title: Feasibility study of first-year medical students identifying cardiac anatomy using ultrasound in rural Panama.
abstract: BACKGROUND
  There are over 15 million children who have cardiac anomalies around the world, resulting in a significant morbidity and mortality. Early recognition and treatment can improve the outcomes and lengthen life-expectancy of these patients. The NIH and WHO have promoted guidelines for screening for congenital cardiac anomalies using ultrasound in rural environments.
  
  
  METHODS
  Our study took place in Bocas Del Toro, Panama where a mobile clinic was established for community healthcare screening and ultrasonographic evaluation by medical student volunteers and volunteer clinical faculty. This was a non-blinded, investigational study utilizing a convenience sample of pediatric patients presenting for voluntary evaluation. Seven first-year medical students were recruited for the study. These students underwent a training program for advanced cardiac ultrasound instruction, termed "Pediatric Echocardiography Cardiac Screening (PECS)".
  
  
  RESULTS
  Ten patients were enrolled in the study. Nine patients had adequate images as defined by the PECS criteria and were all classified as normal cardiac pathology by the medical students, resulting in a sensitivity and specificity of 100%. A single patient was identified by medical students as having a pathologic pulmonic stenosis. This was confirmed as correct by a blinded ultrasonographer.
  
  
  CONCLUSIONS
  In this pilot study, the first-year medical students were able to correctly identify pediatric cardiac anatomy and pathology in rural Panama after undergoing a 12-hour ultrasound PECS training session. We believe that with this knowledge, minimally trained practitioners can be used to screen for cardiac anomalies in rural Panama using ultrasound.
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Brianna
authors.initials: B
authors.lastname: Miner
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Purdy
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Curtis
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Simonson
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Caleb
authors.initials: C
authors.lastname: Shumway
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Jessa
authors.initials: J
authors.lastname: Baker
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Vaughan
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Kara
authors.initials: K
authors.lastname: Percival
authors.affiliation: School of Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Olivia
authors.initials: O
authors.lastname: Sanchez
authors.affiliation: Department of Emergency Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Shadi
authors.initials: S
authors.lastname: Lahham
authors.affiliation: Department of Emergency Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Joseph
authors.affiliation: Department of Emergency Medicine, University of California Irvine, Orange, CA 92868, USA.
authors.forename: J Christian
authors.initials: JC
authors.lastname: Fox
keywords: Medical education; Panama; Rural medicine; Ultrasound