The role of the physician assistant in clinical settings is evolving, enabling them to take on more clinical duties as physician offices now use a wider range of diagnostic tools. Handheld ultrasound education is now empowering these professionals to take on new responsibilities and play a more significant role in care delivery. Physician assistants are being given the opportunity, through technology, to increase involvement in patient assessment and diagnosis. We spoke with award-winning University of North Carolina (UNC) Professor Janelle Bludorn to learn how physician assistant education programs are increasingly implementing curricula that includes this imaging tool.
How have PA programs traditionally implemented ultrasound education?
Bludorn: Before the advent of handheld ultrasound devices, most education on ultrasound diagnostic imaging for physician assistants consisted of a couple of lectures at most. Now, we’re seeing programs integrate education on handheld ultrasound into their curricula holistically, while also implementing standalone courses on the use of this technology.
Why have programs started to include training on the use of handheld ultrasound?
Bludorn: Today’s physician assistant programs shape the profession from the pre-clinical phase. More program leaders are realizing that handheld ultrasound is going to become a major part of the future of medicine. Physician assistant programs are starting to understand that if they exclude training in this modality, they’re doing a disservice to their students.
How has handheld ultrasound education differed from traditional ultrasound training?
Bludorn: Incorporating this technology gives us an amazing amount of flexibility in making diagnoses. At UNC, we introduce handheld ultrasound in our anatomy course and our ultrasound lab early on, so students have probes in their hands within two weeks of starting, and they can continue to gain experience through spaced repetition using the devices throughout their education. Most programs only have 24 to 27 months to turn our students into fully formed clinicians, and handheld ultrasound is an efficient way to help our students make the leap from educational theory to clinical practice.
What kind of emphasis do physician assistant programs place on handheld ultrasound education?
Bludorn: Today we’re past the early adopter phase. Handheld ultrasound education is already becoming widespread. Personally, I’m waiting for the day when our accrediting body further validates the importance of using handheld ultrasound technology. I would love to see requirements for accreditation involving imaging move beyond X-ray interpretations and add handheld ultrasound as a procedure that a program proves they can teach – and teach well.
What do you think this technology means for the physician assistant role in clinical practice?
Bludorn: As big an impact as handheld ultrasound has had on pre-clinical physician assistant education, the influence on clinical practice can be even greater. On a clinical level, handheld ultrasound augments the physical exam, expedites clinical reasoning, and assists with performing procedures.
Physician assistants can also evolve as leaders and educators of interprofessional teams. If their educational and training programs support development of these skills from the start with solid quality improvement and quality assurance, it makes them even more valuable and empowers them to pass on knowledge to other physician assistants, nurses and even physicians.
How are practicing PAs being trained on the use of handheld ultrasound?
Bludorn: Organizations such as the Society of Point of Care Ultrasound and the American Academy of Physician Assistants are creating workshops to educate members on this technology. We’re even seeing options refined for specialties, such as emergency medical clinicians, similar to the education offered by the Society of Emergency Medicine Physician Assistants. Several employers and healthcare systems also have in-house training programs.
What impacts can programs expect to see for students, instructors, and their institutions by encouraging education in this modality?
Bludorn: Fostering training in handheld ultrasound enables students to add this diagnostic capability to their clinical resume. They can use it to explore anatomy and physiology in depth and absorb a new perspective on the human body early in their education. From what I’ve seen, it improves the learning experience and helps students retain information better than static images ever could.
For instructors, the personal nature of handheld ultrasound facilitates the one-on-one interactions they have with students, helping instructors really get to know the future clinicians they’re teaching. In addition, they get specific, real-time feedback on whether their students are really understanding the concepts and implications, helping instructors grow as successful educators.
At the institutional level, deep knowledge of and experience with this technology opens an entirely new dimension of scholarship for instructors. We’re in a boom time for this curricula. Handheld ultrasound use helps instructors propose, deploy and review scholarship, meaning the institution can nurture this research and help schools fulfill their educational mission. In my research, I’ve found that our students at UNC perform better on their anatomy and clinical medicine exams in areas where they’ve been using handheld ultrasound.
How receptive are physician assistant students to this technology? What reactions have you seen to this type of handheld ultrasound education?
Bludorn: What I find most impressive is how handheld ultrasound is changing the educational experience for students. For example, I had one of our students thank me for providing their first true hands-on experience in PA school and for reminding them why they wanted to become a physician assistant. That’s what real engagement is about, and it helps them become better students.
Have you seen any feedback from students who have completed their training and put it into practice?
Bludorn: Yes, I’ve had some of our interventional radiology students working in trauma and orthopedics volunteering to come back and teach. They reached out to me because handheld ultrasound was that significant in sparking their interest in education and professional mentorship.
What advice do you have for physician assistant educators who want to start or expand training programs for handheld ultrasound at their institutions?
Bludorn: I get a lot of cold calls from educators who are curious about integrating handheld ultrasound in physician assistant training. I advise them to find proponents of the technology in their area, make friends with them and look for opportunities to collaborate. Also, stay nimble and collect data that can be used to prove that ultrasound education is worthwhile. Many training program schedules are already overloaded, so it’s best to get creative in finding the right fit where such programs can provide the most value.
Related Resources for Handheld Ultrasound Education
- Ultrasound Education: GE HealthCare’s Handheld Ultrasound Knowledge Center
- Embrace Handheld Ultrasound Training to Expand Patient Engagement
About Janelle Bludorn
Janelle Bludorn, MS, PA-C, is a physician assistant practicing in emergency medicine and an Assistant Professor in the Physician Assistant Program at University of North Carolina at Chapel Hill. Bludorn was named North Carolina Physician Assistant of the Year in 2018. Previously, she practiced at Massachusetts General Hospital in Boston. Bludorn is continuing her clinical pursuits in the emergency departments at UNC Hospitals and UNC Hospitals Hillsborough.
