International consensus conference recommendations on ultrasound education for undergraduate medical students

Hoppmann, Richard A.; Mladenovic, Jeanette; Melniker, Lawrence; Badea, Radu; Blaivas, Michael; Montorfano, Miguel; Abuhamad, Alfred; Noble, Vicki; Hussain, Arif; Prosen, Gregor; Villen, Tomás; Via, Gabriele; Nogue, Ramon; Goodmurphy, Craig; Bastos, Marcus; Nace, G. Stephen; Volpicelli, Giovanni; Wakefield, Richard J.; Wilson, Steve; Bhagra, Anjali; Kim, Jongyeol; Bahner, David; Fox, Chris; Riley, Ruth; Steinmetz, Peter; Nelson, Bret P.; Pellerito, John; Nazarian, Levon N.; Wilson, L. Britt; Ma, Irene W. Y.; Amponsah, David; Barron, Keith R.; Dversdal, Renee K.; Wagner, Mike; Dean, Anthony J.; Tierney, David; Tsung, James W.; Nocera, Paula; Pazeli, José; Liu, Rachel; Price, Susanna; Neri, Luca; Piccirillo, Barbara; Osman, Adi; Lee, Vaughan; Naqvi, Nitha; Petrovic, Tomislav; Bornemann, Paul; Valois, Maxime; Lanctot, Jean-Francoise; Haddad, Robert; Govil, Deepak; Hurtado, Laura A.; Dinh, Vi Am; DePhilip, Robert M.; Hoffmann, Beatrice; Lewiss, Resa E.; Parange, Nayana A.; Nishisaki, Akira; Doniger, Stephanie J.; Dallas, Paul; Bergman, Kevin; Barahona, J. Oscar; Wortsman, Ximena; Smith, R. Stephen; Sisson, Craig A.; Palma, James; Mallin, Mike; Ahmed, Liju; Mustafa, Hassan

doi:10.1186/s13089-022-00279-1

The Ultrasound Journal

Table 3 Domains 1–3 voting results

From: International consensus conference recommendations on ultrasound education for undergraduate medical students

Code	Statement	Refs.	Median voting score	Degree of consensus	Level of quality of evidence	Strength of recommendation
Domain 1: scope of consensus conference curriculum
D1.1	The ICC will produce consensus recommendations on “An integrated ultrasound curriculum” (“curriculum”) for undergraduate medical education (medical school)	[26,27,28,29,30,31,32,33,34,35,36,37,38]	8.38	VGC	Level 1 = 0, Level 2A = 0, Level 2B = 2, Level 3 = 11	Strongly recommend
D1.2	The curriculum forms the foundation for ultrasound as a core clinical competency for all graduates regardless of specialty choice	[3, 13, 27, 33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55]	8.45	VGC	Level 1 = 0, Level 2A = 3, Level 2B = 7, Level 3 = 14	Strongly recommend
D1.3	The curriculum provides the foundation of ultrasound for all medical students, regardless of where their medical degree is obtained or the specific designation of their degree	[27, 28, 56,57,58]	8.07	GC	Level 1 = 0, Level 2A = 0, Level 2B = 0, Level 3 = 5	Recommend
D1.4	The curriculum can serve as a valuable resource for the development of ultrasound training programs for non-physician healthcare providers such as advanced nurse practitioners and physician assistants	[27, 42, 59,60,61,62,63,64,65,66]	7.62	GC	Level 1 = 0, Level 2A = 0, Level 2B = 4, Level 3 = 3	Recommend
Domain 2: rationale for curriculum
D2.1	The curriculum prepares students for POCUS (point-of-care ultrasound use) in future clinical work	[35, 37, 38, 67,68,69,70,71,72,73]	8.36	GC	Level 1 = 0, Level 2A = 0, Level 2B = 7, Level 3 = 3	Recommend
D2.2	The curriculum facilitates teaching of fundamental sciences	[74,75,76,77,78,79,80,81]	8.09	GC	Level 1 = 0, Level 2A = 1, Level 2B = 2, Level 3 = 3	Recommend
D2.3	The curriculum enhances the learning of clinical sciences	[82, 83]	8.16	GC	Level 1 = 0, Level 2A = 0, Level 2B = 1, Level 3 = 1	Recommend
D2.4	The curriculum facilitates integration of fundamental sciences	[82, 84,85,86,87]	7.95	GC	Level 1 = 0, Level 2A = 0, Level 2B = 1, Level 3 = 4	Recommend
D2.5	The curriculum enhances physical examination skills	[44, 45, 80, 86, 88,89,90,91,92,93,94,95,96,97,98,99]	8.24	GC	Level 1 = 0, Level 2A = 2, Level 2B = 8, Level 3 = 1	Recommend
D2.6	The curriculum enhances clinical problem solving	[73, 100, 101]	8.16	SC	Level 1 = 0, Level 2A = 1, Level 2B = 2, Level 3 = 0	Recommend
D2.7	The curriculum prepares learners for additional clinical training and/or practice opportunities	[69, 73, 102,103,104,105,106,107,108,109,110,111,112,113,114,115]	8.34	GC	Level 1 = 0, Level 2A = 1, Level 2B = 9, Level 3 = 5	Recommend
D2.8	The curriculum enhances the overall educational experience	[33, 35, 70, 82, 84, 116,117,118,119,120,121]	8.47	VGC	Level 1 = 0, Level 2A = 0, Level 2B = 2, Level 3 = 9	Strongly recommend
D2.9	Medical students can learn basic ultrasound	[33, 35, 70,71,72, 75, 122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143]	8.64	VGC	Level 1 = 0, Level 2A = 0, Level 2B = 13, Level 3 = 7	Strongly recommend
D2.10	Medical students can learn ultrasound-guided procedures	[122, 143,144,145,146,147,148,149,150,151]	8.16	GC	Level 1 = 0, Level 2A = 2, Level 2B = 4, Level 3 = 3	Recommend
Domain 3: characteristics of the curriculum
D3.1	The ultrasound curriculum forms the foundation for ultrasound training along a continuum of medical education from undergraduate through graduate to continuing medical education	[18, 19, 33, 37, 38, 135, 152,153,154,155]	8.60	VGC	Level 1 = 0, Level 2A = 1, Level 2B = 2, Level 3 = 7	Strongly recommend
D3.2	The ultrasound curriculum supports undergraduate medical education	[18, 19, 106, 107, 135, 152,153,154]	8.29	GC	Level 1 = 0, Level 2A = 0, Level 2B = 2, Level 3 = 0	Recommend
D3.3	The ultrasound curriculum prepares learners for future additional clinical training and/or practice opportunities	[18, 19, 106, 107, 135, 152,153,154]	8.14	GC	Level 1 = 0, Level 2A = 0, Level 2B = 2, Level 3 = 0	Recommend
D3.4	The ultrasound curriculum is developed in accordance with accepted standards for medical education as defined by national and international accrediting bodies	[27, 36, 106, 156,157,158]	7.76	GC	Level 1 = 0, Level 2A = 0, Level 2B = 1, Level 3 = 1	Recommend
D3.5	The ultrasound curriculum lends itself to a competency-based model that includes measurable outcomes and markers of progression toward those outcomes (milestones)	[38, 81, 155, 159, 160]	7.90	GC	Level 1 = 0, Level 2A = 0, Level 2B = 0, Level 3 = 1	Recommend
D3.6	The ultrasound curriculum can incorporate ultrasound knowledge, skills, attitudes, and professional judgment into entrustable professional activities (EPAs) as appropriate for patient care	[38, 81, 155, 159, 160]	7.98	GC	Level 1 = 0, Level 2A = 0, Level 2B = 0, Level 3 = 1	Recommend
D3.7	The ultrasound curriculum enhances the learning of fundamental sciences that are relevant to the understanding of human pathophysiology and the practice of medicine	[19, 116, 118, 158, 161, 162]	8.24	GC	Level 1 = 0, Level 2A = 0, Level 2B = 1, Level 3 = 3	Recommend
D3.8	The ultrasound curriculum enhances the learning of clinical sciences through the integration of ultrasound into clinical problem solving	[3, 44, 45, 99, 100, 154, 163]	8.34	VGC	Level 1 = 0, Level 2A = 1, Level 2B = 4, Level 3 = 0	Strongly recommend
D3.9	The ultrasound curriculum enhances the learning of clinical sciences through the care of patients at their point of care	[3, 44, 45, 99, 100, 154, 163]	8.17	GC	Level 1 = 0, Level 2A = 1, Level 2B = 4, Level 3 = 0	Recommend
D3.10	The ultrasound curriculum includes opportunities for self-directed learning and assessment	[19, 31, 155]	7.83	GC	Level 1 = 0, Level 2A = 0, Level 2B = 0, Level 3 = 0	Recommend
D3.11	The ultrasound curriculum encourages life-long learning	[19, 31, 155]	7.62	GC	Level 1 = 0, Level 2A = 0, Level 2B = 0, Level 3 = 0	Recommend
D3.12	The ultrasound curriculum is based on evidence and expert opinion	[5, 106, 164,165,166,167,168,169,170,171,172]	8.28	VGC	Level 1 = 0, Level 2A = 2, Level 2B = 0, Level 3 = 8	Strongly recommend
D3.13	The ultrasound curriculum is consistent with recommendations and guidelines of well-established specialty organizations	[5, 106, 164,165,166,167,168,169,170,171,172]	8.28	VGC	Level 1 = 0, Level 2A = 2, Level 2B = 0, Level 3 = 8	Strongly recommend
D3.14	The ultrasound curriculum is consistent with recommendations and guidelines of regulatory bodies with significant experience in ultrasound	[5, 106, 164,165,166,167,168,169,170,171,172]	8.12	VGC	Level 1 = 0, Level 2A = 2, Level 2B = 0, Level 3 = 8	Strongly recommend

From left to right: Code of domain statement, Statement, Reference numbers of relevant literature, Median appropriateness score of Round 2, Degree of consensus. (VGC = very good consensus, GC = good consensus, SC = some consensus, NC = no consensus), Level of quality of evidence (Level 1 = high, Level 2A = moderate, Level 2B = low, Level 3 = very low, strength of recommendation (strongly recommend, recommend, not recommend). The table includes article Refs. [26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163,164,165,166,167,168,169,170,171,172]

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