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Online Learning versus Hands-On Learning of Basic Ocular Ultrasound Skills: A Randomized Controlled Non-Inferiority Trial.

ABSTRACT: Background and objectives: Ocular ultrasound is a core application of point-of-care ultrasound (POCUS) to assist physicians in promptly identifying various ocular diseases at the bedside; however, hands-on POCUS training is challenging during a pandemic. Materials and Methods: A randomized controlled non-inferiority trial was conducted in an academic emergency department from October 2020 to April 2021. Thirty-two participants were randomly assigned to one of two groups. Group H (hands-on learning group) participated individually in a hands-on session with a standardized patient for 30 min, whereas Group O (online learning group) learned training materials and video clips for 20 min. They scanned four eyeballs of two standardized patients sequentially following the ocular POCUS scan protocol. Repeated POCUS scans were performed 2 weeks later to assess skill maintenance. Both groups completed the pre- and post-surveys and knowledge tests. Two emergency medicine faculty members blindly evaluated the data and assigned a score of 0-25. The primary endpoint was the initial total score of scan quality evaluated using non-inferiority analysis (generalized estimating equation). The secondary endpoints were total scores for scan quality after 2 weeks, scan time, and knowledge test scores. Results: The least squares means of the total scores were 21.7 (0.35) for Group O and 21.3 (0.25) for Group H, and the lower bound of the 95% confidence interval (CI) was greater than the non-inferiority margin of minus 2 (95% CI: -0.48-1.17). The second scan scores were not significantly different from those of the first scan. The groups did not differ in scanning time or knowledge test results; however, Group H showed higher subjective satisfaction with the training method (p < 0.001). Conclusion: This study showed that basic online ocular ultrasound education was not inferior to hands-on education, suggesting that it could be a useful educational approach in the pandemic era.

SUBMITTER: Kang SY

PROVIDER: S-EPMC9315691 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionTraining Basic Life Support saves lives. However, current BLS training approaches are time-consuming and costly. Alternative cost-efficient and effective training methods are highly needed. The present study evaluated whether a video-feedback supported peer-guided Basic Life Support training approach achieves similar practical performance as a standard instructor-guided training in laypersons.MethodsIn a randomized controlled non-inferiority trial, 288 first-year medical students were randomized to two study arms with different Basic Life Support training methods: 1) Standard Instructor Feedback (SIF) or 2) a Peer Video Feedback (PVF). Outcome parameters were objective data for Basic Life Support performance (compression depth and rate) from a resuscitation manikin with recording software as well as overall Basic Life Support performance and subjective confidence. Non-inferiority margins (Δ) for these outcome parameters and sample size calculation were based on previous studies with Standard Instructor Feedback. Two-sided 95% confidence intervals were employed to determine significance of non-inferiority.ResultsResults confirmed non-inferiority of Peer Video Feedback to Standard Instructor Feedback for compression depth (proportion difference PVF-SIF = 2.9%; 95% CI: -8.2% to 14.1%; Δ = -19%), overall Basic Life Support performance (proportion difference PVF-SIF = 6.7%; 95% CI: 0.0% to 14.3%; Δ = -27%) and subjective confidence for CPR performance (proportion difference PVF-SIF = -0.01; 95% CI: -0.18-0.17; Δ = -0.5) and emergency situations (proportion difference PVF-SIF = -0.02; 95% CI: -0.21-0.18; Δ = -0.5). Results for compression rate were inconclusive.DiscussionPeer Video Feedback achieves comparable results as standard instructor-based training methods. It is an easy-to-apply and cost-efficient alternative to standard Basic Life Support training methods. To improve performance with respect to compression rate, additional implementation of a metronome is recommended.

Project description:Online learning is becoming more and more popular than traditional learning, and the need to investigate its influence within the framework of instruction and learning domains is - in today's emerging, cutting-edge technology world - an academic trend. The current study's problem intends to explore the impact of virtual versus traditional learning on the academic achievement of EFL students, a subject that has garnered substantial attention from English Language Teaching (ELT) researchers. This study aims to clarify if EFL students' academic progress in a listening skills classroom is influenced by traditional or online learning. The present research compiled information on how EFL students performed when English language teaching took place online as opposed to in a traditional classroom environment. This study, using an experimental research design with (N = 30) pairs of students (both male and female), was held at Najran University, KSA, in the academic year 2022-2023 b y using probability (random sampling). This study used pre-and post-tests to gather data from the subjects of the study, bifurcated into controlled and experimental groups employing the two modes of teaching, viz., online and traditional. The findings of the investigation proved that the experimental group achieved better performance compared to the control group in terms of results and scores. There are no significant differences based on gender. In addition, (N = 20) teachers teaching listening skills to EFL learners participated in semi-structured interviews. The qualitative analysis enlisted flexibility, accessibility, effective communication, collaboration, monitoring of student progress, and the use of a blackboard as constructive elements, followed by maintenance costs, wastage of available resources, long-term engagement, limited face-to-face interaction, and demotivation as critical perspectives. According to the findings of this research, the author recommends further studies with more variables.

