The effect of e-learning on point-of-care ultrasound education in novices

ABSTRACT

Background

Current studies assessed the learning efficacy of e-learning in ultrasound (US) training using questionnaires, or simulation in well-controlled conditions. This study investigates the effect of e-learning on the clinical US performance of the first postgraduate year (PGY-1) residents.

Methods

In this prospective observational study, we enrolled PGY-1 and second postgraduate year (PGY-2) residents. The e-learning was introduced on the first day and each PGY-1 was authorized to access the e-learning platform. The point-of-care ultrasound (PoCUS) curriculum for the focused assessment of sonography for trauma (FAST) was conducted on the 7^th day for PGY-1 and the objective structured clinical examination (OSCE) followed. The PGY-2 received bedside one-to-one random learning before the study and did not have the authorization to access the e-learning. The FAST examinations performed by the PGY-1 and PGY-2 were collected on the 30th day. The clinical FAST performance was assessed by the instructor not involved in the curriculum and blinded to the use of e-learning, including numbers, image quality, and diagnostic accuracy between PGY-1 e-learning users, non-users, and the PGY-2.

Results

One hundred and seventy PGY-1 with 736 FAST examinations and 53 PGY-2 residents with 134 examinations were included. Seventy PGY-1 used e-learning with a median time spent of 13.2 mins (IQR, 6.5–21.1 mins) at the first access. The PGY-2 had more PoCUS experience than the PGY-1, however, the 70 e-learning users performed more FAST examinations than the PGY-2 (median [IQR], 4 [2–6] vs. 2 [1–3], p = 0.0004) and had better image quality than the PGY-2 (3 [3–3.2] vs. 3 [2.7–3], p = 0.044). There were no significant differences in the diagnostic accuracy between the PGY-1 and PGY-2.

Conclusions

E-learning has a positive effect on US learning. The PGY-1 users had comparable performance with the PGY-2 and even better image acquisition although the PGY-2 had more PoCUS experience.

Trial registration

NCT03738033 at ClinicalTrials.gov.

KEYWORDS:

• e-learning
• point-of-care ultrasound (PoCUS)
• the first postgraduate year (PGY-1)
• focused assessment of sonography for trauma (FAST)
• resident

List of abbreviations

Point-of-care ultrasound (PoCUS);

Focused assessment of sonography for trauma (FAST);

Ultrasound (US);

Electronic learning (e-learning);

First post-graduate year (PGY-1);

Second post-graduate year (PGY-2);

Emergency Department (ED);

Objective structured clinical examination (OSCE);

Interquartile range (IQR);

Intra-Class Correlation (ICC);

Confidence intervals (CIs).

Acknowledgments

We thank the Ministry of Science and Technology, Taiwan for grant support (Most 103-2627-E-002-008, 104-2627-E-002-003, 105-2627-E-002-001, 110-2511-H-002-009-MY2).

Authors’ contributions

WCL conceived the study, designed the trial, and obtained research funding. PL supervised the conduct of the trial and data collection. CHC, MCW, and CYW undertook the recruitment of participants and managed the data, including quality control. PL provided statistical advice on study design and analyzed the data; WCL drafted the manuscript, and all authors contributed substantially to its revision. WCL takes responsibility for the paper as a whole.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10872981.2022.2152522

Ethics approval and consent to participate

The study protocol was approved by the institutional review board of the hospital (201412004RIND) and registered at ClinicalTrials.gov (NCT03738033).

Consent for publication

Consent for publication was obtained from each participant.

Availability of data and material

All data generated or analyzed during this study are included in this published article.

Additional information

Funding

The Ministry of Science and Technology, Taiwan for grant support (Most 103-2627-E-002-008, 104-2627-E-002-003, 105-2627-E-002-001, 110-2511-H-002-009-MY2).