Session: SAT 281-290-Comparative Effectiveness/Health Outcomes/Quality Improvement/Patient or Provider Education/Endocrine Emergencies
Poster Board SAT-283
Shana Stevens, MD; Frank Dong, PhD; Justin B. Moore, MD; University of Kansas School of Medicine-Wichita
Background: Multiple studies have confirmed its ease of use as an adjunct to the bedside physical examination, even in minimally trained practitioners. We hypothesized that augmenting instruction of the physical examination of the thyroid with handheld ultrasound would improve student physical examination skills, even if the ultrasound was not used in later encounters.
Methods: Through an unblinded, prospective, two-arm randomized controlled trial, this study compared the current standard of instruction for physical examination at KUSM-W –preceptor coaching accompanied by student practice throughout a clerkship—to similar instruction augmented by the use of hand-held ultrasound. Subjects were assessed with a pretest and a posttest that assessed their ability to determine the presence or absence of thyroid nodules and goiters through physical examination.
Results: A total of 13 medical students were enrolled in this study, where 6 were assigned to the control group (preceptor coaching), and 7 were assigned to the intervention group (hand-held ultrasound teaching). These 6 medical students examined 70 standard patients, and 7 medical students examined 81 standard patients. At baseline, the groups were not statistically significantly different in terms of clerkship order or ability to detect thyroid abnormalities on physical examination of the neck (p=0.79). After randomization to ultrasound-augmented instruction or traditional instruction, subjects did not show a difference in their ability to detect thyroid abnormalities (31% correct in traditional group vs. 30% correct in ultrasound-augmented group, p=0.81).
Conclusions: Ultrasound-augmented physical examination training is not superior to traditional instruction in regards to the outcome of students’ ability to accurately judge the presence or absence of thyroid nodules and goiters.
Nothing to Disclose: SS, JBM, FD
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