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

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. (C) 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.