Comparison of ultrasonography learning between distance teaching and traditional methodology. An educational systematic review
Keywords:
Ultrasonography, Telemedicine, Education, distanceAbstract
BACKGROUND: Use of the web for radiological education is an obvious application. Many computer-based teaching materials have been developed over recent years, and e-learning is becoming increasingly popular in medical schools.OBJECTIVE: To assess whether the effectiveness of distance-learning and/or e-learning, m-learning and web-based methods are equivalent to traditional methods. DESIGN AND SETTING: Systematic review of comparative studies of teaching techniques guided by Best Evidence Medical Education. METHODS: A search was carried out in the MEDLINE, EMBASE, Cochrane Library, Tripdatabase, CINAHL and LILACS online databases in April 2020, for original publications in all languages. The following MeSH terms were used: Ultrasonography; Teleradiology; Telemedicine; Education, Medical; Teaching; and Simulation Training; along with the terms e-learning, m-learning and web-based. All eligible studies were assessed using the Kirkpatrick model and Buckley’s quality indicators. RESULTS: The search in the databases and a manual search resulted in 4549 articles, of which 16 had sufficient methodological quality for their inclusion. From analysis of these data, it was observed that teaching of ultrasonography using telemedicine methods is similar to the traditional method, except for venous access procedures, for which the studies did not show agreement. CONCLUSION: We found that learning via telemedicine methodologies presents great acceptance among students, besides demonstrating quality similar to the traditional method. Thus, at least at the moment, this has the capacity to serve as an important adjunct in the teaching of ultrasonography. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/CGUPA at the OPENSCIENCE Framework.
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Silva AB, de Amorim AC. A Brazilian educational experiment: teleradiology on web TV. J Telemed Telecare. 2009;15(7):373-6. PMID: 19815908. https://doi.org/10.1258/jtt.2009.090204
Taylor DC, Hamdy H. Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83. Med Teach. 2013;35(11):e1561-72. PMID: 24004029; https://doi.org/10.3109/0142159X.2013.828153
Ferrer-Torregrosa J, Torralba J, Jimenez MA, García S, Barcia JM. ARBOOK: development and assessment of a tool based on augmented reality for anatomy. J Sci Educ Technol. 2015;24(1):119-124. https://doi.org/10.1007/s10956-014-9526-4
Lozano-Lozano M, Galiano-Castillo N, Fernández-Lao C, et al. The Ecofisio Mobile App for Assessment and Diagnosis Using Ultrasound Imaging for Undergraduate Health Science Students: Multicenter Randomized Controlled Trial. J Med Internet Res. 2020;22(3):e16258. PMID: 32154784; https://doi.org/10.2196/16258
Salajegheh A, Jahangiri A, Dolan-Evans E, Pakneshan S. A combination of traditional learning and e-learning can be more effective on radiological interpretation skills in medical students: a pre- and post-intervention study. BMC Med Educ. 2016;16:46. PMID: 26842495; https://doi.org/10.1186/s12909-016-0569-5
Zafar S, Safdar S, Zafar AN. Evaluation of use of e-Learning in undergraduate radiology education: a review. Eur J Radiol. 2014;83(12):2277-87. PMID: 25242658; https://doi.org/10.1016/j.ejrad.2014.08.017
