1. The Ultrasound Curriculum in Medical Education Session Design, Integration and Hands-On Experience Echocardiography Group

2. Considerations for Design and Implementation Curriculum Format Class size/number of student participants Faculty availability Resources (access to ultrasound machines, sim machines, standardized patients) Target audience/level of learners For this sample module, we are assuming learners are MS 1/2 (preclinical) with basic understanding of knobology, basic principles of ultrasound, some scanning exposure, basic knowledge of cardiac anatomy and physiology

3. Overview of Potential Structure of Modules The Heart through ultrasonography Cardiac Physiology Cardiac Physical Diagnosis Cardiac Pathology Cardiac Anatomy

4. Goals and Learning Objectives Goal: Understand the basic structure of the heart through the use of standard ultrasound. LO’s: – Identify the major structures (chambers and valves) in ultrasound images of the heart. – Properly orient the patient to obtain (or recognize and describe) the standard views of transthoracic cardiac ultrasound and identify the utility of each view. – Demonstrate sensitivity to the patient while performing cardiac ultrasound. (Assumes students are scanning).

5. Potential LO’s for Future Sessions Physiology (including introduction to Doppler on ultrasound) – Correlate events in the cardiac cycle with their appearance on ultrasound. Physical Diagnosis – Effectively communicate findings to patient, other student, or other healthcare professionals – Relate echocardiographic views to cardiac auscultations Pathology – Understand how valvular dysfunction alters normal doppler flow on ultrasound.

6. Prework Goal: Review cardiac anatomy and physiology, basic components of ultrasonography – Possible approaches to accomplish goal: Online modules (with or without assessment quiz) Lecture based session Textbook readings – Possible formative assessment of prework completion/understanding

7. Module Structure Review of prework – TBL session, clicker questions integrated into a large group session Break into smaller groups for ultrasound component – Scanning session or demonstration by faculty or simulation session – Approach implemented determines students’ skill acquisition

8. Apical 4 Chamber Parasternal Short Axis Parasternal Long Axis Pulmonic Valve, RVOT (sometimes) Aorta LV, RV, mitral valve LA Tricuspid Valve, RA Aortic Valve

9. Assessment of Students Computer module to test students’ ability to properly identify probe placement and/or 3 dimensional plane of echo images. Case vignette to ask students which cardiac view would be appropriate to evaluate necessary structures.

10. Sample Student Assessment (MS 1) 35 year old woman with mitral valve prolapse Which cardiac ultrasound view(s) is/are most appropriate to visualize the pathologic structure(s)? Explain your reasoning.

11. Sample Student Assessment (MS 2) 35 year old woman presents to the ER with atypical chest pain and shortness of breath. She is found to have a murmur and click on cardiac auscultation. (could also give presentation and have students listen to the heart sounds with headphones and identify the murmur and click themselves). Which cardiac ultrasound view(s) is/are most appropriate to visualize the pathologic structure(s)? Explain your reasoning.