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J Surg Educ. 2017 May 4. pii: S1931-7204(16)30380-4. doi: 10.1016/j.jsurg.2017.03.007. [Epub ahead of print]

Effectiveness of a 1-Hour Extended Focused Assessment With Sonography in Trauma Session in the Medical Student Surgery Clerkship.

Author information

1
Department of Surgery, Loma Linda University, Loma Linda School of Medicine, Loma Linda, California. Electronic address: ckrause@llu.edu.
2
Department of Surgery, Loma Linda University, Loma Linda School of Medicine, Loma Linda, California.
3
Department of Surgery, Loma Linda University, Loma Linda, California.
4
Department of Emergency Medicine, Loma Linda University, Loma Linda, California.
5
Department of Emergency Medicine, Loma Linda University, Loma Linda, California; Department of Medicine, Loma Linda University, Loma Linda, California.

Abstract

OBJECTIVE:

To demonstrate the effectiveness of incorporating 1 hour of ultrasound training on the extended focused assessment with sonography in trauma (eFAST) into the year-3 medical student surgical clerkship.

DESIGN:

A prospective cohort study where participants served as self-controls. One hour of instruction in the eFAST examination, along with 3 required observed examinations, was incorporated into the year-3 surgery clerkship. Effectiveness of the training was evaluated by a preliminary and posttraining assessment. An online survey was used assessing comfort based on a 5-point Likert scale. An online quiz was used assessing knowledge, and a 2-part objective structured clinical examination (OSCE) was used assessing skill and speed. Participants also logged 3 eFAST examinations during the 10-week clerkship where they reported their comfort in performing and interpreting the eFAST on a 5-point Likert scale. Postassessment was held during the last week of the clerkship and included the same online quiz, survey, and 2-part OSCE.

SETTING:

The study was performed at Loma Linda University and affiliated hospitals where surgical clerkship students rotate.

PARTICIPANTS:

A total of 148 year-3 medical students completed the study.

RESULTS:

All testing modalities showed improvement. The mean average of the OSCE improved from 46% ± 27% to 81% ± 18%. The percentage of participants able to perform the examination in less than 6 minutes increased from 18% ± 27% to 84% ± 36%. Participants' comfort level in recognizing eFAST pathology increased from a mean of 2.40 ± 0.94 to 3.55 ± 0.87 out of 5. Comfort in performing the eFAST examination improved from 2.81 ± 0.79 to 3.77 ± 0.68. Comfort in interpreting the eFAST examination improved from 2.88 ± 0.87 to 3.65 ± 0.72.

CONCLUSIONS:

This study demonstrates that incorporating 1 hour of eFAST training into the general surgery clerkship is feasible and may lead to improved competency in performing and interpreting the eFAST examination.

KEYWORDS:

Medical Knowledge and Patient Care; medical education; medical student; surgery; ultrasound

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