Student tutors for hands-on training in focused emergency echocardiography--a randomized controlled trial

Matthias Kühl, Robert Wagner, Markus Bauder, Yelena Fenik, Reimer Riessen, Maria Lammerding-Köppel, Meinrad Gawaz, Suzanne Fateh-Moghadam, Peter Weyrich, Nora Celebi, Matthias Kühl, Robert Wagner, Markus Bauder, Yelena Fenik, Reimer Riessen, Maria Lammerding-Köppel, Meinrad Gawaz, Suzanne Fateh-Moghadam, Peter Weyrich, Nora Celebi

Abstract

Background: Focused emergency echocardiography performed by non-cardiologists has been shown to be feasible and effective in emergency situations. During resuscitation a short focused emergency echocardiography has been shown to narrow down potential differential diagnoses and to improve patient survival. Quite a large proportion of physicians are eligible to learn focused emergency echocardiography. Training in focused emergency echocardiography usually comprises a lecture, hands-on trainings in very small groups, and a practice phase. There is a shortage of experienced echocardiographers who can supervise the second step, the hands-on training. We thus investigated whether student tutors can perform the hands-on training for focused emergency echocardiography.

Methods: A total of 30 volunteer 4th and 5th year students were randomly assigned to a twelve-hour basic echocardiography course comprising a lecture followed by a hands-on training in small groups taught either by an expert cardiographer (EC) or by a student tutor (ST). Using a pre-post-design, the students were evaluated by an OSCE. The students had to generate two still frames with the apical five-chamber view and the parasternal long axis in five minutes and to correctly mark twelve anatomical cardiac structures. Two blinded expert cardiographers rated the students' performance using a standardized checklist. Students could achieve a maximum of 25 points.

Results: Both groups showed significant improvement after the training (p < .0001). In the group taught by EC the average increased from 2.3±3.4 to 17.1±3.0 points, and in the group taught by ST from 2.7±3.0 to 13.9±2.7 points. The difference in improvement between the groups was also significant (p = .03).

Conclusions: Hands-on training by student tutors led to a significant gain in echocardiography skills, although inferior to teaching by an expert cardiographer.

Figures

Figure 1
Figure 1
OSCE Scores. OSCE-Scores of the medical students before and after the hands-on training supervised by expert echocardiographers (EC) and student tutors (ST).

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Source: PubMed

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