Student Perceptions of Instructional Ultrasound Videos as Preparation for a Practical Assessment

Development and evaluation of a point-of-care ultrasound curriculum for paramedics in Germany - a prospective observational study and comparison

BACKGROUND

Point-of-care ultrasound (POCUS) is steadily growing in use in prehospital emergency medicine. While currently used primarily by emergency physicians, POCUS could also be employed by paramedics to support diagnosis and decision-making. Yet to date, no paramedicine-targeted POCUS curricula exist in Germany. Furthermore, given time and resource constraints in paramedic training, it is unclear whether paramedics could feasibly learn POCUS for prehospital deployment. Hence, this study outlines the development and implementation of a comprehensive POCUS curriculum for paramedics. Through this curriculum, we investigate whether paramedics can attain proficiency in POCUS comparable to other user groups.

METHODS

In this prospective observational study, we first developed a blended learning-based POCUS curriculum specifically for paramedics, focusing on basic principles, the RUSH-Protocol and ultrasound guided procedures. Participants underwent digital tests to measure their theoretical competence before (T1) and after the digital preparation phase (T2), as well as at the end of the on-site phase (T3). At time point T3, we additionally measured practical competence using healthy subjects and simulators. We compared the theoretical competence and the practical competence on a simulator with those of physicians and medical students who had also completed ultrasound training. Furthermore, we carried out self-assessment evaluations, as well as evaluations of motivation and curriculum satisfaction.

RESULTS

The paramedic study group comprised n = 72 participants. In the theoretical test, the group showed significant improvement between T1 and T2 (p < 0.001) and between T2 and T3 (p < 0.001). In the practical test on healthy subjects at T3, the group achieved high results (87.0% ± 5.6). In the practical test on a simulator at T3, paramedics (83.8% ± 6.6) achieved a lower result than physicians (p < 0.001), but a comparable result to medical students (p = 0.18). The results of the study group's theoretical tests (82.9% ± 9.2) at time point T3 were comparable to that of physicians (p = 0.18) and better than that of medical students (p < 0.01). The motivation and attitude of paramedics towards the prehospital use of POCUS as well as their self-assessment significantly improved from T1 to T3 (p < 0.001). The overall assessment of the curriculum was positive (92.1 ± 8.5).

CONCLUSION

With our tailored curriculum, German paramedics were able to develop skills in POCUS comparable to those of other POCUS learners. Integration of POCUS into paramedics' training curricula offers opportunities and should be further studied.

The objective structured clinical examination (OSCE): Main aspects and the role of imaging

The objective structured clinical examination (OSCE) is a format of examination that enables students to be evaluated in a uniform, standardized, reliable, and objective way. It is carried out in different clinical stations that simulate real clinical situations and scenarios. Numerous universities in Spain and other countries employ this approach for the final examination for medical school students. This update describes the organization, design, and fundamentals for the OSCE, proposing that radiology should form part of multidisciplinary OSCEs to the extent that it forms part of clinical practice. Moreover, it is interesting and opportune to introduce the OSCE in undergraduate and postgraduate training in radiology. Online platforms enable bidimensional OSCEs that are cost-effective in terms of staff, resources, and physical space, although this approach has certain limitations. Virtual world technologies make it possible to reproduce OSCE stations in three-dimensional scenarios; recent experiences in radiology have shown that this approach interests and motivates students and is widely accepted by them.

YouTube and Radiology: The Viability, Pitfalls, and Untapped Potential of the Premier Social Media Video Platform for Image-Based Education

RATIONALE AND OBJECTIVES

There are several popular radiology channels on YouTube, reinforcing studies showing interest among medical students and trainees in video education and suggesting the potential use of YouTube for radiology education.

MATERIALS AND METHODS

The CTisus YouTube channel, dedicated to radiology education and based in the Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins Hospital, has 25,000 subscribers. The benefits of this social media platform for radiology education were analyzed. The most popular videos (n = 484) from July 1, 2017 to June 30, 2020 were categorized into "case clips" (short displays of case images); "Facebook Live" (15-20 minute discussions later posted to YouTube); "lectures" (weekly PowerPoint lectures); and "quizzes" (10-question quiz discussions posted monthly). The number of days videos were available from July 2017 to June 2020 were counted and median views per 30 days were recorded. Lecture content was used to determine which of the following topics were more popular (received the most views) than others: Artificial intelligence, chest, gastrointestinal, genitourinary, musculoskeletal, neuro, physics, technique (such as protocols and contrast), technology, and vascular.

RESULTS

Facebook Live videos had the highest median views per 30 days (236.9), the highest median likes per 30 days (2.5), the highest median shares per 30 days (2.0), and the highest median subscribers gained per 30 days (0.7). Unlike video type, there was no obvious favorite lecture topic among viewers.

CONCLUSION

Viewers were most engaged with longer videos, with interaction and watch time indicating greater interest than simple clicks/views. YouTube is an easy-to-use and valuable platform for hosting video content. It reaches a global audience and provides what many radiology trainees and professionals are looking for: video instruction.

Video-based, student tutor- versus faculty staff-led ultrasound course for medical students - a prospective randomized study

BACKGROUND

Ultrasound education is propagated already during medical school due to its diagnostic importance. Courses are usually supervised by experienced faculty staff (FS) with patient bedside examinations or students among each other but often overbooked due to limited FS availability. To overcome this barrier, use of teaching videos may be advantageous. Likewise, peer teaching concepts solely with trained student tutors have shown to be feasible and effective. The aim was to evaluate 1) objective learning outcomes of a combined video-based, student-tutor (ViST) as compared to a FS-led course without media support, 2) acceptance and subjective learning success of the videos.

METHODS

Two ultrasound teaching videos for basic and advanced abdominal ultrasound (AU) and transthoracic echocardiography (TTE) were produced and six students trained as tutors. Fourth-year medical students (N = 96) were randomized to either the ViST- or FS course (6 students per tutor). Learning objectives were defined equally for both courses. Acquired practical basic and advanced ultrasound skills were tested in an objective structured clinical examination (OSCE) using modified validated scoring sheets with a maximum total score of 40 points. Acceptance and subjective learning success of both videos were evaluated by questionnaires based on Kirkpatrick's evaluation model with scale-rated closed and open questions.

RESULTS

79 of 96 medical students completed the OSCE and 77 could be finally analyzed. There was no significant difference in the mean total point score of 31.3 in the ViST (N = 42) and 32.7 in the FS course (N = 35, P = 0.31) or in any of the examined basic or advanced ultrasound skill subtasks. Of the 42 ViST participants, 29 completed the AU and 27 the TTE video questionnaire. Acceptance and subjective learning success of both videos was rated positively in 14-52% and 48-88% of the rated responses to each category, respectively. Attendance of either the student or faculty tutor was deemed necessary in addition to the videos.

CONCLUSIONS

A ViST versus FS teaching concept was able to effectively teach undergraduate students in AU and TTE, albeit acceptance of the teaching videos alone was limited. However, the ViST concept has the potential to increase course availability and FS resource allocation.