Suzuki Reina, Riley William J, Bushman Matthew S, Dong Yue, Sekiguchi Hiroshi
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
Department of General Internal Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Ultrasound J. 2024 Oct 28;16(1):47. doi: 10.1186/s13089-024-00394-1.
Traditionally, ultrasound skills have been taught through a one-on-one approach, where instructors physically guide learners' hands at the bedside or in the workshop. However, this method is frequently challenged by scheduling and cost limitations. Our objective was to create a tele-education model for point-of-care ultrasound training and evaluate its effectiveness and its impact on learners' perceived workload compared to conventional education and self-directed learning methods.
We conducted a 3-arm randomized trial, comparing tele-education (TE), conventional education (CE) and self-directed learning (SL) methods. All subjects underwent online didactic lectures prior to a hands-on ultrasound workshop. The TE group utilized an ultrasound machine equipped with a speakerphone, a webcam for direct visualization of learner's hand maneuvers, and an analog-to-video converter for the real-time streaming of ultrasound images. This configuration enabled remote instructors to provide immediate verbal feedback to learners. In contrast, the CE group received in-person coaching, while the SL group had no instructors present. Following the coaching session, subjects completed a scenario-based skill test and a survey on the National Aeronautics and Space Administration task load index (NASA-TLX) to measure their ultrasound competency and perceived workload, respectively.
Twenty-seven ultrasound novices were randomly allocated into 3 groups. The median skill test score of TE, CE, and SL was 22 [interquartile range (IQR): 18-28], 24 [IQR: 21-31], and 16 [IQR: 15-18], respectively (p < 0.01). Pairwise comparisons of median test scores of 3 groups demonstrated a statistical significance in comparisons of TE vs. SL (22 vs. 16, p = 0.01) and CE vs. SL (24 vs. 16, p < 0.01), but not in TE vs. CE (22 vs. 24, p = 0.56). There was no statistical significance observed in the median NASA-TLX scores among the 3 groups; 54 [IQR:47-61] in TE, 57 [IQR:22-64] in CE, and 66 [IQR: 66-72] in SL (p = 0.05).
Our tele-education model was more effective than self-directed learning. There was no statistically significant difference in effectiveness between the tele-education and the conventional education groups. Importantly, tele-education did not impose a significantly higher workload on learners compared to conventional education or self-directed learning. Tele-education has a substantial potential as an alternative to conventional ultrasound training.
传统上，超声技能是通过一对一的方式传授的，即教师在床边或工作坊中亲自指导学习者的手部操作。然而，这种方法经常受到时间安排和成本限制的挑战。我们的目标是创建一种用于床旁超声培训的远程教育模式，并评估其有效性以及与传统教育和自主学习方法相比对学习者感知工作量的影响。
我们进行了一项三臂随机试验，比较远程教育（TE）、传统教育（CE）和自主学习（SL）方法。所有受试者在实践超声工作坊之前都参加了在线理论讲座。TE组使用配备了免提电话、用于直接观察学习者手部动作的网络摄像头以及用于实时传输超声图像的模拟-to-视频转换器的超声机器。这种配置使远程教师能够立即向学习者提供口头反馈。相比之下，CE组接受面对面指导，而SL组没有教师在场。在指导课程之后，受试者完成了基于场景的技能测试以及关于美国国家航空航天局任务负荷指数（NASA-TLX）的调查，以分别测量他们的超声能力和感知工作量。
27名超声新手被随机分配到3组。TE组、CE组和SL组的技能测试中位数分数分别为22[四分位数间距（IQR）：18 - 28]、24[IQR：21 - 31]和16[IQR：15 - 18]（p < 0.01）。3组中位数测试分数的两两比较显示，TE与SL比较（22对16，p = 0.01）以及CE与SL比较（24对16，p < 0.01）具有统计学意义，但TE与CE比较（22对24，p = 0.56）无统计学意义。3组之间NASA-TLX中位数分数未观察到统计学意义；TE组为54[IQR：47 - 61]，CE组为57[IQR：22 - 64]，SL组为66[IQR：66 - 72]（p = 0.05）。
我们的远程教育模式比自主学习更有效。远程教育组和传统教育组在有效性方面没有统计学上的显著差异。重要的是，与传统教育或自主学习相比，远程教育没有给学习者带来显著更高的工作量。远程教育作为传统超声培训的替代方法具有巨大潜力。
