The Efficacy of Teaching Cardiac Ultrasound by Medical Students Compared to Qualified Trainers

Background: Teaching cardiac ultrasound (CU) imaging acquisition is based on hands-on practice, under supervision of qualified instructors. We assessed the efficacy of training medical students by their classmates who were already trained in CU (teaching assistants [TA]) compared to qualified trainers (cardiologists or echocardiographic tecnicians).

Methods: Sixty-six students received 8 hours training on CU: 4-hours lectures on ultrasound anatomy from 6 trans-thoracic echocardiographic views (parasternal long [PLAV] and short axis [PSAV] views, apical 4-chambers [4ch], 2-chambers [2ch] and 3-chambers [3ch] views, and sub costal [SC] view) followed by 4 hours of hands-on exercise in groups of ≤ 4 students under direct supervision of one of 4 TA (group A: 44 students) or a qualified trainer (group B: 22 students). Students’ proficiency was evaluated by a 6-minutes test. Students’ performance was evaluated by a set checklist of anatomic landmarks needed to be demonstrated in each one of the 6 trans-thoracic views.

Results: The 6 minutes test final grade displayed superiority (P 0.001) of group A over group B (30.2±8.6 vs. 21.9±10.9, respectively). This trend appeared in all 6 main trans-thoracic views: PLAV: 6.9±1.8 vs. 5.4±2.3 respectively; PSAV: 8,1±3.9 vs. 5.4±3.5 respectively; 4ch: 5.7±1.9 vs. 4.3±2.6 respectively; 2ch: 2.2±1.7 vs. respectively; 3ch: 11.7±4 vs. 9.1±5,2 respectively; SC: 1.1±0.9 vs. 0.6±0.9 respectively. All students were able to obtain the parasternal long and short axis views and apical 4ch and 2ch views. The least obtainable views were the SC and the apical 3ch view.

Conclusions: The teaching of cardiac ultrasound imaging acquisition can be perfomred by qualified students acting as teaching assistants. Replacing highly qualified trainers by qualified medical students could help medical schools teach ultrasound techniques without dependancy on cardiologist/technician availiablity.