcontrib>Bockbrader, Marcia</creatorcontrib><creatorcontrib>Bahner, David P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of ultrasound in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walrod, Bryant J.</au><au>Boucher, Laura C.</au><au>Conroy, Mark J.</au><au>McCamey, Kendra L.</au><au>Hartz, Clinton A.</au><au>Way, David P.</au><au>Jonesco, Michael A.</au><au>Albrechta, Steven</au><au>Bockbrader, Marcia</au><au>Bahner, David P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Beyond Bones: Assessing Whether Ultrasound‐Aided Instruction and Practice Improve Unassisted Soft Tissue Palpation Skills of First‐Year Medical Students</atitle><jtitle>Journal of ultrasound in medicine</jtitle><addtitle>J Ultrasound Med</addtitle><date>2019-08</date><risdate>2019</risdate><volume>38</volume><issue>8</issue><spage>2047</spage><epage>2055</epage><pages>2047-2055</pages><issn>0278-4297</issn><eissn>1550-9613</eissn><abstract>Objectives Our purpose was to determine whether ultrasound (US)‐aided instruction and practice on musculoskeletal anatomy would improve first‐year medical students’ ability to locate and identify specific soft tissue structures by unaided palpation in the upper and lower extremities of healthy human models. Methods This study was a randomized crossover design with 49 first‐year medical students randomly assigned to 1 of 2 groups. Each group was provided expert instruction and hands‐on practice using US to scan and study soft tissue structures. During session 1, group A learned the anatomy of the upper extremities, whereas group B learned the lower. Students were then tested on their proficiency in locating 4 soft tissue structures (2 upper and 2 lower extremities) through palpation of a human model. During session 2, group A learned lower extremities, and group B learned upper. At the end of session 2, students repeated the assessment. Results After the first instructional session, neither group performed significantly better on identifying and locating the soft tissue landmarks they learned aided by US. After the second instructional session, however, scores for both groups increased approximately 20 percentage points, indicating that both groups performed significantly better on palpating and identifying both the upper and lower extremity soft tissue landmarks (Cohen d = 0.89 and 0.82, respectively). Conclusions Time and practice viewing soft tissue structures with US assistance seems to have a “palpation‐with‐eyes” effect that improves students’ abilities to correctly locate, palpate, and identify limb‐specific soft tissue structures once the US assistance is removed.</abstract><cop>Hoboken, USA</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>30561028</pmid><doi>10.1002/jum.14894</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1896-3425</orcidid></addata></record>
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subjects Clinical Competence - statistics & numerical data
Cross-Over Studies
Curriculum
Education, Medical, Undergraduate - methods
Extremities - anatomy & histology
Humans
musculoskeletal system
Musculoskeletal System - anatomy & histology
Palpation - methods
Physical Examination
regional anatomy
Students, Medical
Ultrasonography - methods
ultrasound
undergraduate medical education
title Beyond Bones: Assessing Whether Ultrasound‐Aided Instruction and Practice Improve Unassisted Soft Tissue Palpation Skills of First‐Year Medical Students
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