Ultrasound in undergraduate medical education: A systematic and critical review

Introduction: Point-of-care ultrasound (POCUS) use in clinical care is growing rapidly, and advocates have recently proposed the integration of ultrasound into undergraduate medical education (UME). The evidentiary basis for this integration has not been evaluated critically or systematically. In this study, we conducted a critical and systematic review framed by the rationales enumerated by advocates of ultrasound in UME in academic publications.

Methods: This research was conducted in two phases. First, the dominant discursive rationales for the integration of ultrasound in UME were identified using techniques from Foucauldian critical discourse analysis (CDA) from an archive of 403 academic publications. We then sought empirical evidence in support of theses rationales, using a critical synthesis methodology also adapted from CDA.

Results: We identified four dominant discursive rationales, with different levels of evidentiary support. Ultrasound was not demonstrated to improve students’ understanding of anatomy. The benefit of ultrasound in teaching physical examination was inconsistent,and rests on minimal evidence. With POCUS, students’ diagnostic accuracy was improved for certain pathologies, but findings were inconsistent for others. Finally, the rationale that ultrasound training in UME will improve quality of patient care was difficult to evaluate.

Discussion: Our analysis has shown that the frequently repeated rationales for the integration of ultrasound in UME are not supported by a sufficient base of empirical research. The repetition of these dominant discursive rationales in academic publications legitimizes them and may preclude further primary research. Since the value of clinical ultrasound use by medical students remains unproven, educators must consider whether the associated financial and temporal costs are justified or whether more research is required.

Overlapping Notions of Self and Other: the Case of the Anabaptist Body

This paper examines the complex interrelations between notions of ͚“elf͛ and ͚Otheƌ͛ with regards to human bodies, taking as a case study the bodily experiences of Anabaptist Christians, both historically and in the present day. It first examines body practices and discourses through the lens of Anabaptist approaches to baptism and conscience and it relates these to the Foucauldian notion of care of the Self. It then looks at biopolitical relations between individuals and the state through an examination of oath-taking and anti-war protests. Finally, it discusses the roles of bodies and bodiliness in contemporary Anabaptist commemorative practices. 

On the waterfront: neoliberal urbanism and the politics of public benefit

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