Handheld ultrasound and stethoscope make up new diagnostic duo
Looking for a means to improve on the classic stethoscope, University of Chicago physicians are taking diagnostic imaging techniques into their own hands -- literally.
The Chicago physicians recently conducted a study in which 10 fourth-year medical students enrolled in a four-week elective course on cardiac examination used individual handheld ultrasound devices. The researchers found that the portable devices helped medical students refine their diagnostic skills.
"The idea of using ultrasound is attractive," said Dr. Jeanne M. DeCara, an assistant professor of medicine. "It doesn't mean we throw our stethoscopes away, but we can enhance the diagnostic information we get at examination with handheld devices."
DeCara presented results of her study at the American Society of Echocardiography meeting in Las Vegas last week.
The course consisted of a 10-day review of cardiac anatomy, pathophysiology, and auscultation technique using traditional teaching methods. A 10-day individualized, supervised training on portable ultrasound followed. Each student examined 12 patients with known cardiac disease at three different intervals. At their last examination, students submitted a diagnosis. They later performed an ultrasound test and modified their original diagnosis if necessary.
Exam skills improved only marginally, from 38% correct diagnosis to 40%, when students used standard techniques and stethoscopes for their examinations. Correct diagnosis jumped to 60% when the students included ultrasound. The difference was statistically significant, DeCara said.
Recent studies indicate physicians overall are poor at examining the heart. Reasons are unclear, but some suggest it may be due to inadequate training, according to DeCara. Physicians are spending less time at the bedside, and they get used to asking for other studies. As a result, physical exam skills suffer.
Handheld ultrasound devices could enable medical students to make better diagnoses. Besides adding visuals to the information gathered with traditional techniques, they also help as teaching aids, DeCara said.
"There is a role for ultrasound in the curriculum," DeCara said. "The technology is out there. It's our responsibility to ensure that the next generation of physicians learns how to use it responsibly."
