Bedside ultrasound training using web-based e-learning and simulation early in the curriculum of residents

Abstract

BackgroundFocused bedside ultrasound is rapidly becoming a standard of care to decrease the risks of complications related to invasive procedures. The purpose of this study was to assess whether adding to the curriculum of junior residents an educational intervention combining web-based e-learning and hands-on training would improve the residents’ proficiency in different clinical applications of bedside ultrasound as compared to using the traditional apprenticeship teaching method alone.MethodsJunior residents (n = 39) were provided with two educational interventions (vascular and pleural ultrasound). Each intervention consisted of a combination of web-based e-learning and bedside hands-on training. Senior residents (n = 15) were the traditionally trained group and were not provided with the educational interventions.ResultsAfter the educational intervention, performance of the junior residents on the practical tests was superior to that of the senior residents. This was true for the vascular assessment (94% ± 5% vs. 68% ± 15%, unpaired student t test: p < 0.0001, mean difference: 26 (95% CI: 20 to 31)) and even more significant for the pleural assessment (92% ± 9% vs. 57% ± 25%, unpaired student t test: p < 0.0001, mean difference: 35 (95% CI: 23 to 44)). The junior residents also had a significantly higher success rate in performing ultrasound-guided needle insertion compared to the senior residents for both the transverse (95% vs. 60%, Fisher’s exact test p = 0.0048) and longitudinal views (100% vs. 73%, Fisher’s exact test p = 0.0055).ConclusionsOur study demonstrated that a structured curriculum combining web-based education, hands-on training, and simulation integrated early in the training of the junior residents can lead to better proficiency in performing ultrasound-guided techniques compared to the traditional apprenticeship model.

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“…Simulation is superseding the traditional see‐one, do‐one, teach‐one apprenticeship model as a more efficacious teaching strategy 1 – 6 . Procedure simulation has been shown to accelerate intern competency past that of their more clinically experienced peers, 2 , 3 with higher success rates compared to the traditional bedside apprenticeship model 4 . Simulation‐trained proceduralists have improved adherence to sterile technique and decreased complication rates 1 , 5 .…”

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“…The "flipped classroom" approach has been used to facilitate cognitive knowledge acquisition for ultrasound trainees (Table 2). 17,[34][35][36][37][38][39] This educational approach consists of didactics that are primarily webbased, so that learning can be performed off-site and repeated as many times as required. Furthermore, the time spent reviewing online modules can be considered individual study time and does not count as duty hours as per the ACGME definition.…”

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