FoCUS cardiac ultrasound training for undergraduates based on current national guidelines: a prospective, controlled, single-center study on transferability.

INTRODUCTION: In emergency and critical-care medicine, focused cardiac ultrasound (FoCUS) is indispensable for assessing a patient's cardiac status. The aim of this study was to establish and validate a peer-to-peer-supported ultrasound course for learning FoCUS-specific skills during undergraduate studies at a German university. METHODS: A 1-day, 12 teaching units training course was developed for students in the clinical section of medical college, with content based on the current national guidelines. A total of 217 students participated in the study (97 in the course group and 120 in the control group). The course and the participants' subjective assessment of improved skills were evaluated using a questionnaire (7-point Likert scale; 7 = complete agreement and 1 = no agreement at all). Objective learning gains were assessed by tests before and after the course. These consisted of a test of figural intelligence (eight items) and a test of technical knowledge (13 items). RESULTS: The course participants experienced significant improvement (P < 0.001) from before to after the course, with a large effect size of η2part = 0.26. In addition, the course group had significantly better results (P < 0.001) than the control group in the post-test, with a medium to large effect size of η2part = 0.14. No significant differences (P = 0.27) were detected in the test section on figural intelligence. The evaluations showed that the participants had a high degree of satisfaction with the course approach, teaching materials, and tutors. There was also a positive increase in their subjective assessment of their own skills, including areas such as technical knowledge, ultrasound anatomy, and performance of the examination. CONCLUSION: The results of both the objective learning assessment and the subjective evaluations suggest that a FoCUS course originally intended for qualified physicians is equally suitable for students. With the development and provision of modern digital teaching media, even more students will be able to benefit from this approach in the future.

Development and evaluation of a point-of-care ocular ultrasound curriculum for medical students - a proof-of-concept study.

BACKGROUND: Point-of-care Ocular Ultrasound (POCOUS) has gained importance in emergency medicine and intensive care in recent years. This work aimed to establish and evaluate a dedicated ultrasound education program for learning POCOUS-specific skills during medical studies at a university hospital. METHODS: The blended learning-based program (6 teaching units) based on recent scientific publications and recommendations was developed for students in the clinical part of their medical studies. Experts and trainers consisted of physicians from the Ear-Nose-Throat, radiology, ophthalmology and neurology specialties as well as university educational specialists. Lecture notes containing digital video links for preparation was produced as teaching material. In total, 33 students participated in the study. The education program, including the teaching materials, motivation and subjective gain in competency, was evaluated with the aid of a questionnaire (7-point Likert response format). Objective learning success was assessed on the basis of pre- and post-tests. These covered the skill areas: "anatomical basics", "ultrasound basics", "understanding of cross-sectional images", "normal findings" and "pathology recognition". RESULTS: In the objective assessment of image interpretation, the participants improved significantly (p < 0.001) from pre- to post-test with a large effect size (Cohen's d = 1.78, effect size r = 0.66). The evaluations revealed a high level of satisfaction with the course concept, teaching materials and the tutors. In addition, a high level of motivation was recorded in relation to continuing to study "ultrasound diagnostics" and "ophthalmologic diseases". A significant (p < 0.01) positive gain was also achieved in terms of the subjective assessment of competency. This covers areas such as expertise, sonographic anatomy and performing a POCOUS examination as well as recognizing retinal detachment, globe perforation and increased optic nerve sheath diameter. CONCLUSION: The results of this feasibility study show that medical students accept and support a POCOUS-specific education program and are able to develop a higher objective and subjective level of competency. Future transfer to other sites and larger groups of participants seems feasible.

Investigating group formation: An experiment on the distribution of extraversion in educational settings.

Group formation plays a crucial role in enhancing collaborative learning experiences. This study investigates the impact of extraversion as a criterion for group formation on collaborative learning outcomes. A total of 180 students participated in the experiment and were assigned to groups that were homogeneously or heterogeneously distributed in terms of extraversion. The groups met weekly and worked on group assignments throughout the semesters. The first hypothesis posed the outcomes to be explainable at the group-level. Surprisingly, the results show that groups with a homogeneous distribution of extraversion reported higher levels of group work satisfaction than those with a heterogeneous distribution, in contrast to the second hypothesis and the group hierarchy theory. These findings emphasize the potential of considering personality traits when forming groups and extend the existing literature on group formation. The study takes a critical stance by addressing normative definitions of leadership. Future research is suggested to further enhance collaborative learning experiences using similar interdisciplinary and experimental methods.

Daily automated feedback enhances self-regulated learning: a longitudinal randomized field experiment.

