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Background <p>Point-of-care ultrasound (POCUS) is increasingly used in prehospital emergency medical services (EMS), including non-physician providers. However, access to high-quality hands-on training is often limited. Tele-didactic approaches may provide a scalable alternative, but comparative evidence is scarce. This study evaluated whether tele-didactic training is non-inferior to face-to-face instruction for teaching the extended Focused Assessment with Sonography for Trauma (eFAST) protocol.</p> Methods <p>In this multicenter, prospective, randomized controlled non-inferiority trial, non-physician EMS personnel from Austria and Hungary with limited prior POCUS experience were randomly assigned to either tele-didactic or face-to-face hands-on training. All participants first completed a standardized e-learning course, followed by a one-hour practical training session according to group allocation. Performance was subsequently evaluated in a simulated scenario using the Objective Structured Assessment of Ultrasound Skills (OSAUS; range 7–35), with assessments conducted by blinded experts. The inferiority limit was set at a difference in means of 7 OSAUS score points. The analysis was conducted according to the per-protocol principle. Secondary outcomes included OSAUS subdomain scores, time to task completion, cognitive load as measured by the NASA Task Load Index, and user experience.</p> Results <p>A total of 90 participants were analyzed (45 per group). Mean OSAUS scores were 26.6 ± 4.6 (face-to-face) and 27.6 ± 4.3 (tele-didactic), with a mean difference of 1.0 (lower 97.5% confidence limit: -0.8), demonstrating non-inferiority (<i>p</i> &lt; 0.001). No significant differences were observed in adjusted analyses or OSAUS subdomains. Time to completion and cognitive load were comparable between groups. Tele-didactic training showed high technical feasibility and user satisfaction, with minimal technical issues.</p> Conclusion <p>Tele-didactic training achieved comparable short-term performance outcomes and was well accepted by participants, supporting its potential as a feasible approach to expanding access to eFAST training for non-physician EMS providers.</p> Trial registration <p>This study was registered on clinicaltrials.gov (NCT06824675; 07-Feb-2025).</p>

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Point-of-care ultrasound tele-didactic teaching for prehospital emergency personnel (POCUS TT study): a randomized non-inferiority trial

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  • 发表日期：

    2026年7月1日

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  • Josef Michael Lintschinger,
  • Benedikt Degischer,
  • Luca Dronigi,
  • Adrian Bolnberger,
  • Benjamin Erdös,
  • Alexandra Kaider,
  • Daniel Alexander Klaus,
  • Ingrid Magnet,
  • Miklós Constantinovits,
  • Viktória Vadas,
  • Ákos Tiboldi,
  • Christina Hafner

摘要

Background

Point-of-care ultrasound (POCUS) is increasingly used in prehospital emergency medical services (EMS), including non-physician providers. However, access to high-quality hands-on training is often limited. Tele-didactic approaches may provide a scalable alternative, but comparative evidence is scarce. This study evaluated whether tele-didactic training is non-inferior to face-to-face instruction for teaching the extended Focused Assessment with Sonography for Trauma (eFAST) protocol.

Methods

In this multicenter, prospective, randomized controlled non-inferiority trial, non-physician EMS personnel from Austria and Hungary with limited prior POCUS experience were randomly assigned to either tele-didactic or face-to-face hands-on training. All participants first completed a standardized e-learning course, followed by a one-hour practical training session according to group allocation. Performance was subsequently evaluated in a simulated scenario using the Objective Structured Assessment of Ultrasound Skills (OSAUS; range 7–35), with assessments conducted by blinded experts. The inferiority limit was set at a difference in means of 7 OSAUS score points. The analysis was conducted according to the per-protocol principle. Secondary outcomes included OSAUS subdomain scores, time to task completion, cognitive load as measured by the NASA Task Load Index, and user experience.

Results

A total of 90 participants were analyzed (45 per group). Mean OSAUS scores were 26.6 ± 4.6 (face-to-face) and 27.6 ± 4.3 (tele-didactic), with a mean difference of 1.0 (lower 97.5% confidence limit: -0.8), demonstrating non-inferiority (p < 0.001). No significant differences were observed in adjusted analyses or OSAUS subdomains. Time to completion and cognitive load were comparable between groups. Tele-didactic training showed high technical feasibility and user satisfaction, with minimal technical issues.

Conclusion

Tele-didactic training achieved comparable short-term performance outcomes and was well accepted by participants, supporting its potential as a feasible approach to expanding access to eFAST training for non-physician EMS providers.

Trial registration

This study was registered on clinicaltrials.gov (NCT06824675; 07-Feb-2025).