Unfixed Cadavers as an Adjunct to the Texas College of Osteopathic Medicine POCUS Curriculum




Thomas, Alexander
Son, Min Ji
Jackson, Garrett
Oh, James
Terlizzese, Taylor
Banh, Debini
Burrows, Jack
Quach, Shanon
Vedantam, Rahul


0000-0002-1747-2990 (Burrows, Jack)
0000-0002-4430-057X (Thomas, Alexander)
0000-0001-5318-3531 (Terlizzese, Taylor)
0000-0002-2853-5918 (Jackson, Garrett)

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PURPOSE: Point of care ultrasound (POCUS) continues to grow in its application across all primary care settings due to its wide ranging use and high level of patient safety, especially during medical procedures and aiding in diagnostic accuracy. Advanced technological capabilities in conjunction with affordability gives handheld ultrasound devices the ability to acquire higher quality videos and real time images that are conducive for teaching. Due to these factors, many medical schools are incorporating the use of POCUS into their curricula, including the Texas College of Osteopathic Medicine (TCOM). POCUS is introduced in year 2 as a part of the SIM Lab to help promote development of clinical skills and reasoning. This is implemented via a two-part process in which, alongside systems classes, students complete Sonosim modules that teach about using POCUS on various organ systems. Students then, as part of a skills lab, are aided by student teaching assistants and faculty on proper screening technique utilizing a student volunteer. One key limitation, however, is the fact that the majority of the student volunteers are healthy medical students, which makes it harder to screen for pathology. Due to this limitation, the use of fresh, unfixed cadavers could be a useful adjunct to allow students to further sharpen their POCUS skills while simultaneously seeing pathology in real time. METHODS: A total of 27 unfixed, de-identified cadavers were scanned with a handheld Butterfly iQ+ probe. Sixteen body systems were screened: ocular, thyroid, carotid/internal jugular vein (IJV), brachial plexus, heart, kidneys, pancreas, gallbladder, liver, aorta and the inferior vena cava (IVC), femoral artery and vein, knee, popliteal vessels, uterus, scrotum, and shoulder. RESULTS: Of the 16 body systems, we were able to consistently capture anatomical and pathological images in 8. The body systems that we saw in more than 70% of the screened cadavers include: ocular, thyroid, carotid/IJV, brachial plexus, liver, knee, scrotum, and shoulder. An ultrasound-skilled physician reviewed the images obtained from the cadavers and concluded that for certain body systems the images acquired were indiscernible from anatomy obtained from live patients. Additionally, pathologies discovered in unfixed cadavers were similar to the pathologies seen in live patients. These pathologies include: vitreous detachment, thyroid nodule, liver cyst, hydrocele, and others. CONCLUSION: Ultrasound on unfixed cadavers can be a useful adjunct to the current TCOM ultrasound curriculum. Using cadavers allows room for error and cadavers often have common pathology throughout their system that are rare in healthy student volunteers. Prospective studies should include assessing more body systems and introducing procedures that parallel the current SIM lab curriculum. Additionally, creating artificial pathologies in cadaveric models should be explored to broaden the scope of application.