Hempel D, Sinnathurai S, Haunhorst S, et al. Influence of case-based e-learning on students’ performance in point-of-care ultrasound courses: a randomized trial. Eur J Emerg Med. 2016;23(4):298-304. PMID: 25851331; https://doi.org/10.1097/MEJ.0000000000000270
Smith A, Addison R, Rogers P, et al. Remote Mentoring of Point-of-Care Ultrasound Skills to Inexperienced Operators Using Multiple Telemedicine Platforms: Is a Cell Phone Good Enough? J Ultrasound Med. 2018;37(11):2517-25. PMID: 29577381; https://doi.org/10.1002/jum.14609
Kolbe N, Killu K, Coba V, et al. Point of care ultrasound (POCUS) telemedicine project in rural Nicaragua and its impact on patient management. J Ultrasound. 2015;18(2):179-85. PMID: 26191106; https://doi.org/10.1007/s40477-014-0126-1
Borbás J, Forczek E, Sepp R, Bari F. Telekardiológia: A telemedicina feladatai és kötelességei [Telecardiology: Tasks and duties of telemedicine]. Orv Hetil. 2017;158(44):1741-6. PMID: 29086593; https://doi.org/10.1556/650.2017.30884
Noriega O, Ho H, Wright J. The Application of Hand-Held Ultrasound Scanner in Teaching of Telemedicine and Rural Medicine. Donald School Journal of Ultrasound in Obstetrics and Gynecology. 2014;8(1):87-91. https://doi.org/10.5005/JP-JOURNALS-10009-1340
Bansal M, Singh S, Maheshwari P, et al. Value of interactive scanning for improving the outcome of new-learners in transcontinental tele-echocardiography (VISION-in-Tele-Echo) study. J Am Soc Echocardiogr. 2015;28(1):75-87. PMID: 25306222; https://doi.org/10.1016/j.echo.2014.09.001
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. PMID: 27919275; https://doi.org/10.1186/s13643-016-0384-4
Buckley S, Coleman J, Davison I, et al. The educational effects of portfolios on undergraduate student learning: a Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 11. Med Teach. 2009;31(4):282-98. PMID: 19404891; https://doi.org/10.1080/01421590902889897
Steinert Y, Mann K, Centeno A, et al. A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8. Med Teach. 2006;28(6):497-526. PMID: 17074699; https://doi.org/10.1080/01421590600902976
Socransky S, Lang E, Bryce R, Betz M. Point-of-Care Ultrasound for Jugular Venous Pressure Assessment: Live and Online Learning Compared. Cureus. 2017;9(6):e1324. PMID: 28690957; https://doi.org/10.7759/cureus.1324
Hempel D, Haunhorst S, Sinnathurai S, et al. Social media to supplement point-of-care ultrasound courses: the “sandwich e-learning” approach. A randomized trial. Crit Ultrasound J. 2016;8(1):3. PMID: 26968408; https://doi.org/10.1186/s13089-016-0037-9
Chenkin J, Lee S, Huynh T, Bandiera G. Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training. Acad Emerg Med. 2008;15(10):949-54. PMID: 18778380; https://doi.org/10.1111/j.1553-2712.2008.00231.x
Cuca C, Scheiermann P, Hempel D, Via G, Seibel A, Barth M, et al. Assessment of a new e-learning system on thorax, trachea, and lung ultrasound. Emerg Med Int. 2013 Nov 12;2013:145361. PMID: 24324889; PMCID: PMC3845847; https://doi.org/10.1155/2013/145361
Edrich T, Stopfkuchen-Evans M, Scheiermann P, et al. A Comparison of Web-Based with Traditional Classroom-Based Training of Lung Ultrasound for the Exclusion of Pneumothorax. Anesth Analg. 2016;123(1):123-8. PMID: 27159073; https://doi.org/10.1213/ANE.0000000000001383
Haskins SC, Feldman D, Fields KG, et al. Teaching a Point-of-Care Ultrasound Curriculum to Anesthesiology Trainees With Traditional Didactic Lectures or an Online E-Learning Platform: A Pilot Study. J Educ Perioper Med. 2018;20(3):E624. PMID: 30510972.
