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John Kendall, MD, Prepares Clinicians to Use Ultrasound in Clinical Practice across Specialties

The word ultrasound typically brings about visions of pregnancies and specialized technicians. But John Kendall, MD, believes ultrasounds have unlimited potential. And thanks to his point-of-care ultrasound curriculum, all graduates of the University of Colorado School of Medicine learn not just how to perform ultrasounds at a patient’s bedside—but also how  this technology adds diagnostic and therapeutic value to clinical encounters across almost every specialty.

The point-of-care ultrasound represents an entirely different paradigm of ultrasound. This portable technology allows the provider to incorporate ultrasonography into his or her thought process throughout the patient encounter.

“Sometimes the ultrasound is diagnostic; say, fluid around the heart or a pregnancy. Other times, it’s going to be for therapeutic purposes – using ultrasound to make procedures safer and more effective,” he explains.

Ultrasound has been part of the formally-evaluated School of Medicine curriculum for two years. It’s part of the Foundations of Doctoring program, and is also taught in conjunction with the anatomy curriculum.

“Now, at the same time students are dissecting the head and neck during lab, they are also learning how to perform an ultrasound on this same area during a physical exam,” he said.

Dr. Kendall believes seeing how everything in the body interrelates is part of the value of ultrasound.

 “When you’re doing a dissection, you’re not putting everything back together. Ultrasound allows you to see the body and reconstruct the relationships again,” he explains. “It isn’t just a cut—you can do an infinite number of constructions—which helps students think three-dimensionally.”

Beyond the first year, ultrasound is threaded through curriculum. There is a second-year clinical ultrasound rotation, and ultrasound has become part of the third year’s surgery rotation. It’s also part of the OB/GYN rotation, and it’s even being implemented in internal medicine, using ultrasound as a guide during procedures.

The student response to this element of the curriculum has been positive. “Universally, the students really like it. Because it has a clinical application, students feel like clinicians right away, and it makes learning procedures easier,” he said.

The new curriculum also benefits patients—and expands the role clinicians have in their care. Since the use of portable ultrasound has become relatively inexpensive, it has implications for underdeveloped nations as well as rural areas that lack specialty care. Clinicians trained to use ultrasound as part of an examination suddenly expand how they’re able to help the patients they see.

According to Dr. Kendall, Colorado is at the forefront of this movement. Not only are the students graduating each year from CU learning point-of-care ultrasound, CU has also partnered with Rocky Vista to help train their graduates as well, adding 150 additional providers trained in point-of-care ultrasound.

“It’s an exciting thing for patients in Colorado.”

As an emergency medicine physician, Dr. Kendall’s ultrasound training was largely self-taught, learning by scanning patients in his department while completing his training in the early 1990s. He admits mistakes were made along the way, but that’s one of the best things about portable ultrasound: It’s a technology with a very positive risk-benefit ratio.

Incorporating ultrasound training into the curriculum was something he began brainstorming more than 15 years ago. He’s thankful for the support he’s received along the way.

“The deans at CU have been tremendously supportive, and we share a vision of how ultrasound can empower clinicians to use these skills for the patient’s benefit,” he said. “I feel fortunate.”

John Kendall, MD, FACEP, is the Director of Ultrasound Curriculum at the University of Colorado School of Medicine. He also serves as Director of Emergency Ultrasound and staff physician at Denver Health Medical Center.​