Anelah McGinness, Sarah Hancock, Megan Hilbert, Jane Soung, Emily Lovallo

SpacED POCUS: A Randomized Controlled Trial of an Adaptive Spaced Education POCUS Curriculum for Medical Students

Introduction

Spaced pocus: a randomized controlled trial of an adaptive spaced education pocus curriculum for medical students. Randomized trial evaluates SpacED POCUS, an adaptive curriculum for medical students. It significantly boosts POCUS interpretation accuracy, retention, and acceptability.

Abstract

This study evaluated the effectiveness, retention, engagement, and acceptability of adaptive spaced education (spacED) for improving the accuracy of point of care ultrasound (POCUS) image interpretation by medical students. From July 2022-May 2023, students (n=36) were randomized into two groups and each assigned 50 unique POCUS cases: cardiac/vascular or lung/FAST. Each one served as the control for the other group. We measured effectiveness (% posttest 1 – % pretest), six-month retention (% posttest 2 – % posttest 1), engagement (% cases completed), and acceptability (% would recommend). Twenty-nine students (81%) completed the study. On average, 38.6% of cases were completed over the six-month study period. There was a significant increase in test scores covering FAST (Focused Assessment with Sonography in Trauma) (+18%), lung (+25%), and vascular (+23%, all p<0.01). Six-month FAST and lung scores did not have significant loss (+3% and –10%, p >0.05). Acceptability was high; 96% of students indicated they would participate again. Despite an imperfect case completion rate, for some applications, spacED was an effective, long-lasting, and acceptable method for teaching POCUS interpretation to medical students.

Review

The increasing importance of Point of Care Ultrasound (POCUS) in medical practice necessitates effective and enduring educational strategies for medical students. This randomized controlled trial, "SpacED POCUS," addresses this need by evaluating an adaptive spaced education (spacED) curriculum for improving POCUS image interpretation accuracy. The study aimed to assess the curriculum's effectiveness, six-month retention, student engagement, and overall acceptability among medical students, employing a crossover design where each group served as a control for the other across different POCUS modules. Involving 36 students, 29 (81%) of whom completed the study, the research assigned 50 unique POCUS cases within cardiac/vascular or lung/FAST domains. The results demonstrate significant improvements in test scores across multiple POCUS applications, with increases of 18% for FAST, 25% for lung, and 23% for vascular interpretations (all p<0.01). Importantly, these gains showed promising six-month retention, particularly for FAST (+3%) and lung (–10%), indicating sustained knowledge. Student acceptability was exceptionally high, with 96% recommending participation. However, a notable observation was the average case completion rate of only 38.6% over the six-month period. Despite the commendable effectiveness, strong retention, and high acceptability demonstrated for specific POCUS applications, the low case completion rate presents a critical area for further investigation. While the curriculum clearly fosters learning and positive student sentiment, understanding the barriers to full engagement with the assigned cases is crucial for maximizing its potential. Future research should delve into strategies to optimize completion rates, perhaps by refining case presentation, integration into existing curricula, or motivational incentives. Nevertheless, SpacED POCUS offers a promising, scalable, and durable approach to POCUS education, laying a foundation for continued development and broader implementation in medical training programs.

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