New York American College of Emergency Physicians

Tyler Yates, MD

PGY3 Resident Staten Island University Hospital

Maria Tama, MD RDMS

Ultrasound Co-Director Staten Island University Hospital

Simone Rudnin, DO

Ultrasound Co-Director Staten Island University Hospital

Embracing Novel Methods of Medical Teaching: Sono in Wonderland

Background:

Traditional conference didactics may not always meet the learning needs of current emergency medicine (EM) residents. ACGME guidelines recommend a minimum of 16 hours of formal classroom education in ultrasound but it is unclear how this time can be utilized most effectively. EM education has been on the forefront to adopt active-learning strategies (e.g., flipped model classroom) to compliment traditional didactic lecturing. Research in medical education suggests these active learn – ing techniques, (e.g., peer-assisted learning, problem solving and hands-on experiential learning) are effective in engaging learners and enhancing knowledge retention. However, research is scarce regarding the best means of didactic ultrasound education. This could be due in large part to a lack of established educa – tional strategies that can be used for ultrasound teaching. The aim of the current project was to expand our toolbox of effective ultrasound teaching methods.

The purpose of Sono in Wonderland was to teach both core emergency medicine ultrasound as well as advanced ultrasound applications and pathology recognition. During this event, trainees learned about various pathologies, recognized common ultrasound signs and symbols and exercised procedural skills. This innovation was designed to create an environment that fosters competition and teamwork, as groups of students raced to complete ultrasound tasks and challenges.

Objectives:

Create new methods of ultrasound education that employ active learning
Assess resident engagement in team-based active learning activities that focus on problem-solving using ultrasound

Methodology:

Six teams of residents of mixed post-graduate years competed in three time-limited rounds that progressively built upon each other in order to advance to the subsequent round.

Round 1: Kahoot

An initial team score was acquired from a Kahoot quiz. The quiz tested general ultrasound fund of knowledge in multiple-choice format.

Round 2: Escape Wonderland

Task 1: A matching game was completed that required ultrasound signs and symbols to be matched with its clinical significance or diagnosis. The matched pairs spelled out a password used for the next task.

Task 2: Entering the password opened an online quiz that tested making clinical diagnoses based off of ultrasound videos and still images. Passing the quiz provided a lock combination.

Task 3: Residents had a locked manilla enve – lope that opened with the lock combination. The envelope contained a crossword puzzle that tested increasingly more challenging ultrasound diagnoses. A completed crossword puzzle could be traded for a riddle (“I am mostly cold, sometimes hot. You may like it or you may not. You will find me lying around this room. Use it to advance, or you will be doomed”).

Task 4: The riddle took residents on a scavenger hunt for one of multiple hidden bottles of ultrasound gel. Inside the gel bottle was a key to escaping the conference room.

Round 3: RUSH showdown

Teams with the highest quiz scores and best speed at escaping the room were paired against each other in a final scanning showdown. The final two teams competed to perform a RUSH examination the fastest.

What lessons were learned?

Ultrasound teaching in an “escape room” format with hands-on scanning competitions were successful implementations of team- based active learning. Resident engagement in active-learning activities, such as a matching game and a crossword puzzle, exceeded that of traditional didactic lecturing. Subjective feedback from residents indicated these methods were superior in teaching ultrasound-specific pathology and enhanced their interest in implementing ultrasound on shift.