Long-Term Knowledge Retention after Peer-Assisted Abdominal Ultrasound Teaching: Is PAL a Successful Model for Achieving Knowledge Retention?

Abstract

Background Diagnostic ultrasound has a crucial importance in clinical settings, especially in intensive care medicine where bedside ultrasound has become indispensable. Medical students as well as residents therefore have a strong interest in learning this useful skill. Since staff resources are limited, more and more universities are using student tutors in a peer-assisted learning concept (PAL) to teach medical students early in their training. To date, there is very sparse data about knowledge retention after peer-assisted teaching. The aim of this study was to evaluate whether PAL is a suitable method for teaching complex skills like abdominal ultrasound and to evaluate whether students do achieve adequate long-term knowledge retention after peer-assisted teaching.

Method A total of 40 volunteer 3^rd to 5^th year students were randomly assigned to a basic abdominal ultrasound course in small training groups of 5 persons each. Participants were evaluated using a pre-post-test design by a validated objective structured clinical examination (OSCE) before and immediately after the course. To measure the retention of knowledge, 15 former participants were randomly selected to repeat the OSCE assessment after one year.

Results All groups showed a significant improvement in practical skills and knowledge gain after the training with mean values of 13.1 for pre-test compared to 83.5 (maximum 100 points) for post-test (p < 0.001). The overall score achieved after one year was 78.7 and did not significantly differ from the post-test result.

Conclusion PAL is effective for teaching abdominal ultrasound. Students were able to accomplish a satisfactory level of ultrasound skills. We further demonstrated that PAL can assure long-term knowledge retention.

Zusammenfassung

Ziel Ultraschall in der Medizin hat eine immer größere Bedeutung im klinischen Alltag; insbesondere in der Intensivmedizin ist der Ultraschall zu einem unerlässlichen diagnostischen Instrument geworden. Aufgrund limitierter personeller Ressourcen setzten immer mehr Universitäten studentische Tutoren im Sinne eines „Peer-Assisted Learning-Concept” (PAL) ein, um möglichst viele Medizinstudenten in der Ultraschalldiagnostik zu unterrichten. Aktuell sind sehr wenige Daten hinsichtlich des Lernerfolgs nach PAL bekannt. Ziel unsere Studie war es zu evaluieren, ob durch PAL praktische Fähigkeiten wie die Sonografie gelehrt und zudem Langzeit-Lerneffekte erzielt werden können.

Material und Methode 40 Medizinstudenten im 6.–10. klinischen Semester nahmen an einem PAL-geführten Abdomen-Grundkurs in Kleingruppenunterricht (8 Kurstage à 90 min mit je 5 Personen/Gruppe) teil. Alle Teilnehmer wurden mittels Prä-post-Testmethode evaluiert und absolvierten hierzu vor Beginn und am Ende des Kurses eine OSCE. Zur Evaluation des Langzeit-Lerneffekts wurden 15 Kursteilnehmer zufällig ausgewählt, die OSCE nach 1 Jahr erneut abzulegen.

Ergebnisse Alle Teilnehmer zeigten einen signifikanten Wissenszuwachs in ihren praktischen Fähigkeiten. Im Mittel erreichten die Teilnehmer 13,1 Punkte im Prä-Test, verglichen mit 83,5 Punkten im Post-Test von insgesamt 100 erreichbaren Punkten (p < 0,001). Nach 1 Jahr erzielten die Teilnehmer im Mittel 78,7 von maximal 100 Punkten und unterschieden sich nicht signifikant von den Post-Test-Ergebnissen.

Schlussfolgerung PAL ist eine erfolgreiche Methode, um wichtige klinische Fähigkeiten wie die Abdomen-Sonografie zu unterrichten. Darüber hinaus konnten wir zeigen, dass die durch ein PAL-Konzept erlernten Fertigkeiten ohne wesentlichen Wissensverlust über einen langen Zeitraum erhalten bleiben.

Key words

ultrasound - QA/QC - medical education - peer-assisted teaching - long-term knowledge retention

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