Lian A, Rippey JCR, Carr PJ. Teaching medical students ultrasound-guided vascular access - which learning method is best? J Vasc Access. 2017;18(3):255-8. PMID: 28430318; https://doi.org/10.5301/jva.5000730
Maloney E, Hippe DS, Paladin A, Chew FS, Ha AS. Musculoskeletal ultrasound training for radiology residents: lecture versus interactive learning module. Acad Radiol. 2016;23(7):789-96. PMID: 27067604; https://doi.org/10.1016/j.acra.2015.11.018
Platz E, Liteplo A, Hurwitz S, Hwang J. Are live instructors replaceable? Computer vs. classroom lectures for EFAST training. J Emerg Med. 2011;40(5):534-8. PMID: 19892506; https://doi.org/10.1016/j.jemermed.2009.08.030
Platz E, Goldflam K, Mennicke M, et al. Comparison of Web-versus classroom-based basic ultrasonographic and EFAST training in 2 European hospitals. Ann Emerg Med. 2010;56(6):660-7. PMID: 20538370; https://doi.org/10.1016/j.annemergmed.2010.04.019
Bertran S, Boby H, Bertrand PM, et al. Comparison of video-based learning and lecture-based learning for training of ultrasound-guided central venous catheterization: a randomized controlled trial. BJA: British Journal of Anaesthesia. 2017;118(4):628-30. PMID: 28403416; https://doi.org/10.1093/bja/aex059
Soon AW, Toney AG, Stidham T, Kendall J, Roosevelt G. Teaching Point-of-Care Lung Ultrasound to Novice Pediatric Learners: Web-Based E-Learning Versus Traditional Classroom Didactic. Pediatr Emerg Care. 2020;36(7):317-21. PMID: 29698340; https://doi.org/10.1097/PEC.0000000000001482
Brisson A-M, Steinmetz P, Oleskevich S, Lewis J, Reid A. A comparison of telemedicine teaching to in-person teaching for the acquisition of an ultrasound skill - a pilot project. J Telemed Telecare. 2015;21(4):235-9. PMID: 25766853; https://doi.org/10.1177/1357633X15575446
Fernández-Lao C, Cantarero-Villanueva I, Galiano-Castillo N, Caro-Morán E, Díaz-Rodríguez L, Arroyo-Morales M. The effectiveness of a mobile application for the development of palpation and ultrasound imaging skills to supplement the traditional learning of physiotherapy students. BMC Med Educ. 2016;16(1):274. PMID: 27756288; https://doi.org/10.1186/s12909-016-0775-1
Cantarero-Villanueva I, Fernández-Lao C, Galiano-Castillo N, et al. Evaluation of e-learning as an adjunctive method for the acquisition of skills in bony landmark palpation and muscular ultrasound examination in the lumbopelvic region: a controlled study. J Manipulative Physiol Ther. 2012;35(9):727-34. PMID: 23206968; https://doi.org/10.1016/j.jmpt.2012.10.007
Arroyo-Morales M, Cantarero-Villanueva I, Fernández-Lao C, et al. A blended learning approach to palpation and ultrasound imaging skills through supplementation of traditional classroom teaching with an e-learning package. Man Ther. 2012;17(5):474-8. PMID: 22579034; https://doi.org/10.1016/j.math.2012.04.002
Briz-Ponce L, Juanes-Méndez JA, García-Peñalvo FJ. Exploring mobile learning apps for medical students and health care professionals. In: García-Peñalvo FJ, editor. Proceedings of the Fourth International Conference on Technological Ecosystems for Enhancing Multiculturality - TEEM 16. New York, New York, USA: ACM Press; 2016. p. 461-5. https://doi.org/10.1145/3012430.3012557
Gul YA, Wan ACT, Darzi A. Undergraduate surgical teaching utilizing telemedicine. Med Educ. 1999;33(8):596-9. PMID: 10447846; https://doi.org/10.1046/j.1365-2923.1999.00372.x