Project description:ObjectiveTo evaluate learning results of critical care physiotherapists participating in a muscle ultrasound (MUS) educational program.DesignCross-sectional study.SettingA custom-made 20-hour MUS course was performed over a 2-week time period, including knobs familiarization, patient positioning, anatomic landmarks, image acquisition, and limb muscle measurements.ParticipantsNineteen critical care physiotherapists with little to no prior experience in ultrasound (N=19).InterventionsNot applicable.Main outcome measuresTheoretical knowledge, hands-on skills acquisition, and satisfaction were assessed. Inter- and intrarater reliability on landmarks, thickness, and pennation angle of quadriceps between participants was evaluated using intraclass correlation coefficients (ICCs). Reliability among instructors measured prior to the course was also reported as a reference.ResultsThe percentage score (mean±SD) of knowledge questionnaires was 69±11 (pre-course), 89±10 (post-course), and 92±9 (hands-on skills). Course satisfaction scores ranged from 90%-100%. Pooled interrater reliability of participants (median ICC [interquartile range]) was good (0.70 [0.59-0.79]) for thickness, moderate (0.47 [0.46-0.92]) for landmarks, and absent (0.00 [0.00-0.05]) for pennation angle and the intrarater reliability was good (0.76 [0.51-0.91]) for thickness and weak (0.35 [0.29-0.52]) for pennation angle. Interrater ICC values for instructors were excellent (0.90) for thickness, good (0.67) for landmarks, and moderate (0.41) for pennation angle and intrarater ICC values were excellent (0.94) for thickness and good (0.75) for pennation angle.ConclusionsAlthough our sample was quite small and homogeneous, increased theoretical knowledge, high hands-on performance acquisition, and good satisfaction of physiotherapists were observed. Reliability was moderate to excellent for thickness and landmarks and absent to weak for pennation angle. Landmarking and pennation angle remain challenges for physiotherapist training in the application of MUS. Further studies are needed to identify variables that could modify reliability during MUS training.

Project description:CONTEXT:Dyad practice may be as effective as individual practice during clinical skills training, improve students' confidence, and reduce costs of training. However, there is little evidence that dyad training is non-inferior to single-student practice in terms of skills transfer. OBJECTIVES:This study was conducted to compare the effectiveness of simulation-based ultrasound training in pairs (dyad practice) with that of training alone (single-student practice) on skills transfer. METHODS:In a non-inferiority trial, 30 ultrasound novices were randomised to dyad (n = 16) or single-student (n = 14) practice. All participants completed a 2-hour training programme on a transvaginal ultrasound simulator. Participants in the dyad group practised together and took turns as the active practitioner, whereas participants in the single group practised alone. Performance improvements were evaluated through pre-, post- and transfer tests. The transfer test involved the assessment of a transvaginal ultrasound scan by one of two clinicians using the Objective Structured Assessment of Ultrasound Skills (OSAUS). RESULTS:Thirty participants completed the simulation-based training and 24 of these completed the transfer test. Dyad training was found to be non-inferior to single-student training: transfer test OSAUS scores were significantly higher than the pre-specified non-inferiority margin (delta score 7.8%, 95% confidence interval -3.8-19.6%; p = 0.04). More dyad (71.4%) than single (30.0%) trainees achieved OSAUS scores above a pre-established pass/fail level in the transfer test (p = 0.05). There were significant differences in performance scores before and after training in both groups (pre- versus post-test, p < 0.01) with large effect sizes (Cohen's d = 3.85) and no significant interactions between training type and performance (p = 0.59). The dyad group demonstrated higher training efficiency in terms of simulator score per number of attempts compared with the single-student group (p = 0.03). CONCLUSION:Dyad practice improves the efficiency of simulation-based training and is non-inferior to individual practice in terms of skills transfer.

Project description:BackgroundOnline communication has taken over in the last 2 years due to the frequent lockdowns because of the COVID-19 pandemic. Overburdened physicians in this pandemic are struggling to get enough time to teach clinical skills online to the students. Also, due to student's safety issues, the students cannot fully attend the clinics. Therefore, in this scenario, online PAL (Peer Assisted Learning) sessions for clinical skill teaching and learning can be an effective alternative for undergraduate medical students. The academic limitations caused by the COVID-19 related lockdown however can have a pleasurable outcome if certain challenges, related to online PAL, are overcome. Therefore, the present study aims to identify the challenges of Peer Assisted Learning (PAL) sessions during online clinical skills training in the Ophthalmology module of undergraduate medical students.MethodsThis qualitative exploratory study, utilizing online focus group discussions to explore the challenges of online PAL in training and learning of clinical skills were carried at the Ophthalmology department of Batterjee Medical College, Jeddah; Saudi Arabia. A purposive convenient sampling technique was used to collect data. Data were transcribed and analyzed using thematic analysis.ResultsThe study identified six themes that were further divided into smaller subthemes. The subthemes derived from the collected data were organized under the following major themes; infrastructure, learning environment, psychological problems, interaction deficit, learning desires, and desire for feedback on performance. The major challenge reported by the medical student during online PAL sessions was infrastructure in terms of network connection, scheduling, and timing of the session. The unprofessional learning environment, psychological problems in terms of behavioral issues and personality changes, interaction deficit with peers, tutor, and patient, learning desires, and desire for feedback on performance were the other important challenges faced by the students.ConclusionThe challenges explored by our study can be used by the medical educators to incorporate online PAL as an effective, efficient, and alternative teaching and learning modality in the curriculum especially in compromised circumstances like the current COVID-19 pandemic.

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Online Learning versus Hands-On Learning of Basic Ocular Ultrasound Skills: A Randomized Controlled Non-Inferiority Trial.

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