The acquisition of ultrasound skills is an essential part of any medical student’s education. University access restrictions in the context of the COVID-19 pandemic have highlighted the need for digitization in teaching. However, teaching manual skills in online courses has proven to be challenging, not least in terms of human resources. Therefore, the aim of this study was to set up a hybrid head and neck ultrasound course consisting of a preface of video-based self-study followed by supportive instruction by a tutor in telepresence and to evaluate the quality, effectiveness, and feasibility of this teaching method. Thirty-five students were shown video tutorials on systematic ultrasound of the neck course. Learning outcomes were analyzed using self-assessment questionnaires and external assessment by an experienced ultrasonographer. All participants demonstrated statistically significant learning improvement (p < 0.001) when comparing self-assessment scores before and after training. The mean self-assessment scores increased from 13.8 to 26.6 for the telepresence-guided group, from 16.6 to 27.3 for the web-based group, and from 14.0 to 26.2 for the in-person group. The external observer assessment also showed improvement, with mean scores of 46.7, 48.1, and 46.5, respectively. Overall results did not significantly differ when comparing different instruction modalities. A telepresence-guided video-based ultrasound course is well suited to teaching ultrasound skills similar to in-person courses and allows a more resource-efficient targeting of student needs.