Structured, Small-group Hands-on Teaching Sessions Improve Pre-clerk Knowledge and Confidence in Point-of-care Ultrasound Use and Interpretation.

Abstract

IntroductionMany undergraduate medical education (UME) programs have begun adopting point-of-care ultrasound (PoCUS) curricula, reflecting the increasing ubiquity of this technique across medical specialties. The structures of international PoCUS curricula have been extensively studied. However, the efficacy of these curricula to increase knowledge and confidence in PoCUS is less well-studied. We investigated whether a structured, small-group PoCUS teaching session consisting of pre-defined learning objectives, an introductory presentation, and a mandatory hands-on scanning component would increase pre-clerk knowledge of and confidence in PoCUS theory, use, and interpretation.MethodsA pre-post study was designed to assess changes in pre-clerk knowledge and confidence in PoCUS theory, use, and interpretation. Pre-clerks were recruited from the Hamilton campus of the Michael G. DeGroote School of Medicine at McMaster University. Pre-clerks were organized into four groups, with an average group size of seven learners. Two preceptors each taught two groups. Sessions included an introductory PowerPoint presentation and one-on-one preceptor-guided practice in identifying abdominal and genitourinary structures using PoCUS. Student responses on pre- and post-intervention surveys were analyzed to identify changes in knowledge and confidence. Student satisfaction with the teaching session was assessed from self-reported levels of agreement with satisfaction statements. The strengths and areas of improvement for the teaching sessions were identified from open-ended survey responses.ResultsData from 27 students indicated a significant improvement in knowledge test scores (p < .05), with no significant differences between groups (F(3,23) = 0.64, p = n.s.) or between students with different preceptors (p = n.s.). Students’ confidence in PoCUS use and interpretation improved significantly (p < .05 for both), with no significant differences between groups (F(3,23) = 0.70, p = n.s. and F(3,23) = 0.32, p = n.s., respectively) or between students with different preceptors (p = n.s. for both). Improvements in knowledge of and confidence in PoCUS use were significantly correlated (r = .44, p < .05). All of the students agreed that they liked the instruction, content, and structure of the teaching session. The most frequently cited strengths of the teaching sessions were the mandatory individual practice time per student, individualized instruction from and interactions with preceptors, and the small group structure of the sessions.ConclusionThis study provides novel evidence that a structured, small-group teaching session featuring a didactic presentation, defined learning objectives, and mandatory hands-on learning can effectively teach introductory PoCUS knowledge and skills to pre-clerks and increase student confidence. Future studies will investigate the retention and application of PoCUS knowledge and skill throughout clerkship and early residency training to determine if this teaching model can facilitate longitudinal PoCUS learning and competency as well as improved diagnostic capabilities as students advance through undergraduate medical training.