Influence of Clinical Expertise Between Clinician-Instructors Versus Student-Instructors on the Effectiveness of Ultrasound Courses

Abstract

Purpose To investigate how the extent of an ultrasound instructor’s clinical expertise influences the level of hands-on ultrasound competency achieved by clinicians after three-day ultrasound courses in abdominal and emergency ultrasound. The second goal was to determine how physicians in residency rate the sonographic and didactic skills of student instructors compared to medical staff instructors. Method A total of N = 100 residents participating in a 3-day ultrasound workshop were randomly trained either by 15 student instructors or by clinical staff physicians, both with > 2 years of teaching experience. Both instructor groups had previously completed 120 hours of didactic instructor training. Ultrasound competencies were assessed by a standardized objective structured clinical examination (OSCE) of healthy individuals. The sonographic and didactic skills of both instructor groups were rated by questionnaires with six-step Likert items (1 = excellent, 6 = poor). Results The cohort, trained by student instructors, achieved the same scoring level as the second cohort, trained by physician instructors (mean score 76.4, versus 73.7 of max. 100 points, p = 0.28) in the final OSCE. The sonographic qualification was rated for student educators as 1.44 (mean) [1.1–1.62], versus residents 1.46 [1.26–1.61], versus attendings 1.29 [1.05–1.61]. Didactic skill levels were rated without significant differences with means of 1.53, 1.57 and 1.53, respectively. Discussion & Conclusion The didactic competence of student instructors does not differ statistically from the competency levels of experienced physicians. In terms of the acquired ultrasound skills of trainees, our data indicate that student instructors can be as efficient as staff instructors. Therefore, student instructors can be employed as resource-saving ultrasound educators without decreasing the skills level achieved by course participants, provided that they previously underwent a comprehensive didactic and sonographic training program.

FoCUS cardiac ultrasound training for undergraduates based on current national guidelines: a prospective, controlled, single-center study on transferability

“…Since very few of the studies published to date that also use peer-supported training models have discussed the training process in greater detail [ 21 , 22 , 26 , 27 ], a national and international standard needs to be established in this area in the future. This could lead to basic levels of competence among student tutors that would be equivalent to those of experts [ 52 ], ensuring even better quality in the training formats.…”

Describing Ultrasound Skills Teaching by Near-Peer and Faculty Tutors Using Cognitive Apprenticeship

“…Two recent randomized studies with near-peer vs. faculty tutors in ultrasound teaching found similar skills outcomes measured in OSCE exams for musculoskeletal 14 and abdominal ultrasound skills 15 and even superior outcomes for the near-peer group in a cardiac ultrasound course. 16 Other studies underlined the long-term retention of skills in near-peerled ultrasound training for medical students 17 and the favorable effects on the learning of the peer-tutors themselves.…”

Clinical Practice Guidance and Education in Ultrasound: Evidence and experience are two sides of one coin!

“…In der vorliegenden EJU-Ausgabe untersuchten Hofer et al, ob und inwiefern der klinische Hintergrund eines Ultraschallausbilders (Klinik-/Assistenzärzte verglichen mit studentischen Ausbildern) Einfluss hat auf die praktische Ultraschallkompetenz von Klinikärzten nach Absolvierung eines 3-tägigen umfassenden Ultraschallkurses im Abdomen- und Notfall-Ultraschall. Ermittelt wurde dies anhand der Ergebnisse der OSCE- Prüfungs-Scores („Objective Structured Clinical Examination“) der Teilnehmenden und anhand der Bewertungs-Scores von den Kursteilnehmern 24 . Die Autoren kamen zu dem Schluss, dass studentische Tutoren bei der Vermittlung praktischer Ultraschallkompetenzen ebenso effektiv sein können wie klinisch erfahrene Dozenten, die zuvor eine umfassende didaktische Ausbildung absolviert haben.…”

“…To overcome these obstacles implementing e-learning, the use of ultrasound phantoms and simulators or the “Teach-the-teacher” curricula has been suggested. In the present EJU issue, Hofer et al investigated whether and how the extent of an ultrasound instructor’s clinical background, comparing clinicians/residents versus student instructors may influence the resulting level of hands-on ultrasound competency achieved by clinicians after three days of comprehensive ultrasound courses in abdominal and emergency ultrasound – as measured by the results of the participants’ OSCE (objective structured clinical examination) examination scores – and as indicated by evaluation scores gathered from course participants 24 . They concluded that student-peer instructors can be as effective as clinically experienced staff instructors in teaching hands-on ultrasound competencies, based on prior comprehensive didactic skills training.…”