Does the clinical experience of a tutor influence how students learn extended focused assessment with sonography for trauma: A randomized controlled trial

Abstract

Background

Extended focused assessment with sonography for trauma (eFAST) is now an essential part of the primary survey of an emergency patient. The discrepancy between an increasing number of medical students and growing clinical commitments of lecturers is a major challenge in student teaching that needs to be resolved. The practice of using peers in the clinical education of medical students is a well-established tradition and commonly practiced but lacks definition in its implementation. Therefore, we aimed to investigate whether the level of experience of the tutor affects the effectiveness of learning among students using eFAST during a clinical scenario.

Methods

A prospective randomized single-blinded controlled trial, where 168 medical students in the eighth semester were randomized into control and intervention groups. The control group received the 4-h standard ultrasound (US) tutorial from various resident doctors. All residents were at least stage-1-certified in ultrasound. The intervention group received the tutorial from trained peer teachers (TPTs). These TPTs were medical students who were qualified to teach the procedure. All students received an initial tutorial on basic ultrasound principles and a final lecture on recognizing pathological images. Students completed basic questionnaires requesting pre-existing US experience, theoretical and clinical application questions based on eFAST one day later and at the end of the semester. Students also completed a 6-min OSCE (Objective-Structured-Clinical-Exam) station involving clinical emergency scenarios.

Results

Eighty-five percent of participants had no previous eFAST experience. Early and later evaluation of the participants show no significant differences between both groups regarding the theoretical and the clinical application examinations, except the early phase OSCE results, which was not repeated in the late-stage results.

Conclusions

Peer-teaching can be utilized to teach practical skills such as eFAST without a loss of clinical application skills. This relieves the burden of removing doctors from patient care situations and maintains teaching standards.

Keywords:

• Extended focused assessment with sonography for trauma
• medical education
• tutor’s clinical experience

Ethical approval

The presented study obtained local IRB-approval (Ref# 20-9450-BO) according to the Declaration of Helsinki. The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Author contributions

Cynthia Szalai, Sharaf-Eldin Shehada & Ali Haddad: Concept, design, data analysis, Statistics, drafting manuscript editing & revision.

Simona Iancu: Data collection.

Cynthia Szalai & Frank Herbstreit: Methodology & resources.

Arjang Ruhparwar & Thorsten Brenner: Critical revision & editing.

All authors: Manuscript review and final draft.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Peer teaching: Involves students taking an active role in presenting and discussing themes and issues and learning from each other in ways that supplement the teaching of academic staff. Examples may include a student taking responsibility, perhaps within a small group, to investigate one aspect of a topic and give a short summary to the group, leading or facilitating discussions.

Peer Assisted Learning: (1) People from similar social groupings who are not professional teachers helping each other to learn and learning themselves by teaching. (2) Those helping their peers to learn are from similar social groupings to the learners (although not necessarily from the same course or year of study) and are not themselves professional teachers or ‘experts’ in the subject. PAL tutors therefore typically have less expansive knowledge of subject matter, less developed teaching skills and less authority than ‘expert’ tutors. Other terms used: Peer appraisal, Peer assessment, Peer tutoring, Peer teaching, Student teaching/tutoring/mentoring, Peer assisted writing, Study advisory schemes, Peer supported learning.

1) Topping KJ. 1996 The effectiveness of peer tutoring in further and higher education: A typology and review of the literature. Higher Education 32:321–345. 2) Ross M Cameron H. (2007) Peer assisted learning: a planning and implementation framework: AMEE Guide no. 30. Medical Teacher 29(6): 527–545.

Additional information

Notes on contributors

Cynthia Szalai

Szalai, Cynthia, Dr FRCS, MME Anesthesiologist and Teaching Coordinator, Faculty of Medicine, University Hospital Essen, University Duisburg-Essen.

Sharaf-Eldin Shehada

Shehada, Sharaf-Eldin, MD, PhD. Associate professor and consultant cardiac surgeon at the Department of Thoracic and Cardiovascular Surgery at West-German Heart & Vascular Center Essen, University Hospital Essen, University Duisburg-Essen.

Simona Iancu

Iancu, Simona, Resident Doctor at the Department of anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen.

Frank Herbstreit

Herbstreit, Frank, Dr Med., Priv.-Doz. Anesthesiologist, Intensive Care, Emergency Medicine & Transplantation Doctor at the Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen.

Arjang Ruhparwar

Ruhparwar, Arjang, MD, Professor. Chairman and Head of the Department of Thoracic Cardiovascular Surgery at West-German Heart & Vascular Center Essen, University Hospital Essen, University Duisburg-Essen.

Thorsten Brenner

Brenner, Thorsten, Dr Med., Professor. Chairman and Head of the Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen.

Ali Haddad

Haddad, Ali, Dr Med., Anesthesiologist, Intensive Care & Emergency Medicine Doctor at the Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen.