Educational Innovation Award/Educational Research Award

“Coolest class ever.”

Point of care ultrasound allows us to be able to see inside a patient without scheduling them for X-Ray, moving them from their room, or worrying about ionizing radiation exposure. Images are obtained in real time, allowing quicker assessment and improved patient care. It has rapidly been incorporated into patient care in nearly every specialty, so it is important for our medical students to learn this skill. Introducing any curricular innovation, especially one that requires hands-on training, is challenging with a medical school class size of over 200 students. Even more daunting can be coordinating this new material with the rest of the curriculum to enhance and reinforce student learning.

Enter Drs. Sammy Pedram and Michael Joyce. Dr. Pedram joined the VCU faculty in 2009, and is Assistant Professor of Internal Medicine, Division of Pulmonary Diseases and Critical Care, Medical Director of the Resource Intensivist Program, and Co-Medical Director of the Pulmonary Fellows Clinic. He is certified in critical care ultrasonography from the American College of Chest Physicians (ACCP) and is a member of the Ultrasound Simulation Faculty of the ACCP. In 2012 he developed a formal curriculum in Critical Care Ultrasound for the Pulmonary and Critical Care fellows and continues to provide training and oversight. He has received the Distinguished Teaching Award, Outstanding Faculty Award, and Excellence in Teaching Awards from the Department of Internal Medicine.

As an attending, Dr. Pedram met intern Dr. Michael Joyce, who joined the VCU Faculty in 2015 as Assistant Professor of Emergency Medicine, after completing a fellowship in Emergency Clinical Ultrasound. As a registered diagnostic medical and cardiac sonographer, Dr. Joyce is a key ultrasound educator for our faculty, residents, and students.

Seeing ultrasound as an extension of the physical examination, Dr. Pedram and Dr. Joyce collaborated to design an ultrasound course for first year medical students. The Ultrasound Course is designed to complement the longitudinal Principles of Clinical Medicine (PCM) course, which introduces history taking and physical examination skills. Students learn using an asynchronous “flipped-classroom” model. Students must complete pre-course reading and video assignments, and their progress is tracked to assure all modules are successfully completed before the hands-on class session. Then, students attend small group, hands-on training with experienced instructors using standardized patients. Students receive one-on-one teaching and immediate feedback about their technique, image acquisition, and interpretation. Whenever possible, ultrasound sessions cover the same topics as students are covering in PCM, for example, learning cardiac ultrasound (echocardiography) along with heart auscultation.

The new course started in the 2016-17 academic year and was immediately a favorite of students – and those teaching them. As Thomas Iden, M.D., Assistant Professor, Division of Pulmonary and Critical Care Medicine and a small group leader in the PCM Course, explains, “the wonderment that emerges as a first-year medical student visualizes the heart for the first time while performing his/her initial cardiac ultrasound – a picture really is worth a thousand words.”

As Course Directors, Drs. Pedram and Joyce were not satisfied with the glowing feedback they received – they want to see if their course is making a real difference. At the first annual SOM Medical Education Symposium last spring, they presented their preliminary data, comparing PCM student OSCE scores pre- and post- ultrasound course. Their work received an Honorable Mention award, recognizing their creativity and rigorous approach to evaluating their work.

Future plans for the Ultrasound Course include expansion to integrate throughout medical school, and the development of learning resources to allow students to continue learning ultrasound skills while on clinical rotations. As Directors of the VCU Undergraduate Medical Student Ultrasound Course, Dr. Sammy Pedram and Dr. Michael Joyce benefit our students, and our patients, through their dedication to innovative teaching and educational scholarship.