Table 1 Publications on education in lung ultrasound: study characteristics
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 |