Comparison of learning focused cardiac ultrasound between self-directed and proctored simulator teaching

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Physician-performed focused cardiac ultrasound (FCU) is established in anaesthesia and critical practice and is increasingly taught in undergraduate medicine curricula. The most important barrier to adoption, reported by Conlin (Conlin et al., Anesth Analg 2017;125:1878–82) was lack of training opportunity, and identifies a strong need for a scalable teaching process that provides acceptable learning outcomes The traditional training model for FCU is a combination of didactic learning followed by proctored practical teaching of ultrasound image acquisition with FCU trainers (eg. iHeartScan, University of Melbourne), who are in short supply. Reliability on trainers restricts training to participants who can access the limited number of courses. Ultrasound simulators are increasingly adopted by medical institutions to teach FCU. We have developed an FCU course that reduces the requirement for trainers from one and a half days to only three hours (FCU TTE Course) using a cloud-based platform that provides eLearning of knowledge base and instruction to participants on their personal device on how to teach themselves image acquisition using an ultrasound simulator. We have demonstrated that the simulator course was more effective in teaching FCU image acquisition (Canty et al. J Crit Care 2019;49:38–44). This reduction in trainer time required to teach FCU increases the capacity for training FCU, however is still significantly restricted by the 3-hour proctored session. We have recently eliminated the requirement for trainers by replacing the 3-hour proctored learning session with an eLearning package and on-line automated assessment. The aim of this study is to determine whether the learning of image acquisition skills by medical students who complete the self-directed simulator course is non-inferior to students not exposed to the course, and to determine if the learning of cardiovascular clinical examination of patients with cardiac disease is improved. Justification and expected benefits There is increasing demand for FCU training and for this to begin in medical school. An entirely self-directed FCU teaching course that also course improves the learning of cardiovascular clinical examination would be a significant step to answering this demand.

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