bowra, justin - 21st century ultrasound education
DESCRIPTION
Sonophiliac, Justin Bowra highlights strategies for teaching our juniors to become adept at utilising bedside ultrasound in critical care settingsTRANSCRIPT
ULTRASOUND: the last art?
THE FUTURE OF ULTRASOUND EDUCATION
Justin Bowra
Sydney Australia
About me
Emergency physician
Ultrasound nut
Sydney
Declaration
Signostics medical advisory board
The future
No US
Ask radiology
Why don’t I do the scan?
The past
The most senior dr poses a question
The most senior dr poses a question
The most junior dr orders the test
The most junior dr orders the test
The radiologist queries the test
The junior begs for the test
The sonographer summons the patient
The wardsman brings the patient
The scan is performed
The patient arrests in Radiology
The goal
The goal
The goal
The present
How we got here
• Bedside machines
• Pioneers
• Pilot studies
• Introductory courses
• Standards & guidelines
• Mandatory training
One day we will all be sonophilic
But we’re not there yet
The future of US education
Driven by technology
Removing the barriers
THE NEW TEXTBOOKS
WEBSITES
eBOOKS
SMARTPHONE APPS
WEBSITES
123sonography.com
ASUM Scholar
EMCrit
Life In the Fast Lane
Sonoworld
Sonoguide
SonoSite e-Learning
Ultrasoundpodcast
Smartphone Apps
1 minute US
Echo calc
Echocardio
Pocket atlas of Emergency US
Sonoaccess
Echo Calc (BSE)
X
Xxxxxxxxxxxxxx
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Description
Make an ultrasound with your mobile phone and watch the baby of your pregnant girlfriend!
Description
Make an ultrasound with your mobile phone and watch the baby of your pregnant girlfriend!
… Of course there is this app is just a fun app, because it is technically not possible to
ultrasound with a smartphone.
Trash or treasure?
http://www.imedicalapps.com/2013/12/top-emergency-medicine-ultrasound-apps/
http://www.imedicalapps.com/
iMedicalApps is an independent online medicalpublication written by a team of physicians andmedical students who provide commentary andreviews of mobile medical technology andapplications. We receive over 400,000 views amonth by the medical community. Reviews andcommentary are based on our own experiencesin the hospital and clinic setting and creativeand content control are strictly managed by themedical professionals running the site.
iMedicalApps is an online medical publication, from America, created by independent physician editors, who lead a team of physicians and allied
health professionals, in reviewing mobile medical technology and applications for medical
professionals….
iMedicalApps is an online medical publication, from America, created by independent physician editors, who lead a team of physicians and allied
health professionals, in reviewing mobile medical technology and applications for medical
professionals….
… Its reviews and comments are clearly of a high standard; hence it has been referred to by the Cochrane Collaboration, as an evidence-based
trusted Web 2.0 Website.
… Its reviews and comments are clearly of a high standard; hence it has been referred to by the Cochrane Collaboration, as an evidence-based
trusted Web 2.0 Website.
What does a teacher do?
Curriculum setterContent provider
GatekeeperDemonstrator
Role modelFeedback Mentor
Machines that teach
X
Quality assurance
Quality assurance
Can we automate it?
X
Are we done?
The last constraint
The last constraint
• The hardware?
Anatomy As Never Seen Before
Anatomy As Never Seen Before
(15-6MHz)
Radial artery comparison
Anatomy As Never Seen Before
M-Turbo L25 (13-6MHz)
Radial artery comparison
Vevo 50MHz
The last constraint
• The hardware? X
The last constraint
• The hardware? X
• The software?
The last constraint
• The hardware? X
• The software? X
The last constraint
• The hardware? X
• The software? X
• The algorithms?
No US
FASTEFAST
RUSH ?
The last constraint
• The hardware? X
• The software? X
• The algorithms? X
The last constraint
• The hardware? X
• The software? X
• The algorithms? X
• The operator
Ultrasound: the last art
The last art
• Apprenticeship
• Performed by hand
• Operator dependent
• Prone to error
What happens to handicrafts during a technological revolution?
The industrial revolution
• The scribe
• The sage
• The miller
• The blacksmith
The digital revolution
• The travel agent
• The secretary
• The interpreter
• The accountant
The digital revolution
• The secretary
• The travel agent
• The interpreter
• The accountant
• The sonographer
• (The doctor?)
The future of US is operator-independent.
The dream
The dream
High quality panoramic images
The dream
High quality panoramic images
Doppler
The dream
High quality panoramic images
Doppler
Rapid (one second)
The dream
High quality panoramic images
Doppler
Rapid (one second)
At the touch of a button
One day? Soon? Never?
1977
X
Don’t worry about the future of US…
Because you won’t be part of it.
Thanks to…
Dirk Bass
Zoltan Galambos
Alan Giles
Kimberley Poole
Dave Willis
References • http://www.asum.com.au/newsite/Files/Documents/History/Posters_new/Poster1
0.pdf
• Biegler N et al. Just-in-time cost-effective off-the-shelf remote telementoring of paramedical personnel in bedside lung sonography-a technical case study. TelemedJ E Health. 2012 Dec;18(10):807-9
• Bowra J, Forrest-Horder S, Caldwell E, Cox M, Damours S. Validation of Nurse-Performed FAST Ultrasound. Injury, Int. J. Care Injured 41 (2010) 484–487
• Life In The Fast Lane
References
• Perera P et al. The RUSH exam 2012
• www.Resus.me
• Su MJ et al. Application of tele-ultrasound in emergency medical services. TelemedJ E Health. 2008 Oct;14(8):816-24
• Takeuchi R et al. Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology. J Med Syst. 2008 Jun;32(3):235-42.
• www.Ultrasoundpodcast.com