eFast, Medical Education, Point of Care Ultrasound (POCUS)
Conditions
Keywords
eFAST, point-of-care ultrasound, randomised controlled trial, medical education, bedside teaching, video-based learning
Brief summary
This study compared two methods of teaching the Extended Focused Assessment with Sonography for Trauma (eFAST) examination to final-year medical students. Participants were randomly assigned in a 1:1 ratio to either a 60-minute standardized video-based training session or a 60-minute instructor-led bedside training session. Both groups received the same educational content, for the same duration, from the same instructor. Within one hour after completing the training, each participant performed an individual eFAST examination on a healthy volunteer. Performance was assessed by an evaluator who was unaware of the participant's training group, using an eFAST Image Acquisition Checklist. The study compared overall immediate eFAST performance between the two teaching methods and also examined performance in individual eFAST examination windows.
Detailed description
This was a single-center, parallel-group, individually randomized educational trial involving final-year medical students undertaking an emergency medicine clerkship. Participants with previous formal ultrasound training or prior practical ultrasound experience were excluded. One hundred consenting participants were randomized, with 50 assigned to standardized video-based eFAST training and 50 assigned to instructor-led bedside eFAST training. Both interventions lasted 60 minutes and covered the same theoretical and practical eFAST content. Participants underwent an individual practical assessment on a healthy volunteer within one hour after training. Outcome assessors were blinded to training allocation. Performance was assessed using an eFAST Image Acquisition Checklist, which generated an overall score ranging from 0 to 100 and window-specific classifications of error-free performance. No primary outcome was designated in advance of the analysis. For the present report and retrospective trial registration, the overall eFAST performance score is designated as the primary outcome, while the window-level comparisons are considered exploratory secondary outcomes.
Interventions
OTHERStandardized Video-Based eFAST Training
Participants watched a standardized 60-minute instructional video covering the theoretical principles and practical performance of eFAST. The video was recorded on a healthy volunteer and included demonstrations of the examination with visual annotation. Content included the principles and clinical indications of eFAST, ultrasound physics, examination windows, transducer selection, probe positioning and orientation, image optimization, normal anatomical landmarks, and representative pathological images.
OTHERInstructor-Led Bedside eFAST Training
Participants received a 60-minute instructor-led bedside training session delivered by the same emergency physician on a healthy volunteer. The session covered the same theoretical and practical eFAST content as the video-based intervention and included live demonstration of each examination window followed by supervised practice, during which each participant performed the examination once under direct guidance.
Sponsors
Gorkem Alper Solakoglu
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors were blinded to training allocation. Participants could not be blinded because they were aware of the training format received. The instructor who delivered both interventions held the allocation list
Intervention model description
Single-center, parallel-group, individually randomized educational trial with a 1:1 allocation ratio and an immediate post-training assessment only.
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
Current enrollment as a final-year (sixth-year) medical student at İstanbul Medeniyet University Faculty of Medicine. Participation in the emergency medicine clerkship during the study period. Provision of written informed consent before randomization.
Exclusion criteria
Previous formal ultrasound training. Prior practical ultrasound experience. A physical condition that could interfere with performing an ultrasound examination. Declining or not providing written informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall eFAST Performance Score | Within 1 hour after completion of the assigned training session | Overall practical eFAST performance was assessed using the eFAST Image Acquisition and Interpretation Assessment Checklist. The checklist comprised 21 image-acquisition items across six eFAST windows and one image-differentiation component. Image-acquisition items contributed a maximum of 84 points and image differentiation contributed a maximum of 16 points, yielding a total score from 0 to 100, with higher scores indicating better performance. For this retrospective registration, the overall performance score is designated as the primary outcome; no primary outcome was prospectively designated before the analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Error-Free Anterior Lung Window Performance | Within 1 hour after completion of the assigned training session | Proportion of participants who completed all required steps for the anterior lung eFAST window correctly. Any incorrectly performed required step resulted in classification as not error-free. |
| Error-Free Subxiphoid Window Performance | Within 1 hour after completion of the assigned training session | Proportion of participants who completed all required steps for the subxiphoid eFAST window correctly. Any incorrectly performed required step resulted in classification as not error-free. |
| Error-Free Right Upper Quadrant Window Performance | Within 1 hour after completion of the assigned training session | Proportion of participants who completed all required steps for the right upper quadrant eFAST window.correctly. Any incorrectly performed required step resulted in classification as not error-free. |
| Error-Free Left Upper Quadrant Window Performance | Within 1 hour after completion of the assigned training session | Proportion of participants who completed all required steps for the left upper quadrant eFAST windowcorrectly. Any incorrectly performed required step resulted in classification as not error-free. |
| Error-Free Pelvic Window Performance | ithin 1 hour after completion of the assigned training session | Proportion of participants who completed all required steps for the pelvic eFAST window correctly. Any incorrectly performed required step resulted in classification as not error-free. |
Countries
Turkey (Türkiye)
Outcome results
None listed