Peer-teaching cardiac ultrasound among medical students: A real option

• Published in: PloS one 2019-03, Vol.14 (3), p.e0212794-e0212794
• Main Authors: Ben-Sasson, Alon, Lior, Yotam, Krispel, Jonathan, Rucham, Moshe, Liel-Cohen, Noah, Fuchs, Lior, Kobal, Sergio L
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Biology and Life Sciences; Cardiology; Cardiovascular diseases; Clinical Competence; Clinical trials; Comparative analysis; Copper; Core curriculum; Critical care; Curriculum; Dependence; Diagnostic systems; Echocardiography; Education; Education, Medical, Undergraduate - methods; Educational Measurement - statistics & numerical data; Feasibility Studies; Female; Hand (anatomy); Health sciences; Heart; Heart - diagnostic imaging; Humans; Image acquisition; Imaging techniques; Internal medicine; Learning; Male; Medical diagnosis; Medical imaging; Medical personnel training; Medical schools; Medical students; Medicine and Health Sciences; Peer Group; Peer tutoring; People and Places; Program Evaluation; Prospective Studies; Research and Analysis Methods; Schools; Schools, Medical; Social Sciences; Students; Students, Medical - statistics & numerical data; Studies; Teachers; Teaching; Teaching methods; Ultrasonic imaging; Ultrasonic methods; Ultrasonic testing
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0212794

Teaching cardiac ultrasound (CU) image acquisition requires hands-on practice under qualified instructors supervision. We assessed the efficacy of teaching medical students by their previously trained classmates (teaching assistants [TAs]) compared to teaching by expert trainers (cardiologists or diagnostic medical sonographers. Sixty-six students received 8-hour CU training: 4-hour lectures on ultrasound anatomy and imaging techniques of 6 main CU views (parasternal long [PLAV] and short axis [PSAV]; apical 4-chamber [4ch], 2-chamber [2ch], and 3-chamber [3ch]; and sub costal [SC]) followed by 4 hours of hands-on exercise in groups of ≤5 students under direct supervision of a TA (group A: 44 students) or a qualified trainer (group B: 22 students). Students' proficiency was evaluated on a 6-minute test in which they were required to demonstrate 32 predetermined anatomic landmarks spread across the 6 views and ranked on a 0-100 scale according to a predetermined key. The 6-minute test final grade displayed superiority of group A over group B (54±17 vs. 39±21, respectively [p = 0.001]). This trend was continuous across all 6 main views: PLAV (69±18 vs. 54±23, respectively), PSAV (65±33 vs. 41±32, respectively), 4ch (57±19 vs. 43±26, respectively), 2ch (37±29 vs. 33±27, respectively), 3ch (48±23 vs. 35±25, respectively), and SC (36±27 vs. 24±28, respectively). Teaching medical students CU imaging acquisition by qualified classmates is feasible. Moreover, students instructors were superior to senior instructors when comparing their students' capabilities in a practical test. Replacing experienced instructors with TAs could help medical schools teach ultrasound techniques with minimal dependence on highly qualified trainers.