Use of Multimedia for Resident Education in Aorta Ultrasound

Abstract

It has been suggested that independent study and individual educational activities can be more effective than didactic lectures in resident education. Our primary objective was to show that a multimedia application could be effective in teaching emergency medicine residents basic aorta ultrasound for identification of normal anatomy and common pathology. If individual educational activities show superior (or equivalent) performance, as compared to traditional didactic teaching, then it can be incorporated into the curriculum of a residency program. This was an educational interventional trial at a 3-year residency program in emergency medicine approved by the Accreditation Council for Graduate Medical Education (ACGME). All subjects were evaluated on their ability to identify aorta anatomy and pathology with the use of still and video ultrasound (US) images. The residents were asked 22 multiple-choice questions on basic aorta ultrasound. Half the residents from each post-graduate year (PGY) were divided into 2 groups. Both groups received a pre-test (22 multiple choice questions) prior to the start of the learning activity. Group 1 received a didactic lecture based on aorta ultrasound. The lecture format was a case-based presentation and was delivered by a senior member of the ultrasound division. Group 2 received a 1-hour case-based multimedia tutorial in aorta US. Both presentations were identical in format, cases and images. At the end of the learning activity, residents were given a post-test (22 multiple-choice questions). The post-test will be repeated at 6-month and 12-month interval to evaluate for retention of educational objectives. There were 28 total subjects: 9 PGY-1, 10 PGY-2, and 9 PGY-3. Median (IQR) scores for the pretest were: PGY-1 16 (14, 19), PGY-2 17 (15, 18), and PGY-3 19 (18, 19). These differences were statistically significant at p=0.05. Scores for the posttest were: PGY-1 19 (18, 22), PGY-2 18.5 (18, 20), and PGY-3 19 (19, 19). These differences were not statistically significant at p=0.36. The change in scores from pretest to posttest were: PGY-1 4 (1, 5), PGY-2 2 (2, 3), and PGY-3 0 (0, 0). These differences were statistically significant at p=0.002. The differences in score change by lecture versus multimedia were: lecture 2 (0, 2), multimedia 1 (0, 3). These differences were not statistically significant at p=0.98. Independent learning with a multimedia tutorial in aorta ultrasound is an appropriate alternate to traditional didactic lecture. The greatest impact is on the novice sonographers.