Romania 2013

USIG/International Project Summary

Location: Brasov, Romania

Duration of trip: 10 days

 

Student Travelers:

Cosmin Florescu- florescu@uci.edu

Jeffrey Mullen- jamullen@uci.edu

Vivian Nguyen-nguyenvm@uci.edu

Brooke Sanders- besander@uci.edu

Priscilla Vu- priscilv@uci.edu

 

Faculty Advisor:

J Christian Fox, MD, FAIUM

Professor of Clinical Emergency Medicine

Assistant Dean, Student Affairs

Director of Instructional Ultrasound

University of California, Irvine School of Medicine

email: jfox@uci.edu; cell: 949-842-2167

www.ultrasound.uci.edu

 

International Organization/University:

Faculty of Medicine at Transilvania University of Brasov

Liliana Rogozea, MD, PhD
Vice-rector of Public Relations and Promotion of University Image

Department of Fundamental and Prophylactic Disciplines
Str. Mircea cel Batran, nr 45, bl 39 sc C, ap 12, 500193
Brasov, Romania

Telephone: +40721510223

Fax: +40268410564

E-mail: r_liliana@yahoo.com

 

Description of Project:

The use of ultrasound technology is limited to radiologists and gynecologists in Romania. While students who completed their clerkships had seen ultrasound in the clinic, they had never taken a course on bedside ultrasound (BUS) nor held an ultrasound transducer.

Our introductory ultrasound course was the first of its kind in Romania and at the Faculty of Medicine in Braşov. Over the span of seven days, we were able to teach the fundamentals of BUS, pulmonary BUS, cardiovascular BUS, hepatobiliary BUS, and the Focused Assessment with Sonography for Trauma (FAST) exam.

In total, we taught 76 medical students. While one of our objectives was to teach the students at the Faculty of Medicine BUS, we also wanted to evaluate the efficacy of three different didactic methods used to teach BUS.

The students who participated were divided into three groups. The first group attended both a daily lecture and hands-on ultrasound sessions. The second group watched a podcast daily and attended hands-on ultrasound sessions. The third only attended daily hands-on ultrasound sessions.

Student BUS skill was analyzed with a pre- and post-training quiz that focused on the FAST exam, which incorporates many of the skills learned in the other four modules taught. On the last day, students performed a FAST exam as their practical test.

While introducing ultrasound and studying the efficacy of different didactic methods one can use to teach ultrasound was an amazing experience, the most fulfilling part of our time in Romania was establishing a new connection with the Faculty of Medicine at the University of Braşov in Transilvania.

 

Outlook for Summer 2014:

The UCI SOM team excited not only the students in Transilvania but also the faculty with the practicality of BUS. The faculty expressed interest in starting a BUS program and integrating it into their medical school curriculum, an initiative that we are proud to be a part of and one that we hope UC Irvine can help facilitate.

We hope that medical students from UC Irvine will continue conducting research on the efficacy of different didactic methods. Our research results found no statistically significant difference among the efficacy of the didactic methods studied.  This was evident by similar score improvements and practical performance for all three groups.  However, several research limitations preclude a definitive conclusion.  We had a relatively small sample size and did not limit participation to fifth and sixth year medical students as originally anticipated.  Adding more students would increase the power of the study.

The future team of medical students from UCI SOM should work with the University of Brasov, Faculty of Medicine, to establish ultrasound into their curriculum. This would be a very worthwhile and exciting venture.

 

A few notes for the trip:

Be sure to pick a week when the student body is free of any large obligations. We ran into the issue of having the graduation ceremony and post-graduation party scheduled right in the middle of the week during our workshop.  These festivities decreased student attendance.

Furthermore, one of the sixth year medical students was in charge of organizing the students and ensuring that they came to the ultrasound course.  It would be beneficial to have a faculty member ensure that students understand the commitment to the training session once they sign up.

Also, having an incentive for students to participate would increase attendance. Many students missed at least one day of the workshop. However, any incentive given to the students for participation (i.e. elective credit) would have to be disclosed to the IRB in advance.  A letter from the Faculty of Medicine would be needed to include in the IRB application.

 

Ultrasound machines/supplies:

–  Six (6) portable Sonosite NanoMAXX ultrasound machines with P21, L38, C60 transducers & chargers

– USBs for transferring data (should come with ultrasound machines)

– Six (6) international prong adapters *3 prong à 2 prong are necessary for the Sonosite NanoMAXX machines

– 20 bottles of ultrasound gel

 

***In Romania we purchased paper towels and water for the lecturers. It would have been nice to purchase “pool lounge” inflatables for the ultrasound models to lie down on.  If you need a data plan for your iPad, that can be purchased in Romania as well for relatively inexpensive. We found that the school had WiFi for us and Ethernet cords allowed us to connect our laptops at the dorms and make HotSpots for the other devices.  It is important to have TV adapters for your laptops.  It is a good idea to have HDMI and VGA adapters to ensure that you can project PowerPoint presentations on the TV’s at the Faculty of Medicine.

