gms | German Medical Science

Background: Extended FAST is already an integral part of many curricula and is quickly becoming a basic skill for all clinicians [1]. eFAST is now an essential part pf the primary survey of an emergency patient. The discrepancy between an increasing number of medical students and growing clinical commitments of lecturers is a major challenge in student teaching that needs to be resolved, especially when a competency-based curriculum is being emphasized [https://www.bundesaerztekammer.de/fileadmin/user_upload/downloads/pdf-Ordner/Stellungnahmen/AEApprO_Arbeitsentwurf_SN-BAEK_Synopse_final_24012020.pdf]. The practice of using peers in the clinical education of medical students is a well-established tradition and commonly practiced, but lacks definition in its implementation [2]. The planned study investigates whether the level of experience of the ultrasound tutor affects the effectiveness of learning among students and has an impact on students' competence, knowledge and skills when using eFAST during a clinical scenario.

Methods: 50 prospective students from the emergency medicine elective in the eighth semester were planned to be randomized into control and intervention groups. Control groups received the four-hour standard ultrasound tutorial with trained peer teachers (SHKs). These SHKs had previously received two eight-hour training courses, based in part on the principles of the German Society for Anaesthesia and Intensive Care Medicine (DGAI) for the implementation of eFAST. All SHKs had successfully completed a performance assessment after the training course to ensure that they were qualified to teach the procedure. The intervention group received the same four-hour standard ultrasound tutorial but from various resident doctors from the department of Anaesthesia and Intensive Care. All residents were at least DEGUM stage 1 certified in ultrasound. All students received an initial tutorial on basic physical ultrasound principles as well as a final lecture on recognizing pathological ultrasound images. One day later, students were asked to complete basic questionnaires requesting pre-existing US experience as well as 15 theoretical and clinical application questions based on eFAST. Students also completed a 6 min OSCE station involving clinical emergency scenarios. Plans to repeat the questionnaire and OSCE exam at the end of the semester were cancelled due to the present CoVID situation.

Results: Till publication n=57 equally distributed between both groups. With a female preponderance, 85% of participants had no previous eFAST experience. Using Chi² test data show no significant differences between the two groups in the OSCE exam, theoretical and clinical application questions as seen by unchaged p values. Further results will follow on continuation in summer.

Take home message: Despite prematurely stopping the study early results suggest that peer teaching can be utilized in the short term retention of eFAST competence without a loss of clinical application skills. This may relieve the burden of removing doctors from patient care situations and maintains teaching standards.