title: USEFUL: Ultrasound Exam for Underlying Lesions incorporated into physical exam.
abstract: BACKGROUND
  The Ultrasound Screening Exam for Underlying Lesions (USEFUL) was developed in an attempt to establish a role for bedside ultrasound in the primary and preventive care setting. It is the purpose of our pilot study to determine if students were first capable of performing all of the various scans required of our USEFUL while defining such an ultrasound-assisted physical exam that would supplement the standard hands-on physical exam in the same head-to-toe structure. We also aimed to assess the time needed for an adequate exam and analyze if times improved with repetition and previous ultrasound training.
  
  
  METHODS
  Medical students with ranging levels of ultrasound training received a 25-minute presentation on our USEFUL followed by a 30-minute hands-on session. Following the hands-on session, the students were asked to perform a timed USEFUL on 2-3 standardized subjects. All images were documented as normal or abnormal with the understanding that an official detailed exam would be performed if an abnormality were to be found. All images were read and deemed adequate by board eligible emergency medicine ultrasound fellows.
  
  
  RESULTS
  Twenty-six exams were performed by 9 students. The average time spent by all students per USEFUL was 11 minutes and 19 seconds. Students who had received the University of California, Irvine School of Medicine's integrated ultrasound curriculum performed the USEFUL significantly faster (p< 0.0025). The time it took to complete the USEFUL ranged from 6 minutes and 32 seconds to 17 minutes, and improvement was seen with each USEFUL performed. The average time to complete the USEFUL on the first standardized patient was 13 minutes and 20 seconds, while 11 minutes and 2 seconds, and 9 minutes and 20 seconds were spent performing the exam on the second and third patient, respectively.
  
  
  CONCLUSIONS
  Students were able to effectively complete all scans required by the USEFUL in a timely manner. Students who have been a part of the integrated ultrasound in medicine curriculum performed the USEFUL significantly faster than students who had not. Students were able to significantly improve upon the time it took them to complete the USEFUL with successive attempts. Future endpoints are aimed at assessing the feasibility and outcomes of an ultrasound-assisted physical exam in a primary care setting and the exam's effect on doctor-patient satisfaction. [West J Emerg Med. 2014;15(3):260-266.].
authors.affiliation: University of California, Irvine School of Medicine, Irvine, California.
authors.forename: Jon
authors.initials: J
authors.lastname: Steller
authors.affiliation: University of California, Irvine School of Medicine, Irvine, California.
authors.forename: Bianca
authors.initials: B
authors.lastname: Russell
authors.affiliation: University of California, Irvine School of Medicine, Irvine, California ; Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors.forename: Shahram
authors.initials: S
authors.lastname: Lotfipour
authors.affiliation: University of California, Irvine School of Medicine, Irvine, California.
authors.forename: Graciela
authors.initials: G
authors.lastname: Maldonado
authors.affiliation: Department of Family Medicine, State University of New York, Buffalo, New York.
authors.forename: Tim
authors.initials: T
authors.lastname: Siepel
authors.affiliation: University of California, Irvine School of Medicine, Irvine, California.
authors.forename: Halsey
authors.initials: H
authors.lastname: Jakle
authors.affiliation: University of California, Irvine School of Medicine, Irvine, California.
authors.forename: Stacy
authors.initials: S
authors.lastname: Hata
authors.affiliation: University of California, Olive View-University of California, Los Angeles Medical Center, Sylmar, California.
authors.forename: Alan
authors.initials: A
authors.lastname: Chiem
authors.affiliation: University of California, Irvine School of Medicine, Irvine, California ; Department of Emergency Medicine, University of California, Irvine, Orange, California.
authors.forename: John Christian
authors.initials: JC
authors.lastname: Fox
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D010808:Physical Examination / Q000379:methods; D010865:Pilot Projects; D019095:Point-of-Care Systems; D013337:Students, Medical; D013647:Task Performance and Analysis; D014463:Ultrasonography