The goal of the present study was to investigate the effects of automatically generated, adaptive feedback on daily self-regulated learning (SRL) in an experimental field study. University students reported their application of SRL strategies in the morning and in the evening over the course of 36 days using electronic learning diaries. Students were randomly assigned to the experimental group with feedback (LDF, n = 98) or the control group without feedback (LD, n = 96). Based on their self-reports, students in group LDF received daily written feedback regarding their satisfaction with the study day, adherence to time schedule, procrastination, and effort. This feedback either reinforced students in their study approach (confirmative feedback), encompassed information on learning outcomes or processes (informative feedback), or included feed forward on how to improve learning processes (transformative feedback). Multilevel analysis of daily process data revealed better average goal setting, planning and adherence to time schedule, as well as higher self-efficacy, and satisfaction with the study day in group LDF compared to group LD. Motivation, procrastination and effort were not affected by feedback. In contrast to the process measures, pre-post comparisons of students' self-reported general use of SRL strategies (trait measures) did not reveal any effects of feedback on SRL. Further explorative analyses investigated the effects of confirmative, informative, and transformative feedback on next day's learning behavior, showing that confirmative and transformative feedback had stronger effects on students' satisfaction and procrastination than informative feedback. Transformative feedback, which included specific strategies for moving forward, was effective in improving time management. Results provide theoretical insight into the interplay of feedback and SRL and offer practical implications regarding the design of feedback in a learning context.

Long-Term Effectiveness and Sustainability of Integrating Peer-Assisted Ultrasound Courses into Medical School-A Prospective Study.

INTRODUCTION: Ultrasound diagnostics is an important examination method in everyday clinical practice, but student education is often inadequate for acquiring sufficient basic skills. Individual universities have therefore started integrating (extra)curricular training concepts into medical education. This study aimed to evaluate sustainable skills development through participation in peer-assisted ultrasound courses. METHODS: From 2017, students in the clinical part of medical school could opt for extracurricular peer-assisted ultrasound courses. Depending on the format (10-week course/2-day compact course) these comprised 20 teaching units focusing on abdominal and emergency ultrasonography. Students attending compulsory workshops at the start of their practical year were enrolled in this study, allowing for a comparison between the study group (attended ultrasound course) and the control group (did not attend ultrasound course). Competency from two out of four practical exams (subjects: "aorta", "gallbladder", "kidney" and "lung") was measured, and a theory test on the same subject areas ("pathology recognition") was administered. Additional questions concerned biographical data, subjective competency assessment (7-point Likert scale), and "attitude to ultrasound training in the curriculum". RESULTS: Analysis included 302 participants in total. Ultrasound courses had been attended on average 2.5 years earlier (10-week course) and 12 months earlier (2-day compact course), respectively. The study group (n = 141) achieved significantly better results than the control group (n = 161) in the long-term follow-up. This applies both to practical exams (p < 0.01) and theory tests (p < 0.01). After course attendance, participants reported a significantly higher subjective assessment of theoretical (p < 0.01) and practical (p < 0.01) ultrasound skills. CONCLUSIONS: Peer-assisted ultrasound courses can sustainably increase both theoretical and practical competency of medical students. This highlights the potential and need for standardised implementation of ultrasound courses in the medical education curriculum.

Fostering Self-Regulated Learning in Online Environments: Positive Effects of a Web-Based Training With Peer Feedback on Learning Behavior.

Although training in self-regulated learning (SRL) is effective in improving performance, human trainers can reach only a few people at a time. We developed a web-based training for potentially unlimited numbers of participants based on the process model of SRL by Schmitz and Wiese (2006). A prior study (Bellhäuser et al., 2016) observed positive effects on self-reported SRL and self-efficacy. In the present randomized controlled trial, we investigated an improved version of the web-based training, augmented by the application of peer feedback groups. Prospective university students in an online mathematics preparation course were assigned randomly to one of four experimental conditions: Group D (diary), group TD (training + diary), group TDP (training + diary + peer feedback group), and group C (control). Complete data was obtained for 136 participants (78.8% male; M = 19.8 years). The learning diary was intended to trigger goal setting, planning, and self-motivation in the morning and reflection in the evening. The web-based training consisted of three lessons (approximately 90 min each) with videos, presentations, self-tests, and exercises. In the peer feedback condition, participants were randomly assigned to groups of five persons each and used a bulletin board to discuss pre-defined topics related to the content of the web-based training. Outcome measures included a test of declarative SRL knowledge, an SRL questionnaire, a general self-efficacy scale, log file data, and a mathematics test. Results showed positive effects for the web-based training, particularly when combined with peer feedback on both SRL knowledge and SRL questionnaires, self-efficacy, and on objective time-investment, but not on the mathematics test. The learning diary did not exhibit positive effects. We conclude that additional peer-feedback seems to be a useful supplement to web-based trainings with comparably low organizational costs.