Peer-teaching cardiac ultrasound among medical students: A real option

Introduction Teaching cardiac ultrasound (CU) image acquisition requires hands-on practice under qualified instructors supervision. We assessed the efficacy of teaching medical students by their previously trained classmates (teaching assistants [TAs]) compared to teaching by expert trainers (cardiologists or diagnostic medical sonographers. Methods Sixty-six students received 8-hour CU training: 4-hour lectures on ultrasound anatomy and imaging techniques of 6 main CU views (parasternal long [PLAV] and short axis [PSAV]; apical 4-chamber [4ch], 2-chamber [2ch], and 3-chamber [3ch]; and sub costal [SC]) followed by 4 hours of hands-on exercise in groups of <= 5 students under direct supervision of a TA (group A: 44 students) or a qualified trainer (group B: 22 students). Students' proficiency was evaluated on a 6-minute test in which they were required to demonstrate 32 predetermined anatomic landmarks spread across the 6 views and ranked on a 0-100 scale according to a predetermined key. Results The 6-minute test final grade displayed superiority of group A over group B (54 +/- 17 vs. 39 +/- 21, respectively [p = 0.001]). This trend was continuous across all 6 main views: PLAV (69 +/- 18 vs. 54 +/- 23, respectively), PSAV (65 +/- 33 vs. 41 +/- 32, respectively), 4ch (57 +/- 19 vs. 43 +/- 26, respectively), 2ch (37 +/- 29 vs. 33 +/- 27, respectively), 3ch (48 +/- 23 vs. 35 +/- 25, respectively), and SC (36 +/- 27 vs. 24 +/- 28, respectively). Conclusions Teaching medical students CU imaging acquisition by qualified classmates is feasible. Moreover, students instructors were superior to senior instructors when comparing their students' capabilities in a practical test. Replacing experienced instructors with TAs could help medical schools teach ultrasound techniques with minimal dependence on highly qualified trainers.