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Table 4 Themes and representative quotes from focus group interviews. IMR = Internal Medicine residents

From: Building a bigger tent in point-of-care ultrasound education: a mixed-methods evaluation of interprofessional, near-peer teaching of internal medicine residents by sonography students

Themes

Representative Quotes

Learning Environment

 IMR felt the DMS students created a positive learning environment.

“It made it easier to just try and see what happens and you fail. You have students teaching you and they’re very willing to work with you. It’s not like having a faculty [instructor]... It’s someone else who you know is also learning and it makes it more comfortable, definitely.” IMR

 IMR felt the DMS coaches offered a unique, yet complimentary, skill set compared to workshops led by faculty. DMS students were more proficient at acquiring images, while faculty were better at recognize clinical relevance.

“When she did it, it was actually really helpful to understand and watch how she positions her hand, watch how she holds the probe, watch her fine tuning the images just to get that perfect shot. It’s hard doing it for the first couple of times to understand exactly how hard to push and how to exactly manipulate the probe. Since they do it every day, it seemed better to ask.” IMR

“Using the ultrasound as an extension of our physical exam. But listening to it from the faculty’s perspective knowing that this is going to applicable. We’re not just learning this to check it off. We’re actually going to need this and rely on it to make clinical decisions was helpful to have from a faculty standpoint that makes sense.” IMR

 Both groups felt it was important to ensure there was a clear mutual understanding of expectations and terminology prior to the workshop.

“I feel that the expectations of what our job [as instructors] was done nicely with the sheets [we were given] and the grading rubric. [We knew] exactly wat they wanted us to point out to make sure that we were covering everything. That was very helpful.” DMS

“I don’t know if they had enough direction to know what our expectations were.. .. They were all ‘here’s the paper’ that they’re [IMRs] are going to be tested on. So I’m sure they were thinking like ‘let’s go down this list of stuff that they need to know’ and let’s check off the boxes rather than use it as a hand-on experience.” IMR

“[The terminology] is not universal. Where they use short access, we use transverse. Like I said, their lingo is a little bit different.” DMS

Scanning Technique

 IMR and DMS students felt there was sometimes conflicting scanning strategies. IMR tended to favor the step-wise approach demonstrated in their pre-course videos, whereas DMS students favored a more exploratory strategy.

“I think it was kind of hard sometimes. Like it was nice that they watch those videos before but then sometimes they wouldn’t stray away from the video. They’d go where the video told them to go and not listen to what I was trying to say, like we can try to go more inferior posterior here or whatever. They won’t be very receptive because they kept trying to revert back to that video.” DMS

“I feel like before when we have the lectures, they give us more like a step-by-step, like put it this way and then you turn this direction and you do this. You know it was more step-by-step and they’re [DMS instructors] are kind of like put it on and we’ll kind of see what happens and then just kind of adjusted to this regimen. I think it is kind of nice to have both sides of things but you know it’s like if I went into a new patient, then I would have to have a framework on how to approach it.” IMR

Recommendations

 Participants suggested that future IPE workshops should allot more time for DMS students to demonstrate their scanning technique for the IMR.

“Maybe a little bit more time or letting us show them maybe a couple of minutes. This is how we do it. And then maybe that would kind of help them too if they see us moving around and not just staying in one spot, maybe that will help them.” DMS

“We can have the sonographer go through every organ.. [to].. show us how they obtain all their views, on all their windows, and then we’ll rotate…That way we can see six different techniques on how to obtain the same view and then we can take which one we thought works best for us.” IMR

  1. DMS diagnostic medical sonographer