Hari, Roman; Kälin, Kaspar; Birrenbach, Tanja; Tal, Kali; Roumet, Marie; Limacher, Andreas; Huwendiek, Sören; Serra, Andreas; Walter, Robin (2024). Near-peer compared to faculty teaching of abdominal ultrasound for medical students - A randomized-controlled trial. Ultraschall in der Medizin, 45(1), pp. 77-83. Thieme 10.1055/a-2103-4787
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Purpose Medical schools increasingly rely on near-peer tutors for ultrasound teaching. We set out to compare the efficacy of a blended near-peer ultrasound teaching program to that of a standard faculty course in a randomized controlled non-inferiority trial. Methods 152 medical students were randomly assigned to receive 21 hours of ultrasound teaching either by near-peer teachers or medical doctors. The near-peer course consisted of a blended learning that included spaced repetition; the faculty-led course was the European common course for abdominal sonography. Primary outcome measurement was students' ultrasound knowledge at Month 6, assessed by structured examination (score 0 to 50). Secondary outcomes included scores at Month 0 and changes in scores after the course. Results Students in the near-peer group scored 37 points; students in the faculty group scored 31 points six months after course completion. The difference of 5.99 points (95% CI 4.48;7.49) in favor of the near-peer group was significant (p<0.001); scores immediately after the course were 3.8 points higher in the near-peer group (2.35;5.25, p<0.001). Ultrasound skills decreased significantly in the six months after course completion in the faculty group (- 2.41 points, [-3.39;-1.42], p<0.001]) but barely decreased in the near-peer group (-0.22 points, [-1.19;0.75, p=0.66]). Conclusions The near-peer course that combined blended learning and spaced repetition outperformed standard faculty teaching in basic ultrasound education. This study encourages medical schools to use peer teaching combined with e-learning and spaced repetition as an effective means to meet the increasing demand for ultrasound training. Ziel Um die wachsende Nachfrage für Ultraschalllehre zu decken, werden Near-Peer Tutoren zunehmend in die Kurse eingebunden. Wir verglichen die Effektivität von Near-Peer Lehre in einem blended learning Programm mit ärztlich-geführter Lehre in einer kontrolliert-randomisierten Nicht-Unterlegenheitsstudie. Methodik 152 Medizinstudierende wurden zu jeweils 21 Stunden Ultraschalllehre, entweder durch near-peer Tutoren oder ärztliche Tutoren randomisiert. Der Near-Peer Kurs beinhaltete Spaced Repetition, der ärztliche Kurs war der europäische Basiskurs für Abdomenultraschall. Hauptergebnis waren die Ultraschallfähigkeiten nach sechs Monaten (0-50 Punkte). Nebenergebnisse waren die Fähigkeiten direkt nach dem Kurs und die Veränderung der Fähigkeiten über sechs Monate. Ergebnisse Studierende in der Near-Peer Gruppe erreichten 37 Punkte, Studierende in der ärztlichen Gruppe 31 Punkte sechs Monate nach Kursabschluss. Der Unterschied von 5.99 Punkten (95% CI 4.48;7.49) zu Gunsten der Near-Peer Gruppe war signifikant (p<0.001). Die Punktzahlen direkt nach dem Kurs waren in der Near-Peer Gruppe 3.8 Punkte besser (2.35;5.25, p<0.001). In der ärztlichen Gruppe nahmen die Fähigkeiten über sechs Monate signifikant ab (- 2.41 Punkte, [-3.39;-1.42, p<0.001]), im Gegensatz zur Near-Peer Gruppe (-0.22 Punkte, [-1.19;0.75], p=0.66]). Schlussfolgerungen Der Near-Peer Kurs, welcher blended learning und spaced repetition kombinierte, zeigte bessere Lernergebnisse als der ärztlich-geführte Kurs. Diese Studie ermutigt medizinische Fakultäten, Near-Peer Lehre in Kombination mit spaced repetition und e-Learning anzubieten um dem steigenden Bedarf für Ultraschalltraining zu entsprechen.
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