E-learning and practical performance in musculoskeletal ultrasound: a multicenter randomized study

OBJECTIVES: To examine the effect of pre-course e-learning on residents' practical performance in musculoskeletal ultrasound (MSUS).

METHODS: Multicentre, randomized controlled study following the CONSORT statement. Residents with no or little MSUS experience were randomized to either an e-learning group or a traditional group. One week before a 2-day face-to-face MSUS course, the e-learning group received access to an interactive platform consisting of online lectures, assignments, and practical instruction videos aligned with the content of the course. The traditional group only received standard pre-course information (program, venue, and time). All participants performed a pre- and post-course practical MSUS examination and were assessed by two individual raters, blinded to the group allocation, using the validated Objective Structured Assessment of Ultrasound skills (OSAUS) tool.

RESULTS: Twenty-eight participants completed the study. There were no statistically significant differences in the pre- or post-course practical MSUS performance between the e-learning group and the traditional group; the mean pre-course OSAUS score (±SD) in the e-learning group was 5.4 ± 3.7 compared with 5.2 ± 2.4 in the traditional group, p= 0.8, whereas the post-course OSAUS score in the e-learning group was 11.1 ± 2.8 compared with 10.9 ± 2.4 in the traditional group, p= 0.8. There was a significant difference between the mean pre- and post-course scores (5.74-point p< 0.001). The OSAUS assessment tool demonstrated good inter-rater reliability (ICC = 0.84).

CONCLUSION: We found no significant impact of pre-course e-learning on novices' acquisition of practical MSUS skills. Hands-on training is of utmost importance and improves MSUS performance significantly. The OSAUS assessment tool is an applicable tool with high interrater reliability.

TRIAL REGISTRATION: https://clinicaltrials.gov/ NCT04959162.