Use of an Online Ultrasound Simulator to Teach Basic Psychomotor Skills to Medical Students During the Initial COVID-19 Lockdown: Quality Control Study

Comparative Effectiveness of a 30-minute Online Lecture on Abdominal Ultrasonography in the Post-COVID-19 era: A Multi-center Study

Background/Aims

Coronavirus 2019 (COVID-19) accelerated the importance of online learning in the field of medical education. This study compared the impact of online lectures on abdominal ultrasonography (USG) with that of offline lectures and assessed the efficacy of abdominal USG lectures for internal medicine (IM) residents and gastroenterology (GI) fellows.

Methods

A 30-minute lecture on upper abdominal USG was delivered online or offline, and a test with 39 short-answer questions was conducted before and after the lecture.

Results

The study population included 25 physicians (13 IM residents and 12 GI fellows) in the online group and 23 (20 IM residents, three GI fellows) in the offline group. The rates of USG education experience for online and offline groups were 64.0% and 69.6%, respectively (p=0.919). A significant increase in the test scores was observed after a one-time USG lecture in IM residents in both the online and offline, as well as GI fellows in the online (p<0.0001, <0.0001, and p=0.004, respectively). In addition, the delta scores were similar in the online and offline after a one-time lecture (8.8±4.3 vs. 7.8±3.7, respectively; p=0.406). A comparison of the delta-scores of the IM resident and GI fellow showed no significant difference within either the online or offline (9.0±4.5 vs. 8.4±3.6, p=0.927; 7.3±3.8 vs. 7.3±3.0, p=0.985).

Conclusions

The effectiveness of online USG lectures was comparable to that of offline lectures. In addition, a 30-minute, one-time abdominal USG lecture provided value to IM residents and GI fellows.

Teledidactic Versus Hands-on Teaching of Abdominal, Thoracic, and Thyroid Ultrasound-The TELUS II Study

BACKGROUND

The worldwide COVID-19 pandemic has initiated a change in medical education and the development of new teaching concepts has become inevitable to maintain adequate training.

OBJECTIVE

This pilot study aims to compare teledidactic teaching with traditional face-to-face teaching for abdominal, thoracic, and thyroid ultrasound.

DESIGN

Concurrently, a teledidactic and a face-to-face ultrasound course were held. The students completed seven 90-min modules using mobile ultrasound probes (Butterfly IQ). Each module consisted of a lecture, a demonstration of probe guidance, and independent training.

PARTICIPANTS

A total of thirty medical students took part in the study and were randomly assigned to a teledidactic and a face-to-face group.

MAIN MEASURES

An objective structured assessment of ultrasound skills (OSAUS) was performed as a pre-test and as the final exam and ultrasound images obtained during the exam were evaluated using the brightness mode quality ultrasound imaging examination (B-QUIET) scale.

KEY RESULTS

No significant difference between the two cohorts on the OSAUS final exam was shown (p > 0.05 in all modules). There was a significant difference in the assessment of the images in the focused assessment with sonography for trauma (FAST) (p 0.015) and aorta (p 0.017) modules. Students in the teledidactic group performed better in both modules, scoring 33.59 (± 2.61) out of 44 in the module FAST (face-to-face group 30.95 (± 1.76)) and aortic images averaged 35.41 (± 2.61) points (face-to-face group 32.35 (± 3.08)).

CONCLUSIONS

A teledidactic course for abdominal and thoracic ultrasound examinations is equally effective to traditional face-to-face teaching in this pilot study. Digital implementation with a portable ultrasound machine could be a great opportunity to promote ultrasound education worldwide and over great distances.

[State of the art: Simulation in US]

Technical simulation of diagnostic and therapeutic procedures is of growing relevance for student education and advanced medical training and has already been introduced in the field of ultrasound. This review gives a broad overview on different levels of simulation for ultrasound diagnostics and highlights the technical background of the methodology. A critical review of the literature reveals recommendations for implementing simulation techniques in medical studies and professional ultrasound training. An analysis of strengths and weaknesses shows the advantages of simulation especially in the context of individual learning situations and COVID-19-related restrictions for personal interaction. However, simulation techniques cannot replace the experiences of complex clinical examinations with direct interaction to real patients. Therefore, future applications may focus on repetition and assessment of achieved competencies by using standardized feedback mechanisms in order to preserve the limited resources for practical medical training.

Adaptive Peer Tutoring and Insights From a Neurooncology Course

Peer teaching in medicine is a valuable educational approach that benefits students and tutors alike. The COVID-19 pandemic has significantly impacted the advancement of remote education in the medical field. In response, the Cerrahpasa Neuroscience Society organized a web-based, volunteer-based peer tutoring program to introduce students to central nervous system tumors. This viewpoint examines our peer mentoring experience in medical education. We discussed how we shaped the course, its positive effects, and the flexible nature of the course, which brought medical students from different regions together. In addition to evaluating academic results, we examined the social relations made possible by this unique teaching method by analyzing student feedback and test scores. Finally, we discussed the promise of global web-based mentoring, highlighting its significance in the dynamic and global context of medicine.

