A Comparison of Web-Based with Traditional Classroom-Based Training of Lung Ultrasound for the Exclusion of Pneumothorax

Edrich, Thomas; Stopfkuchen-Evans, Matthias; Scheiermann, Patrick; Heim, Markus; Chan, Wilma; Stone, Michael B.; Dankl, Daniel; Aichner, J.; Hinzmann, Dominik; Song, Pingping; Szabo, Ashley L.; Frendl, György; Vlassakov, Kamen; Varelmann, Dirk

doi:10.1213/ane.0000000000001383

Cited by 41 publications

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“…Intraclass correlation coefficient and confidence interval. Interobserver agreement by Bland–Altman plotTest-score agreement (trainee vs. trainer)In conclusion, this study performed in the framework of the LUST trial shows that nephrologists and cardiologists can be effectively trained to measure lung congestion by an entirely web-based educational program4Edrich et al [28]. A comparison of web-based with traditional classroom-based training of lung ultrasound for the exclusion of pneumothorax.…”

Section: Resultsmentioning

confidence: 82%

“…In all, 99 videos were compiled (52 without pneumothoraces and 47 with)5-min online presentation of the use of ultrasound for detection of pneumothorax79 (70 at 6 month follow-up) residents and faculty members from Department of anaesthesiaAbbasi et al [26]Prospective cross-sectional studyHands-on assessment (± pneumothorax)Healthy live models and patients admitted in Emergency Department with thoracic trauma2 h training course including 30 min didactic lecture, 30 min hands-on training on healthy volunteers, 1 h training on patientsFour emergency physiciansGargani et al [27]Post course evaluationOnline assessment of uploaded LUS examinations and theoretical assessment of b -line interpretation (44 videos)PatientsPart A: web-based training program; 26 min educational video with focus on b -line assessment. Upload of 7 self-performed lung ultrasound videos, when videos were approved by experts, trainees proceed to Part B: b -line interpretationThirty nephrologists and 14 cardiologistsRandomized controlled trial Edrich et al [28]Randomized controlled trial with 4 weeks follow-upTheoretical pre-, post-, and sustainability test (10 MCQs and one video clip) and practical examination (blinded reviewers)Healthy live modelsGroup I: web-based (powerpoint 25 min and online demonstration 5 min). Group II: Classroom-based (powerpoint) 45 min didactic lectures and 20 min hands-on training.…”

Section: Resultsmentioning

confidence: 99%

“…Five of the pre- and post-test studies had a follow-up time from 1 week to 6 months, average 13 weeks ± 4.83 [14, 16, 18, 20, 25], and one recorded number of scans performed from baseline to follow-up [20]. Three descriptive studies were identified [25–27] and one randomized controlled trial [28]. Five of the studies (31%) were courses in general critical care ultrasound, or basic skill ultrasound, where thoracic or lung ultrasound was a specific and independently evaluated topic [17, 19–21, 24].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies also included other healthcare professionals as prehospital providers, nurses, and veterinarians [18, 22, 24]. Two studies excluded participants with the previous ultrasound certification or attendance in a formal critical care ultrasound course within 12 months [20, 28], and two studies only included a study population with no experience [21, 24]. …”

Section: Resultsmentioning

confidence: 99%

“…Web-based learning or online presentations were used in 7 (44%) studies [16, 19, 21, 23, 25, 27, 28]. Four of those had only online presentations or web-based learning modules without didactic lectures or hands-on sessions [16, 25, 27, 28].…”

Section: Resultsmentioning

confidence: 99%

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Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training

et al. 2018

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BackgroundClinical lung ultrasound examinations are widely used in the primary assessment or monitoring of patients with dyspnoea or respiratory failure. Despite being increasingly implemented, there is no international consensus on education, assessment of competencies, and certification. Today, training is usually based on the concept of mastery learning, but is often unstructured and limited by bustle in a clinical daily life. The aim of the systematic review is to provide an overview of published learning studies in clinical lung ultrasound, and to collect evidence for future recommendations in lung ultrasound education and certification.MethodsAccording to PRISMA guidelines, three databases (PubMed, Embase, Cochrane Library) were searched, and two reviewers examined the results for eligibility. Included publications were described and assessed for level of evidence and risk of bias according to guidelines from Oxford Centre for Evidence-Based Medicine and Cochrane Collaboration Tool for Risk of Bias assessment.ResultsOf 7796 studies screened, 16 studies were included. Twelve pre- and post-test studies, three descriptive studies and one randomized controlled trial were identified. Seven studies included web-based or online modalities, while remaining used didactic or classroom-based lectures. Twelve (75%) studies provided hands-on sessions, and of these, 11 assessed participants’ hands-on skills. None of the studies used validated neither written nor practical assessment. The highest level of evidence score was 2 (n = 1), remaining scored 4 (n = 15). Risk of bias was assessed high in 11 of 16 studies (68.75%).ConclusionAll educational methods proved increased theoretical and practical knowledge obtained at the ultrasound courses, but the included studies were substantial heterogeneous in setup, learning-, and assessment methods, and outcome measures. On behalf of current published studies, it was not possible to construct clear guidelines for the future education and certification in clinical lung ultrasound, but the use of different hands-on training facilities tends to contribute to different aspects of the learning process. This systematic review proves a lack of learning studies within this content, and research with validated theoretical and practical tests for assessment is desired.

