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Open Access Research article

Student tutors for hands-on training in focused emergency echocardiography – a randomized controlled trial

Matthias Kühl1, Robert Wagner2, Markus Bauder3, Yelena Fenik3, Reimer Riessen4, Maria Lammerding-Köppel5, Meinrad Gawaz1, Suzanne Fateh-Moghadam1, Peter Weyrich2 and Nora Celebi2*

Author affiliations

1 University Hospital Tübingen, Department of Internal Medicine, Division of Cardiology, University Hospital of Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany

2 University Hospital Tübingen, Department of Internal Medicine, Division of Diabetes, Endocrinology, Angiology, Nephrology and Clinical Chemistry, University Hospital of Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany

3 University of Tübingen, Medical School, Geisweg 3, 72076, Tübingen, Germany

4 University Hospital Tübingen, Medical Intensive Care Unit, University Hospital of Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany

5 Competence Center for Medical Didactics, Elfriede-Aulhorn-Straße 10, 72076, Tübingen, Germany

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Citation and License

BMC Medical Education 2012, 12:101  doi:10.1186/1472-6920-12-101

Published: 29 October 2012

Abstract

Background

Focused emergency echocardiography performed by non-cardiologists has been shown to be feasible and effective in emergency situations. During resuscitation a short focused emergency echocardiography has been shown to narrow down potential differential diagnoses and to improve patient survival. Quite a large proportion of physicians are eligible to learn focused emergency echocardiography. Training in focused emergency echocardiography usually comprises a lecture, hands-on trainings in very small groups, and a practice phase. There is a shortage of experienced echocardiographers who can supervise the second step, the hands-on training. We thus investigated whether student tutors can perform the hands-on training for focused emergency echocardiography.

Methods

A total of 30 volunteer 4th and 5th year students were randomly assigned to a twelve-hour basic echocardiography course comprising a lecture followed by a hands-on training in small groups taught either by an expert cardiographer (EC) or by a student tutor (ST). Using a pre-post-design, the students were evaluated by an OSCE. The students had to generate two still frames with the apical five-chamber view and the parasternal long axis in five minutes and to correctly mark twelve anatomical cardiac structures. Two blinded expert cardiographers rated the students’ performance using a standardized checklist. Students could achieve a maximum of 25 points.

Results

Both groups showed significant improvement after the training (p < .0001). In the group taught by EC the average increased from 2.3±3.4 to 17.1±3.0 points, and in the group taught by ST from 2.7±3.0 to 13.9±2.7 points. The difference in improvement between the groups was also significant (p = .03).

Conclusions

Hands-on training by student tutors led to a significant gain in echocardiography skills, although inferior to teaching by an expert cardiographer.