FEATURES OF THE PROCESS OF TRAINING IN EDUCATIONAL MEDICAL INSTITUTIONS OF UKRAINE AT THE PRESENT STAGE. PART 2. REACTION OF HIGHER EDUCATIONAL INSTITUTIONS TO DISTANCE LEARNING

Higher education is one of the areas most affected by the Covid-19 pandemic and martial law. Against the backdrop of severe restrictions, universities faced the issue of the existing opportunities for the implementation of educational programs, the need to change the format of the educational process with the transition mainly to electronic educational technologies. Under these conditions, it was necessary to consolidate all the forces and resources of the university community. The governments of many countries have recognized the need to provide infrastructural and technological support to educational institutions. Thanks to the institutional support of the state and relevant ministries, universities managed to reduce financial losses and implement initiatives for continuous education. These measures have contributed to the sustainability of universities. In response to the COVID-19 pandemic, educational institutions all over the world have adopted different approaches and made significant changes to the education system itself in accordance with their resources and capabilities.

Towards a Low-Cost Monitor-Based Augmented Reality Training Platform for At-Home Ultrasound Skill Development

Ultrasound education traditionally involves theoretical and practical training on patients or on simulators; however, difficulty accessing training equipment during the COVID-19 pandemic has highlighted the need for home-based training systems. Due to the prohibitive cost of ultrasound probes, few medical students have access to the equipment required for at home training. Our proof of concept study focused on the development and assessment of the technical feasibility and training performance of an at-home training solution to teach the basics of interpreting and generating ultrasound data. The training solution relies on monitor-based augmented reality for displaying virtual content and requires only a marker printed on paper and a computer with webcam. With input webcam video, we performed body pose estimation to track the student's limbs and used surface tracking of printed fiducials to track the position of a simulated ultrasound probe. The novelty of our work is in its combination of printed markers with marker-free body pose tracking. In a small user study, four ultrasound lecturers evaluated the training quality with a questionnaire and indicated the potential of our system. The strength of our method is that it allows students to learn the manipulation of an ultrasound probe through the simulated probe combined with the tracking system and to learn how to read ultrasounds in B-mode and Doppler mode.

“A Head Start or a Pain in the Neck?”—Establishment and Evaluation of a Video-Based “Hands-On” Head and Neck Ultrasound Course

The COVID-19 pandemic has strongly highlighted the need for more digitalization in healthcare. Teaching ultrasound skills in online courses is a key challenge in this context. The aim of this study was to establish an online video-based head and neck ultrasound course with an evaluation of the quality, effectiveness, and feasibility of this teaching method compared to in-person teaching. Twenty-two medical students were taught head and neck ultrasound in two groups: one group in an in-person course and the other one in a video-based course. Learning success was analyzed using self-evaluation forms and external assessment by an experienced ultrasonographer. Comparing pre- and post-training self-evaluation, all participants showed statistically significant learning progress. In the external assessment, the overall scores in both groups did not differ significantly. The courses themselves were positively evaluated by all participants. Herein, we present the first feasibility study of a web-based head and neck-ultrasound course for medical students. The methodology provides the potential for future changes in telemedical education and sustainable improvements in telemedical teaching and global intra-clinical and interdisciplinary patient care.

Adaptation of an anatomy graduate course in ultrasound imaging from in-person to live, remote instruction during the Covid-19 pandemic

Health concerns during the Covid-19 pandemic required the adaptation of a lecture-laboratory course in ultrasound imaging for graduate students from an in-person to a live, remote learning format. The adaptation of in-person lectures to live, remote delivery was achieved by using videoconferencing. The adaptation of in-person laboratory sessions to live, remote instruction was achieved in the first half of the course by providing a hand-held ultrasound instrument to each student who performed self-scanning at their remote locations, while the instructor provided live instruction using videoconferencing. In the second half of the course, the students transitioned to using cart-based, hospital-type instruments and self-scanning in the ultrasound laboratory on campus. The aim of this study was to measure the success of this adaptation to the course by comparing assessment scores of students in the live, remote course with assessment scores of students in the in-person course offered in the previous year. There were no statistically significant differences in the assessment scores of students in the two courses. The adaptation of a course in ultrasound imaging from an in-person to a live, remote learning format during the Covid-19 pandemic described here suggests that contrary to the prevailing view, ultrasound imaging can be taught to students without in-person instruction. The adapted course can serve as a model for teaching ultrasound where instructors and learners are physically separated by constraints other than health concerns during a pandemic.

"Fun slipping into the doctor's role"-The relationship between sonoanatomy teaching and professional identity formation before and during the Covid-19 pandemic

The various psychological dimensions of professional identity formation (PIF) are an important aspect of the study course for undergraduate medical students. Anatomical learning environments have been repeatedly shown to play a critical role in forming such an identity; however, relevance of PIF during sonoanatomical training remains underexplored. At the end of their basic anatomy studies, third-semester medical students took part in a four-day block course on anatomy and imaging. Anatomical content was revised in small groups using peer teaching and imaging methods, including one hour of hands-on sonoanatomy sessions each day. On-site sonoanatomy was identified as an excellent format to support students' transition from the pre-clinical to clinical phase as medical experts-to-be. Students enjoyed practical exercises and the clinical input, which increased their interest in the medical profession and their academic studies. This study further examined the effects of the transition into an online-only format, necessitated by the current Covid-19 pandemic. A comparison was made between the quantitative and qualitative evaluation data, and the written results of examinations of several on-site (n = 1096, mean age = 22.4 years ± 2.18), and online-only cohorts (n = 230, mean age = 22.6 years ± 2.21). The online-only transition led to a reduction of all PIF-related variables measured, losing identity-related variables, increasing students' stress levels, and reducing their long-term academic performance. Together, this study demonstrates presence of PIF in undergraduate sonoanatomy teaching, and cautions against the uncritical online-only substitution of hands-on learning environments.