Presentations

Abstract

Introduction:

One of the many benefits of student-led academic clubs is the opportunity for peer-to-peer education and peer-designed curricula. This style of learning has been shown to provide an excellent addition to traditional educational opportunities. One such program at EVMS is the EVMS Ultrasound (US) Club, which organizes ultrasound rounds in Emergency Medicine, OBGYN, Family Medicine, and soon in the intensive care unit. These rounds represent student-led initiatives to generate learning opportunities. This project aims to assess whether supplementing the faculty-designed curriculum with peer-to-peer student-organized ultrasound rounds provides improved subjective and objective clinical performance for US club members when compared to those students not involved in the ultrasound club and receive only the faculty-designed curriculum. Researchers and Master of Physician Assistant (MPA) program faculty analyzed student responses from a subjective survey of confidence levels involving ultrasound interpretation along with academic scoring of their Objective Structured Clinical Exam (OSCE) to evaluate whether such a benefit to student performance exists. Students from the graduating classes of 2023 - 2025 were invited to participate. Combining this survey and the ultrasound OSCE results would additionally allow faculty to establish subjective and objective benchmarks for each MPA class to determine the academic baseline of both member and non-member US Club students.

Methods:

MPA students at EVMS completed a REDCap survey that asked for class, membership in US Club, and if so how many club events they participated in. The survey then presented students with nine different, uninterpreted ultrasound images of commonly scanned images. All of the anatomical locations of these images were included in their ultrasound curriculum and previously evaluated by every student. For each window, students ranked their confidence from 1 (no confidence) to 4 (very confident) for each category: 1) acquiring a clinically significant image, 2) interpreting anatomy, and 3) interpreting pathology. Data was exported to Microsoft Excel where averages of confidence for each imaging window were stratified according to MPA class and participation in US Club. Individual student OSCE scores were viewed only by the faculty member who is the Course Director for the Ultrasound Program. This faculty member was provided a list of US Club MPA student members for the graduating classes of 2023-2025 and reported deidentified OSCE averages, again stratified by student participation in the US Club along with those students who were not members.

Results:

Consent was obtained from 105 MPA students who fully completed the initial survey. Of these respondents 19 were members of the US club and had participated an average 1.0 events. A two-tailed t-test found statistically significant differences (p<0.05) in average confidence of members (n=19) vs non-members (n=86) in all three above categories for all images, except in acquiring the sub-xyphoid window, interpreting lung pleura pathology and the female pelvic anatomy. All three categories for the Inferior Vena Cava (IVC) images demonstrated a statistically significant improvement for US club members in interpreting IVC pathology. MPA25 data was excluded from this analysis due to not yet having been instructed on this topic. Comparing MPA23 and '24 to MPA25 demonstrated statistically significant higher confidence in all windows for all categories.

Conclusion:

The timing of this initial survey at the beginning of the academic year was purposeful in order to capture baseline MPA25 data with minimal involvement in formal ultrasound curriculum and academic clubs. Longitudinal follow-up of MPA25 confidence will be necessary in order to obtain similar data points for comparison. Comparing MPA23 and '24 classes to the baseline MPA25 data suggests that the current ultrasound curriculum and other opportunities are effective in improving ultrasound confidence, which is expected. The overall lack of difference between members and non-members in MPA23 and '24 suggests that current participation in US Club does not provide a noticeable increase in self-perceived confidence for aggregate class data, but may have benefits to self-perception on an individual student basis. Finally, club membership and participation appeared relatively low compared to all survey participants which invites opportunities to explore ways to increase access to and participation in club events for MPA students.