Case-Based Learning for Bedside Lung Ultrasound Teaching in ICU

CBL Mode in Clinical Teaching of Bedside Lung Ultrasound in Intensive Care Unit: A Randomized Controlled Study

This single-center randomized controlled study aims to evaluate the effectiveness of Case-Based Learning (CBL) compared with traditional teaching in clinical training of bedside lung ultrasound (BLUE) for emergency medicine residents and medical students. The hypothesis is that CBL improves theoretical understanding, practical ultrasound skills, and clinical reasoning in emergency settings.

Study Overview

• Status: Not yet recruiting
• Conditions: Emergency Medicine; Medical Education; ICU; Lung Ultrasound; Case-based Learning
• Intervention / Treatment: Behavioral: Case-Based Learning (CBL); Behavioral: Traditional lecture-based teaching

Detailed Description

This single-center randomized controlled educational trial will be conducted in the Intensive Care Unit (ICU) of the First Affiliated Hospital of Wannan Medical College, China. The study aims to compare the effectiveness of Case-Based Learning (CBL) and traditional lecture-based teaching in bedside lung ultrasound (BLUE) education for residents and medical students participating in critical care rotations.

Participants will be randomized in a 1:1 ratio by computer-generated sequence into either the CBL group or the traditional teaching group. Both groups will receive a total of 8 hours of instruction delivered in two 4-hour sessions during their ICU rotation period.

In the CBL group, teaching will be guided by authentic clinical cases that include varied respiratory pathologies (e.g., pneumonia, pneumothorax, pulmonary edema). Each case will involve small-group discussion of diagnostic reasoning, interpretation of ultrasound findings, and supervised scanning practice at the bedside. Instructors will facilitate feedback and reflective learning, integrating theoretical concepts with clinical application.

In the traditional teaching group, participants will attend classroom lectures on ultrasound principles and watch instructor-led demonstrations of standardized BLUE examination techniques. Short hands-on practice sessions will follow under supervision but without case-based discussion or peer-feedback components.

All teaching sessions will be delivered by faculty certified in critical ultrasonography, using standardized instruction materials and the same ultrasound equipment and scanning protocols across groups. Data collection will occur within one week after completion of the teaching intervention. Primary outcomes include Objective Structured Clinical Examination (OSCE) score reflecting image acquisition, interpretation, and clinical reasoning. Secondary outcomes comprise written knowledge test scores and learner-reported measures of learning motivation and satisfaction.

All analyses will follow the intention-to-treat principle. Group differences will be tested using appropriate statistical methods (e.g., independent t-test or Mann-Whitney U test for continuous variables and chi-square test for categorical variables). The results will provide empirical evidence to guide optimization of bedside lung ultrasound education and the implementation of interactive, case-based teaching strategies in the context of intensive and emergency care training programs.

• Study Type: Interventional
• Enrollment (Estimated): 106
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: qiancheng xu; Phone Number: +86-18297529106; Email: qianchengxu@wnmc.edu.cn

Study Locations

• China
  • Anhui
    • Wuhu, Anhui, China, 241001
      • The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College)
      • Contact: qiancheng xu; Email: xu19871011@163.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Standardized residency trainees currently rotating in the Intensive Care Unit (ICU), specializing in Internal Medicine, Surgery, Emergency Medicine, Anesthesiology, or General Practice.
• Have completed institutional basic ultrasound theory training or possess preliminary ultrasound knowledge.
• Voluntarily participate and provide written informed consent.
• Able to complete the entire teaching and evaluation schedule (including written test and OSCE).

Exclusion Criteria:

• Prior formal training or certification in lung/critical care ultrasound.
• Unable to complete the study period due to rotation scheduling or absence.
• Decline or withdraw informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Case-Based Learning (CBL) Group; Participants study authentic emergency cases, analyze lung ultrasound images, perform bedside scanning under instructor facilitation, and discuss diagnostic reasoning in small groups.	Behavioral: Case-Based Learning (CBL); Participants study authentic emergency cases, analyze lung ultrasound images, perform bedside scanning under instructor facilitation, and discuss diagnostic reasoning in small groups.
Active Comparator: Traditional Teaching Group; Participants receive conventional didactic lectures and instructor demonstration of BLUE examination followed by limited practice.	Behavioral: Traditional lecture-based teaching; Participants receive conventional didactic lectures and instructor demonstration of BLUE examination followed by limited practice.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Objective Structured Clinical Examination (OSCE) Total Score	he Objective Structured Clinical Examination (OSCE) total score (0-100 points) evaluates overall bedside lung ultrasound proficiency. It includes five weighted stations: (1) image acquisition and scanning technique (20 points), (2) image interpretation (20 points), (3) clinical decision-making (20 points), (4) structured case reporting and teamwork (20 points), and (5) emergency communication with patients or families (20 points). Each station is rated by three blinded assessors using standardized checklists and global rating scales. Higher scores indicate better ultrasound performance and clinical reasoning ability. Scale Range: 0 (poor performance) to 100 (excellent performance); higher = better	Within one week after completion of the teaching sessions

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Written Theoretical Knowledge Test Score	Description: Written examination assessing understanding of lung ultrasound principles, BLUE protocol workflow, and case analysis. The test includes multiple-choice, multiple-response, short-answer, and case-analysis items. Total score ranges from 0 to 100 points. Higher scores indicate greater theoretical knowledge mastery. Scale Range: 0 (lowest) to 100 (highest); higher = better	Within one week after the intervention
Clinical Decision Substation Score	Description: Subscore from the Objective Structured Clinical Examination (OSCE) Station 3, evaluating diagnostic reasoning and initial management decisions based on bedside lung ultrasound findings. Scored on a 0-20 point checklist by blinded assessors. Higher values reflect stronger clinical decision-making ability. Scale Range: 0 (lowest) to 20 (highest); higher = better	Within one week after intervention
Self-Assessment Questionnaire Scores	Description: Study-specific questionnaire evaluating self-perceived improvement in learning motivation, clinical reasoning, teamwork, and communication. Each dimension consists of 5 dichotomous items (Yes = 1; No = 0). Scores are summarized as the proportion (%) of participants responding "Yes" in each domain. The possible range is 0%-100%; higher proportions indicate more participants reporting improvement. Scale Range: 0%-100%; higher = better perceived improvement	Within one week after the intervention
Overall Learning Satisfaction Rating	Description: Overall satisfaction measured by a single 5-point Likert-type item (1 = Very dissatisfied, 2 = Dissatisfied, 3 = Neutral, 4 = Satisfied, 5 = Very satisfied). Reported as the proportion (%) of participants rating ≥4. Higher proportions reflect greater satisfaction with the assigned teaching method. Scale Range: 1-5 for individual ratings; 0%-100% for proportion ≥4; higher = better satisfaction	Within one week after the intervention

Collaborators and Investigators

• Sponsor: First Affiliated Hospital of Wannan Medical College

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): June 30, 2027
• Study Completion (Estimated): June 30, 2027

Study Registration Dates

• First Submitted: May 10, 2026
• First Submitted That Met QC Criteria: May 14, 2026
• First Posted (Actual): May 18, 2026

Study Record Updates

• Last Update Posted (Actual): May 18, 2026
• Last Update Submitted That Met QC Criteria: May 14, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Emergency Medicine; Intensive Care Unit; Case-based learning; Bedside Lung Ultrasound (BLUE); Case-Based Learning (CBL); Critical ultrasonography
• Other Study ID Numbers: 2026-0511

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No