Self-Directed Learning for Pulmonary Ultrasound Education

Overview

This study compared two ways of teaching medical students how to recognize lung conditions using ultrasound images. All participants were third-year medical students taking part in a structured ultrasound training session at the University of Turin. Students were randomly assigned to one of two groups. One group learned lung ultrasound pathology recognition with direct guidance from a tutor. The other group used a self-directed digital learning tool called MEDQUIZ, which allowed students to review clinical cases and ultrasound videos independently. The main goal of the study was to determine whether self-directed learning was equivalent to tutor-guided instruction for recognizing pulmonary ultrasound findings. Students completed ultrasound image-based assessments before and after the training. The assessments evaluated their ability to recognize anatomical structures, distinguish normal from abnormal findings, and identify specific lung conditions such as pneumonia, pleural effusion, interstitial syndrome, and pneumothorax. The study also evaluated student satisfaction with the learning experience.

This was a single-center, randomized, controlled equivalence trial conducted at the SimTO Advanced Medical Simulation Center, University of Turin, Italy. The study included third-year medical students enrolled in the curricular "Approach to Ultrasound" internship. Before the in-person training session, all students completed online instructional materials on thoracic and abdominal ultrasound. During the internship, students participated in a structured two-hour ultrasound training session composed of four 30-minute stations. The stations included hands-on scanning of healthy volunteers and case-based pathology recognition activities. At the thoracic pathology station, students were randomly assigned to either tutor-guided learning or self-directed learning. In the tutor-guided group, students worked through pulmonary ultrasound cases with direct supervision, clinical reasoning guidance, and feedback from a tutor. In the self-directed learning group, students used MEDQUIZ, a purpose-built digital learning tool that presented clinical cases, patient information, and lung ultrasound video clips in an interactive format. The primary outcomes were based on pre-training and post-training assessments using ultrasound video cases. Students were assessed on three levels of competency: recognition of the anatomical structure shown in the ultrasound clip, classification of the finding as physiological or pathological, and identification of the specific pulmonary condition when a pathological finding was present. An overall case resolution score was also calculated. Secondary outcomes included student satisfaction with the simulation-based learning experience, assessed at the end of the internship.