Integrated Ultrasound Curriculum (iUSC)

First Year Students (M1)

Taught in conjunction with Gross Anatomy and Physiology

Fall Semester

Gross Anatomy

  • Introductory lecture during Orientation
  • “Knobology”
  • Cardiac ultrasound
  • Neck ultrasound (carotid artery, internal jugular vein, thyroid)
  • Pelvic ultrasound (urinary bladder)
  • Abdominal (hepatic, spleen, renal) ultrasound

Evaluated with Objective Structured Clinical Examination (OSCE)

Spring Semester

Physiology

  • Vascular hemodynamics (introduces concepts of color flow and doppler to demonstrate direction of flow and measurement of velocity, recognition of arterial and venous wave forms)
  • Cardiac hemodynamics (normal function) Wall and valve motion, flow through cardiac chambers

Evaluated for cardiogenic shock: gross LV/RV function and size, gross valve function
Evaluated with the addition of case-based multiple choice test questions to standard Physiology quizzes and tests

Second Year Students (M2)

Expansion of M1 curriculum, coordinated with lecture topics in Pathology/Pathophysiology and Physical Diagnosis

Activities coordinated with Introduction to Clinical Medicine (ICM)

Fall Semester

Physical Diagnosis

  • All standard cardiac views
  • General abdominal ultrasound

Pathophysiology

  • Abdominal aorta (AAA screen)
  • Lower extremity vascular (DVT screen)

Evaluating based on Web-based modules with multiple choice questions, “open book” multiple choice quiz

Spring Semester

Pathophysiology

  • Pelvic ultrasound (female gynecology)
  • Vascular ultrasound (inferior vena cava for volume status estimation)
  • Cardiogenic shock
  • Ultrasound guided procedures
  • (uses ultrasound phantoms)

Evaluated with OSCE

Third Year Students (M3)

Thirty pocket-size, hand-held ultrasound units (GE Healthcare Vscan) have been purchased for integration into the third year family medicine, pediatrics, and internal medicine clerkship training programs. These units have been purchased with a grant from the Fullerton Foundation. Please see the Grants page for more information about this project.

Most core clerkships have an ultrasound learning component and OSCE

Internal Medicine – thyroid, central line placement

OB/Gyn – pregnancy with bleeding

Surgery – FAST exam

Family Medicine – AAA

Pediatrics – HOCM, situs inversus, dehydration

Hospital "Gel" Rounds - Clinical ultrasound rounds at affiliated hospitals

Fourth Year Students (M4)

  • Review of essential skills
  • Elective in emergency bedside ultrasound
  • Capstone workshop

Delivery of Course Content Ultrasound Labs

Primarily hands-on labs: 1 hour groups

  • May have brief (max 30 minutes, usually less than 10 minutes) pre-lab lecture/demonstration
  • Occasional (usually no more than 1/semester) longer classroom lecture for complex topics
  • Group size of ~ 20 students, 4 faculty preceptors, 4-5 standardized patients
  • 2-4 “open lab sessions”/semester, 2 hours each, staffed by iUSC faculty (1 or 2 faculty per session)

Web-based Modules

  • Cover a wide range of topics from ultrasound physics to specific clinical indications
  • Demonstrate relevant technique plus discuss evidence based guidelines for use of ultrasound in the clinical setting
  • Include ultrasound images and loops
  • Generally 12-15 minutes in length

Ultrasound Image Portal

A secure web-base ultrasound image portal is used to transmit and archive images that students create. This allows faculty reviewers to assess image quality and give feedback to the students and also serves to document the progress of the student’s ultrasound skills over time.