Use of an online ultrasound simulator to teach the basic psychomotor skills to medical students during the initial COVID-19 breakdown (Preprint)

BACKGROUND Teaching medical ultrasound (US) has gained in popularity in medical schools. Hands-on workshops are an essential part of teaching. The lockdown induced by COVID-19 kept our medical school from conducting these workshops. OBJECTIVE The aim of this paper is to describe an alternative method we used to allow our students to acquire the essential psychomotor skills requisite to produce US images. METHODS Our students should study online US courses. After this study, they had to practice exercises on a virtual simulator, using the mouse of their computer to control a simulated transducer. We measured the precision reached at the completion of simulation exercises. Before and after completion of the courses and simulator’s exercises, students had to complete a questionnaire dedicated to psychomotor skills. A general evaluation questionnaire was also submitted. RESULTS One hundred and ninety three students returned the pre-course questionnaire. One hundred and eighty four performed all the simulator exercises and 181 answered the post-course questionnaire. One hundred and ninety general evaluation questionnaires were sent and 136 returned (76%). The average pre-course score was 4.23 (SD 2.14), after exercising, the average post-course score was 6.36 (SD 1.82), with a significant improvement (p< .001). The post-course score was related to the accuracy with which the simulator exercises were performed (Spearman's rho 0.2664, p< 0.01). Nearly two-thirds (62.6%) of the students said they enjoyed working on the simulator. Seventy-nine (58.0%) students felt that they had achieved the course's objective of reproducing ultrasound images. Inadequate connection speed had been a problem for 40.2% of students. CONCLUSIONS The integration of an online simulator for the practical learning of US in remote mode has allowed substantial acquisitions in the psychomotor field of US diagnosis. Despite the absence of workshops, the students were able to learn and practice how to handle an US probe in order to reproduce standard images. CLINICALTRIAL Not considered as a RCT by our ethics committee (Req-2021-00589)

Novel and flexible ultrasound simulation with smartphones and tablets in fetal echocardiography

Purpose Evaluation of a novel ultrasound-simulation-app for training fetal echocardiography as a possible useful addition for students, residents and specialist doctors. Furthermore, comparison to a conventional learning-method with special attention on orientation and recognition of physiological structures. Methods Prospective two-arm study with the participation of 226 clinical students. 108 students were given an extract from a textbook on fetal echocardiography (PDF-group, n = 108) for 30 min to study. 118 students were able to use the new ultrasound-simulator-app (Simulator-group, n = 118) to learn for 30 min. The knowledge of the students was examined both before and after the learning-period by having them identify sonographic structures in videos using single-choice selection. Results There were no significant differences between the two groups regarding age (p = 0.87), gender (p = 0.28), and the number of previously performed ultrasound-examinations (p = 0.45). In the Simulator-group, there was a significantly higher learning effect regarding the proportion of students with an increase of correct answers in the video test examination (p = 0.005). At the end of learning, the students in the Simulator-group needed significantly less time to display the structures in the app’s simulation (median initially 10.9 s vs. 6.8 s at the end; p < 0.001). Conclusions The novel ultrasound-simulation-app seems to be a useful addition and improvement to ultrasound training. Previous difficulties such as simultaneously having patients, ultrasound-machines, and professors at disposal can thus be avoided. This means that another important step towards remote learning can be taken, which has been proven increasingly essential lately, due to the COVID-19 pandemic.

Usefulness of an Intrapartum Ultrasound Simulator (IUSim™) for Midwife Training: Results from an RCT

<b><i>Introduction:</i></b> We conducted a randomized study to determine whether a training session on a dedicated simulator (IUSim™) would facilitate the midwives in learning the technique of transperineal intrapartum ultrasound. <b><i>Methods:</i></b> Following a 30-min multimedia presentation including images and videos on how to obtain and measure the angle of progression (AoP) and the head-perineum distance (HPD), 6 midwives with no prior experience in intrapartum ultrasound were randomly split into 2 groups: 3 of them were assigned to the “training group” and 3 to the “control group.” The midwives belonging to the former group were taught to measure the 2 sonographic parameters during a 3-h practical session conducted on IUSim™ under the supervision of an expert obstetrician. In the following 3 months, all the 6 midwives were asked to independently perform transperineal ultrasound during their clinical practice and to measure on the acquired images either the AoP or the HPD. The sonographic images were examined in blind by the teaching obstetrician who assigned a 0–3 score to the image quality (IQS) and to the measurement quality (MQS). <b><i>Results:</i></b> A total of 48 ultrasound images (24 patients) from 5 midwives were acquired and included in the study analysis. A midwife of the “training group” declined participation after the practical session. Independently from the randomization group, the image quality score (IQS + MQS) was significantly higher for the HPD compared with the AoP (2.5 ± 0.66 vs. 1.79 ± 1.14; <i>p</i> = 0.01). In the training group, the MQS of either AoP (2.66 ± 0.5 vs.1.46 ± 1.45. <i>p</i> = 0.038) and the HPD (2.9 ± 0.33 vs. 1.87 ± 0.83 <i>p</i> = 0.002) was significantly higher in comparison with the control group, while the IQS of both measurements was comparable between the 2 groups (1.91 ± 1.24 vs. 2.25 ± 0.865; <i>p</i> = 0.28). <b><i>Conclusion:</i></b> The use of a dedicated simulator may facilitate the midwives in learning how to measure the AoP and the HPD on transperineal ultrasound images.