We are wrapping up our interview with guests Janelle Bludorn and Laura Blesse-Hampton as part of a collaborative series with the Society of Point of Care Ultrasound (SPOCUS) and Practical POCUS with this portion discussing the logistics of integrating ultrasound into a program.

In both Podcasts #129 and #130 we have talked about why and how to integrate ultrasound into your educational program.  However, there are some logistical aspects that can become a headache and are worth discussing.  As a quick reminder, this podcast series is beneficial to not only those in an academic program but are beneficial to anyone teaching ultrasound.

As always, listen to the podcast for all of the details, but here are some of the key highlights:

• Ultrasound machines can be expensive!
  
  
  
  • Pocket ultrasounds tend to be the least expensive, but have some limitations.
    
    
    
    • Some like the Philips Lumify you can rent.
    
    
    • The Butterfly is the least expensive currently starting at under $2000 a unit.
    
    
    • There are many more options that are of high quality such as the iViz and Vscan.
    
    
    
    
  
  
  • Smaller ultrasound machines do not have the same clarity and detail as larger machines, but are great on a budget and are improving with time.
  
  
  • There is always the possibility of getting machines through a grant or by donation.
  
  
  
  


• Purchasing a machine is not always necessary.
  
  
  
  • Consider sharing this high expense resource with another program.
  
  
  • In graduate programs, this could be sharing within the same school (such as different residencies or with a PA and medical school program) or at a neighboring program.
  
  
  
  


• Models are necessary but there are potential complications.
  
  
  
  • Practice is usually done by other students, but formal assessments are often done on standardized patients.
  
  
  • Anyone who is scanned has a chance of an incidental finding being found (normal or abnormal variants such as renal cysts, gallstones, aortic aneurysms, or pregnancy).
    
    
    
    • Many times this can fall under the incidental finding policy currently in place (like when you find a heart murmur).
    
    
    • There are some examples below as far as policies that can be used (thanks to our guests for providing examples.
    
    
    
    
  
  
  
  


• Having an educator can sometimes be difficult.
  
  
  
  • Optimally, the faculty of the program should be teaching students.
  
  
  • Have someone who has the main training teach as other faculty learn with time.
  
  
  • There are many options such as having local experts, training organizations, or gradual learning as we have previously discussed.
  
  
  
  

Examples of incidental findings policies:
Incidental Findings
It is possible that during a student’s course of study incidental findings may be noted. These incidental findings may include previously known or previously unknown pathological findings or normal variants. These discoveries may occur in physical examination, point of care ultrasound, or laboratory sessions, among other educational settings. When an incidental finding is noted, faculty should maintain confidentiality and instruct the student to follow up with his/her primary care provider, student health, or emergency services, as indicated for diagnosis and consideration of management. It is important to note that the UNC-CH PA program faculty, the Program Director and the Medical Director are not allowed to access health records or provide medical care to students, unless in the event of an emergency, but they may facilitate referrals to health facilities.

Standardized Patient Overview
The Baldwin Wallace Physician Assistant Program utilizes Standardized Patients for educational activities, including, but not limited to, student sessions and exams. I understand that for educational purposes only I will be interviewed and/or examined by one or more Physician Assistant students. I will undergo routine medical interviews and/or physical examinations that do not involve invasive procedures, noxious stimuli, or medications.  I understand that the exercises are for education only and not for my health care.  At no time may I be diagnosed or treated by any Baldwin Wallace student or personnel while acting as a volunteer. I understand that if an incidental finding is noted, it will be recommended that I follow up with my primary care provider or emergency services.

Let us know what you think by giving us feedback here in the comments section or contacting us on Twitter or Facebook.  Remember to look us up on Libsyn and on iTunes.  If you have any questions you can also comment below, email at thetotalem@gmail.com, or send a message from the page.  We hope to talk to everyone again soon.  Until then, continue to provide total care everywhere.