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Table 1 Publications on education in lung ultrasound: study characteristics

From: Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training

  Study design Assessment Facility Education tool Participants
Pre and post-test studies
 Noble et al. [13] Pre- and post-test Theoretical pre- and post-test (50 video clips) Ultrasound video clips 2 h didactic lecture (one for pneumothorax and one for pulmonary oedema) 27 physicians working for the SAMU at l’Hôpital Necker in Paris, France
 Oveland et al. [14] Pre- and post-test and 6-months follow-up Theoretical pre- and post-test (34 MCQs, 10 US physics questions, 17 recognition pictures, 7 video clips) and hands-on practical examination (6 months follow-up Healthy live models and porcine models 8 h attendance course including didactic (2 h), practical (2 h) and experimental (4 h) sessions 20 first-year to graduate-year medical students (11 at 6 months follow-up)
 Breitkreutz et al. [15] Pre- and post-test Theoretical pre- and post-test (15 MCQs and 5 recognition images), post course recognition quiz (15 video clips) and practical post course examination (16 predefined sonoanatomic items) Healthy live models, patients with chronic or malignant lung diseases or who had recently underwent thoracotomy. Custom-made gel phantoms Two and a half hour theoretical training (six brief lectures in anatomy, physiology and pathology of thorax and four case presentations). Two and a half hour hands-on training 54 trainees. Group A: 14 medical students, Group B: 32 anaesthesiologists, Group C: 8 trauma surgeons
 Cuca et al. [16] Pre- and post-test Theoretical pre-, post-, and sustainability test (20 MCQs, results compared with THOLUUSE-study [14]) E-learning module including physiological and pathological sonographic patterns (Five topics: basics and pleural effusion, pneumothorax, pulmonary oedema and consolidation, trachea, workflow of LUS) estimated time 30–50 min 29 medical students and medical doctors
 Hulett et al. [17] Pre- and post-test Theoretical pre- and post-test (46 questions including MCQs, true/false, matching items, fill-in-the blank image and video recognition), practical pre- and post course skills Patients located in medical ICU at the North Carolina Hospital 1 h didactic instruction, 1 h image interpretation workshop and image acquisition training, in 1 work week supervised hands-on training Eight critical care medicine fellows
 Bhat et al. [18] Pre- and post-test and 1-week follow-up Theoretical (16 MCQs) Ultrasound images and video clips obtained in the Emergency Department by trained ultrasound physicians 1 h didactic lecture including basic scan technique, normal ultrasound anatomy, image interpretation of normal or pathological pattern 57 prehospital providers (19 medical technicians students, 16 paramedic students, 18 certified medical technicians and four certified paramedics
 Connolly et al. [19] Pre- and post-test Theoretical pre- and post-test (21 MCQs) and practical examination (real-time scans saved and blinded evaluated by instructors) Live models and phantom task trainer models and simulators Five 1-h workshops and 4 h didactic online preparatory training. Hands-on with supervised scans 24 medical students in MCQ pre- and post-test evaluation and 16 in clinical skill assessment
 Dinh et al. [20] Pre- and post-test and 3 months follow-up Theoretical pre-, post-, and sustainability test (50 MCQs—12 pulmonary) (84 point checklist). Pathologic image interpretation (4 cases with each 20 questions each). Ultrasound comfort level and use of ultrasound Healthy live models, simulators 2 days course including didactic lectures, live demonstrations, hands-on sessions on healthy models, pathologic image interpretation with cases using ultrasound simulator Eight ICU fellows, participants with the previous ultrasound experience were excluded
 Heiberg et al. [21] Pre- and post-test Theoretical pre- and post-test (56 MCQs) and practical three test sessions Four healthy medical students E-learning course including text, pictures, animations and movies (5–8 h) and hands-on session (4 h; 30 min LUS) 20 medical students
 Sanchez-de-Toledo et al. [22] Pre- and post-test Theoretical pre-, and post-test (four written cases). Practical skill test after 60 min hands-on session (four cases) Porcine models One and a half hour theoretical and practice-based course Four veterinaries, eight neonatologists, seven paediatric intensive care specialists, two intensive care nurses, three paediatric surgeons, eight paediatric anaesthesiologists, four paediatricians
 See et al. [23] Pre- and post-test Theoretical pre- and post-test (20 MCQs) and hands-on (blinded evaluation of image acquisition and interpretation) Mechanically ventilated patients or patients with respiratory failure, requiring at least 40% inspired oxygen fraction to maintain an oxygen saturation of 90% 30 min didactic introduction, 1 month self-study (powerpoint slides, criticalecho.com and court.net). Supervised scans with immediately feedback with focus on image acquisition, afterwards image interpretation by blinded observer 22 respiratory therapists
 Greenstein et al. [24] Pre- and post-test Theoretical pre- and post-test (20 MCQs) and hands-on assessment Healthy human models 3 days course including didactic lectures with real-time ultrasound scan on healthy models, image interpretation sessions and hands-on training 363 critical care physicians, hospitalists, surgeons, physician assistants, advanced practice nurses and medical residents
Descriptive studies
 Krishnan et al. [25] Post course evaluation and sustainability test Theoretical post- and sustainability test (20 video clips ± pneumothorax) Ultrasound video of 53 patients before and after elective thoracic surgery. In all, 99 videos were compiled (52 without pneumothoraces and 47 with) 5-min online presentation of the use of ultrasound for detection of pneumothorax 79 (70 at 6 month follow-up) residents and faculty members from Department of anaesthesia
Abbasi et al. [26] Prospective cross-sectional study Hands-on assessment (± pneumothorax) Healthy live models and patients admitted in Emergency Department with thoracic trauma 2 h training course including 30 min didactic lecture, 30 min hands-on training on healthy volunteers, 1 h training on patients Four emergency physicians
Gargani et al. [27] Post course evaluation Online assessment of uploaded LUS examinations and theoretical assessment of b-line interpretation (44 videos) Patients Part A: web-based training program; 26 min educational video with focus on b-line assessment. Upload of 7 self-performed lung ultrasound videos, when videos were approved by experts, trainees proceed to Part B: b-line interpretation Thirty nephrologists and 14 cardiologists
Randomized controlled trial
 Edrich et al. [28] Randomized controlled trial with 4 weeks follow-up Theoretical pre-, post-, and sustainability test (10 MCQs and one video clip) and practical examination (blinded reviewers) Healthy live models Group I: web-based (powerpoint 25 min and online demonstration 5 min). Group II: Classroom-based (powerpoint) 45 min didactic lectures and 20 min hands-on training. Group III: No education or hands-on training. Blinded reviewers 138 anaesthesiologists from four academic hospitals. Participants with the previous ultrasound experience excluded