title: Bedside ultrasound training using web-based e-learning and simulation early in the curriculum of residents.
abstract: BACKGROUND
  Focused bedside ultrasound is rapidly becoming a standard of care to decrease the risks of complications related to invasive procedures. The purpose of this study was to assess whether adding to the curriculum of junior residents an educational intervention combining web-based e-learning and hands-on training would improve the residents' proficiency in different clinical applications of bedside ultrasound as compared to using the traditional apprenticeship teaching method alone.
  
  
  METHODS
  Junior residents (n = 39) were provided with two educational interventions (vascular and pleural ultrasound). Each intervention consisted of a combination of web-based e-learning and bedside hands-on training. Senior residents (n = 15) were the traditionally trained group and were not provided with the educational interventions.
  
  
  RESULTS
  After the educational intervention, performance of the junior residents on the practical tests was superior to that of the senior residents. This was true for the vascular assessment (94% ± 5% vs. 68% ± 15%, unpaired student t test: p < 0.0001, mean difference: 26 (95% CI: 20 to 31)) and even more significant for the pleural assessment (92% ± 9% vs. 57% ± 25%, unpaired student t test: p < 0.0001, mean difference: 35 (95% CI: 23 to 44)). The junior residents also had a significantly higher success rate in performing ultrasound-guided needle insertion compared to the senior residents for both the transverse (95% vs. 60%, Fisher's exact test p = 0.0048) and longitudinal views (100% vs. 73%, Fisher's exact test p = 0.0055).
  
  
  CONCLUSIONS
  Our study demonstrated that a structured curriculum combining web-based education, hands-on training, and simulation integrated early in the training of the junior residents can lead to better proficiency in performing ultrasound-guided techniques compared to the traditional apprenticeship model.
authors: Faculty of Medicine, Department of Medicine and Hôpital Sacré-Coeur, 5400 boul. Gouin ouest, Montréal, H4J 1C5 Canada.
authors: Yanick
authors: Y
authors: Beaulieu
authors: Faculty of Medicine, Department of Medicine and Centre d'Apprentissage des Attitudes et Habiletés Cliniques (CAAHC), Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, H3T 1J4 Canada.
authors: Réjean
authors: R
authors: Laprise
authors: Faculty of Medicine, Department of Medicine and Centre d'Apprentissage des Attitudes et Habiletés Cliniques (CAAHC), Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, H3T 1J4 Canada.
authors: Pierre
authors: P
authors: Drolet
authors: Faculty of Medicine, Department of Medicine and Centre d'Apprentissage des Attitudes et Habiletés Cliniques (CAAHC), Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, H3T 1J4 Canada.
authors: Robert L
authors: RL
authors: Thivierge
authors: Faculty of Medicine, Department of Medicine and Hôpital Sacré-Coeur, 5400 boul. Gouin ouest, Montréal, H4J 1C5 Canada.
authors: Karim
authors: K
authors: Serri
authors: Faculty of Medicine, Department of Medicine and Hôpital Sacré-Coeur, 5400 boul. Gouin ouest, Montréal, H4J 1C5 Canada ; Research Centre, Hôpital Sacré-Coeur, 5400 boul. Gouin ouest, Montréal, H4J 1C5 Canada.
authors: Martin
authors: M
authors: Albert
authors: Faculty of Medicine, Department of Anesthesia, Montreal Heart Institute, Université de Montréal, 5000 Bélanger, Montréal, H1T 1C8 Canada.
authors: Alain
authors: A
authors: Lamontagne
authors: Faculty of Medicine, Department of Anesthesia, Montreal Heart Institute, Université de Montréal, 5000 Bélanger, Montréal, H1T 1C8 Canada.
authors: Marc
authors: M
authors: Bélliveau
authors: Faculty of Medicine, Department of Anesthesia, Montreal Heart Institute, Université de Montréal, 5000 Bélanger, Montréal, H1T 1C8 Canada.
authors: André-Yves
authors: AY
authors: Denault
authors: Faculty of Medicine, Department of Medicine and Centre d'Apprentissage des Attitudes et Habiletés Cliniques (CAAHC), Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, H3T 1J4 Canada.
authors: Jean-Victor
authors: JV
authors: Patenaude
keywords: Education; Residents; Safety; Simulation; Ultrasound; e-learning