Weber U, Zapletal B, Base E, et al. Resident performance in basic perioperative transesophageal echocardiography: Comparing 3 teaching methods in a randomized controlled trial. Medicine. 2019;98(36):e17072. PMID: 31490407; https://doi.org/10.1097/MD.0000000000017072
Roubidoux MA, Chapman CM, Piontek ME. Development and Evaluation of an Interactive Web-Based Breast Imaging Game for Medical Students. Acad Radiol. 2002;9(10):1169-78. PMID: 12385511; https://doi.org/10.1016/s1076-6332(03)80518-4
van Os MA, van der Ven AJ, Bloemendaal PM, et al. Effect of e-learning on quality of cervical-length measurements. Ultrasound Obstet Gynecol. 2015;46(3):327-31. PMID: 25504977; https://doi.org/10.1002/uog.14764
Gotwald TF, Daniaux M, Stoeger A, Knapp R, zur Nedden D. The value of the World Wide Web for tele-education in radiology. J Telemed Telecare. 2000;6(1):27-30. PMID: 10824387; https://doi.org/10.1258/1357633001933907
Piraino D, Recht M, Richmond B. Implementation of an electronic teaching file using web technology. J Digit Imaging. 1997;10(1):190-2. PMID: 9268879; https://doi.org/10.1007/BF03168697
Peters A, Patil PV. Tele-echocardiography: enhancing quality at the point-of-care. Heart. 2019;105(4):264-5. PMID: 30244198; https://doi.org/10.1136/heartjnl-2018-313969
Kim MS, Aro MR, Lage KJ, et al. Exploring the usability of mobile apps supporting radiologists’ training in diagnostic decision making. J Am Coll Radiol. 2016;13(3):335-43. PMID: 26482814; https://doi.org/10.1016/j.jacr.2015.07.021
Clavier T, Ramen J, Dureuil B, et al. Use of the Smartphone App WhatsApp as an E-Learning Method for Medical Residents: Multicenter Controlled Randomized Trial. JMIR Mhealth Uhealth. 2019;7(4):e12825. PMID: 30964435; https://doi.org/10.2196/12825
Ma M, Fallavollita P, Seelbach I, et al. Personalized augmented reality for anatomy education. Clin Anat. 2016;29(4):446-53. PMID: 26646315; https://doi.org/10.1002/ca.22675
Marks A, Maizels M, Mickelson J, et al. Effectiveness of the computer enhanced visual learning method in teaching the society for fetal urology hydronephrosis grading system for urology trainees. J Pediatr Urol. 2011;7(2):113-7. PMID: 21094626; https://doi.org/10.1016/j.jpurol.2010.09.009
Bretholz A, Doan Q, Cheng A, Lauder G. A presurvey and postsurvey of a web- and simulation-based course of ultrasound-guided nerve blocks for pediatric emergency medicine. Pediatr Emerg Care. 2012;28(6):506-9. PMID: 22653464; https://doi.org/10.1097/PEC.0b013e3182586f42
Long MC, Angtuaco T, Lowery C. Ultrasound in telemedicine: its impact in high-risk obstetric health care delivery. Ultrasound Q. 2014;30(3):167-72. PMID: 25148484; https://doi.org/10.1097/RUQ.0000000000000073
Rösch J. Tele-education in Interventional Radiology. Cardiovasc Intervent Radiol. 2001;24(5):295-6. PMID: 11815833; https://doi.org/10.1007/s00270-001-0020-z
Robertson TE, Levine AR, Verceles AC, et al. Remote tele-mentored ultrasound for non-physician learners using FaceTime: A feasibility study in a low-income country. J Crit Care. 2017 Apr 7;40:145–148. PMID: 28402924; https://doi.org/10.1016/j.jcrc.2017.03.028
Zimmermann R, Mousty E, Mares P, Letouzey V, Huberlant S. E-learning et simulation en échographie focalisée pour la formation continue des sages-femmes en salle de naissance [Optimizing training in limited obstetric ultrasound for midwives through a combination of e-learning and simulation]. Gynecol Obstet Fertil Senol. 2019;47(12):836-40. PMID: 31634587; https://doi.org/10.1016/j.gofs.2019.10.010