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Section: Resultsmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training

et al. 2018

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Evaluation of a pilot programme on diagnostic thoracic ultrasound curriculum for acute care physiotherapists

Ntoumenopoulos

Ong

Toh

et al. 2017

Australas J Ultrason Med

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Introduction/purpose: Diagnostic thoracic ultrasound is increasingly being used by non-physicians; hence, we evaluated a curriculum for acute care physiotherapists in critical care. Methods: The one-day course included didactic lectures combined with expert-led hands-on training. Participants undertook preand post-course knowledge questionnaire covering key ultrasound findings for normal lungs, pleural and pulmonary pathologies. Course participants who worked at the institution where the course was undertaken undertook a practical examination. We also did a 4-to 6-week follow-up survey of participants. The pretest and post-test questionnaire and survey results were reported using descriptive statistics (means SD or median and IQR). Results: A total of 12 acute care physiotherapists undertook the training and questionnaire scores (mean percentage, SD, 95% CI) increased from 73.3 AE 15.5% (63.4-83.2) before the training to 86.3 AE 5.5% (82.8-89.8) after training. Discussion: This diagnostic thoracic ultrasound training course resulted in improvements of diagnostic thoracic ultrasound knowledge including lung and pleural pathology image recognition skills in a small group of acute care physiotherapists with nil previous diagnostic thoracic ultrasound skills. Two-thirds of the participants who responded to the survey undertook only one to three scans in clinical practice, and the most frequent barrier to clinical use of diagnostic thoracic ultrasound was time constraints. Conclusion: Further investigation of such a diagnostic thoracic ultrasound training programme on knowledge and skills retention and image acquisition and interpretation in real life clinical practice in a larger group of acute care physiotherapists is warranted.

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Impact of an intensive education programme of diagnostic lung and lower limb ultrasound on physiotherapist knowledge: A pilot study

Ntoumenopoulos

Parry

Neindre

2018

Australas J Ultrason Med

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Introduction/Purpose: Diagnostic ultrasound of the respiratory system and peripheral muscular systems is increasingly being used by clinicians. The aim of this study was to evaluate the knowledge outcomes of a bespoke one-day curriculum for physiotherapists that incorporated lung, diaphragm and lower limb muscle diagnostic ultrasound theory and practical training in image acquisition and analysis. Methods: A one-day course comprised of three instructors and 32 participants on key diagnostic ultrasound findings of the lungs, diaphragm and lower limb musculature included didactic lectures combined with expert-led hands-on training in practical sessions. Participants undertook pre-and post-course knowledge questionnaire covering key ultrasound findings for normal lungs, pleural/ pulmonary pathologies and normal and abnormal findings for the diaphragm and key lower limb muscle groups. The pre-test and post-test questionnaire and survey results were reported using parametric descriptive statistics (means SD) as the data were normally distributed. Results: Of the 32 physiotherapists who undertook the one-day training, 25 (78%) completed the pre-and post-course questionnaires. The pre-course knowledge scores (mean percentage, SD) were 63% (21), and the post-course scores were 62% (20) after training. Discussion: This novel diagnostic ultrasound course led to limited improvements of ultrasound knowledge in the specific areas of the key ultrasound findings pulmonary system and lower limb muscle anatomy. The pre-reading material and course structure may have been too burdensome for the participants. Conclusion: Combined lung and muscle diagnostic ultrasound course may require more than the standard one-day training for appropriate knowledge acquisition, and use of online pre-course video lectures may facilitate learning.

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A Comparison of Web-Based with Traditional Classroom-Based Training of Lung Ultrasound for the Exclusion of Pneumothorax

Abstract: When training anesthesiologists to perform LUS for the exclusion of pneumothorax, we found that Web-based training was not inferior to traditional classroom-based training and was effective, leading to test scores that were similar to a group of clinicians experienced in LUS.

Cited by 41 publications

References 11 publications

Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training

Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training

Evaluation of a pilot programme on diagnostic thoracic ultrasound curriculum for acute care physiotherapists

Impact of an intensive education programme of diagnostic lung and lower limb ultrasound on physiotherapist knowledge: A pilot study

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