 

Breakdown of budget/travel expenses:

One thing to keep in mind is the inflation rate, which has been quite high, but has decreased substantially in recent years.  While 14% may seem high by American standards (where it is around 2%), it is an improvement.  Prices should still seem reasonable compared to prices in the U.S.  Your purchasing power will be higher in Romania that it is in the U.S.  Below is our proposed budget for the project when we submitted the proposal for JONUHTS funding.  You will want to check the latest cost for airfare, lodging, etc. when you put your budget proposal together.

 

Item	Cost per person	Cost per team
Airfare	$1,700[1]	$8,500
Train	$65[2]	$325
Lodging (Bucharest)	$495[3]	$2,475
Lodging (Brasov)	Complimentary university housing	Complimentary university housing
Meals and Incidentals (Bucharest)	$270[4]	$1,350
Meals and Incidentals (Brasov)	$600[5]	$3,000
Passport fee	$165[6]	$825
Total	$3,295	$16,475

 

Please describe any travel advice or tips you have for the next group. This can include travel logistics (airports, buses), fun activities to do before or after the project etc.

 

Before you leave

Get your passport.  Make sure that you have extra pages in the back for customs and stamps.  You need to do this a few months before your trip just to be sure you have everything ready.  You do not want to pay expedited shipping fees or be stranded in an airport and pay extra fees to change your ticket.

Be sure to have practiced your ultrasound before you go! This is very important. You will not be completely confident, but try your best! You know more than you think you do.  A few months before you leave, contact second and third year students to go over the things that you want to learn while you are over there.

Be sure to weigh your bags and make sure they do not exceed your airline’s limit. The airline will charge you a great deal of money if you go over the limit. Our best option was the take the machines as carry-ons and checking in the probes and chargers was best. Be sure to have the gel in baggies in your suitcases because the gel is not allowed as a carry-on item. Also, be sure to know the specific policies of your airline. Be sure to know the rules for all airlines if you are flying with multiple carriers, not just your first flight. For example, if you have a layover and transfer to a different airline, they may have different weight restrictions.

 

Obtain letters from Dr. Maguire on UCI SOM letterhead explaining that you are given permission from UC Irvine School of Medicine to take the ultrasound machines to Romania for teaching purposes. A draft of such letters will be given to you from last year’s team. Even with the letters, you will probably have to remove the ultrasound machines from all bags when you go through security. This will be much easier if you make them easily accessible.   Keep copies of the letter in a separate place just in case.  Nancy Koehring and Melanie Ley can help procure the letters.

 

Travel

It is best to purchase your tickets from LAX to OTP (Bucharest), especially if all the team members fly together.  Otherwise, SNA to OTP is another good option, but it generally costs more.

 

When you take a taxi from the airport to the hotel, walk away from the airport and get a yellow taxi near the exit.  Also walk away from the “taxi drivers” in nice Mercedes or other cars.  Those are a complete rip off.  Make sure the taxi has 1.39 lei/km on the side. They will give you a better fare and are regulated by the government. Getting the phone number of the taxi driver before you get in is always a good idea. It can sometimes be difficult to flag down a taxi and calling a particular driver or taxi company can make this easier.  The faculty or a designated student at the Faculty of Medicine should be able to get taxis for you.

 

You can find nice lodging accommodations in Bucharest relatively inexpensively. Be sure to book these in advance via Travelocity, Kayak, Expedia, etc.

 

Food is wonderful there. If you have doubts about where to go, look at what places are full! That is always a good sign.  The nice outdoor terraces are also good options.

 

Other

Since you are traveling to a foreign country, EXPLORE! Romania is rich in history & culture.  The best option is to stop by Peles Castle on the way from Bucharest to Brasov.  From Brasov, you should visit Sighisoara and go up to the watchtower to get an incredible view of the best preserved medieval town in the world.

 

Some sites to see include:

-Bran Castle (aka Dracula’s castle), Bran, Romania

-Sighisoara (a gorgeous medieval town)

-House of George Enescu (famous Romanian composer)

– Peles Castle (a 19th Century castle) and Pelisor (the guest house to the left)

– Bran Castle near Brasov (about a 45 minute car ride)

– Poiana Brasov (you can take a cable ride up the side of the mountain)

-Old Town in Bucharest, The Little Paris of the East

–Dimitrie Gusti National Village Museum