Comparative Evaluation of Self-Learning Versus Instructor-Guided Cardiac Ultrasonography Training.

Abstract

Purpose: Point-of-care ultrasonography (PoCUS) has improved the diagnostic capacity of medical conditions; however, integrating it into medical curricula is constrained by cost, time, accessibility, and teaching style variability. This study examines whether simulator-based self-learning for cardiac PoCUS is noninferior to instructor-guided teaching.

Method: This randomized controlled trial, conducted at Ben-Gurion University of the Negev, enrolled 116 medical students as part of the medical school's PoCUS curriculum. Participants were randomly assigned to a simulator-based self-learning or conventional instructor-guided teaching group. After training, which took place January 29 to February 22, 2023, participants completed exams on February 23, 2023, assessing their abilities to obtain specific cardiac views, capture images of quality, and correctly identify common cardiac pathologies.

Results: Of 116 participants, 57 (49.1%) were categorized into the instructor-guided group and 59 (50.9%) the self-learning group. Participants in the self-learning group had higher total test scores compared with the instructor-guided group (81.6% vs 77.2%, P = .30), with only the apical 2-chamber view reaching statistical significance in favor of the self-learning group (81.3% vs 68.3%, P = .04). The self-learning group also scored higher on image quality, but the difference was not statistically significant (59.5% vs 55.6%, P = .26). There was no significant difference in total scores for cardiac pathology identification (93.5% in the self-learning group vs 94.7% in the instructor-guided group, P = .81). A multivariable logistic regression presented no significant difference in achieving an above median score when adjusted for gender, chest anatomy academic grade, and prior PoCUS training (adjusted odds ratio, 1.55; 95% CI, 0.69-3.53; P = .30).

Conclusions: This study suggests that the self-learning approach is noninferior to instructor-guided teaching for cardiac ultrasonography training. Incorporating these programs into medical curricula may enhance the quantity and proficiency of PoCUS operators, improving diagnostic capabilities and treatment outcomes across medical specialties.