Ultrasound Education Group

In simplest terms, clinical ultrasound can be used as an extension of clinical evaluation by all medical practitioners. Think of it as “ultrasound assisted clinical evaluation”, and so basic ultrasound of the heart, lungs, deep veins, abdomen, musculoskeletal system and even during pregnancy simply improves the diagnostic fidelity of routine clinical evaluation. In this most complex form, ultrasound forms a part of specialties such as cardiology or radiology.

Many universities are now teaching basic clinical ultrasound as part of the undergraduate medical curriculum. In a few years’ time this is likely to be routine across most universities. This is where you get started in incorporating clinical ultrasound into your practice. However, it is just the start and like most medical skills, needs further training to improve knowledge and skill. To this end, there are number of options available including purely online learning, or blended learning program such as workshops or simulator-based programs. Within clinical learning, mentors will help guide and check skills and interpretation.

The Ultrasound Education Group in the Melbourne Medical School, at the University of Melbourne already has many options available from simple online courses to graduate award programs such as certificate, diploma, or master courses; as well as a suite of workshop and simulated base courses.

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In the future, all doctors should be able to perform basic clinical ultrasound. The range and type of ultrasound scans will depend on the scope of practice of the medical practitioner. Within each specialty craft group, there will also emerge a group of practitioners who become advanced clinical ultrasound usages.

For example, in the critical care specialties (anaesthesia, intensive care and emergency medicine) all doctors should be able to perform basic clinical ultrasound, but some will become experts including applications such as transoesophgeal echocardiography. The two core specialties where ultrasound is seen as a subspecialty is cardiology and radiology. Practitioners become very expert in their field of ultrasound use, and typically will supervise ultrasound laboratories which are staffed by ultrasound sonographers.

The uptake of clinical ultrasound by non-cardiology/radiology practitioners is a highly disruptive process that is excellent for patient care. The ability to more accurately diagnose medical conditions during their first presentation will enormously improve patient care and probably reduce cost due to misdiagnosis.

However, when abnormalities are detected with basic ultrasound, there will frequently be a need to confirm and quantify the diagnosis and severity with more advanced ultrasound imaging. It is likely that specialists in diagnostic sonography will see fewer “normal studies” but more studies with pathology. Furthermore, over time more basic uses will extend their knowledge and skill to diagnostic level. Within departments or groups of practitioners from multiple specialties including general practice specialists, there will be “in-house” ability to confirm findings from basic ultrasound.

Studying ultrasound has two key components-knowledge and practical skills. When a practitioner starts to learn ultrasound, the knowledge, hands on learning, and practice of roughly equal proportions. However, as the transition from basic to advanced practitioner the greatest proportion of learning is knowledge.

When starting, it is important to have a systematic approach to learning and starting with basic before tackling advanced topics. It is important to have good instruction on how to perform the ultrasound in a systematic manner and then applying it in practice.

One of the difficulties is when students have a burst of learning and then don’t practice. We highly recommend that the student tries to perform a number of echocardiography studies early on to boost their confidence. We know that after about 30 scans, their confidence improved enormously and the rate of continued learning begins to slow.

Online learning is very good for delivering knowledge and for practicing interpretation. Part of that learning is how to perform the scan. However, sooner rather than later, the student does need to learn and practice the actual acquisition of ultrasound images-and that cannot be done online.

It is best to think of the online learning as a part of a blended learning program whereby the knowledge and interpretive practice is delivered online and the hands-on learning and practice must be done with the patient.

The ultrasound scan is considered completely safe. This includes ultrasound scans during pregnancy. Some types of ultrasound scans are considered “invasive procedures” where body cavities are entered, and then there is risk of damage to the body organ or discomfort to the patient.

For example, Transoesophageal echocardiography or vaginal ultrasound are examples. When performing a scan, it is important to consider how to position and expose the patient maintaining their privacy at all times.

Physical pressure of the probe on the skin can be uncomfortable, particularly if there is bruising or fractures around the site that you’re putting the ultrasound probe onto. Sometimes, one has to not scan a certain part for the patient comfort sake.