Self-Directed Learning for Pulmonary Ultrasound Education

This was a single-center, randomized, controlled equivalence trial conducted at the SimTO Advanced Medical Simulation Center, University of Turin, Italy. The study included third-year medical students enrolled in the curricular "Approach to Ultrasound" internship.

Before the in-person training session, all students completed online instructional materials on thoracic and abdominal ultrasound. During the internship, students participated in a structured two-hour ultrasound training session composed of four 30-minute stations. The stations included hands-on scanning of healthy volunteers and case-based pathology recognition activities.

At the thoracic pathology station, students were randomly assigned to either tutor-guided learning or self-directed learning. In the tutor-guided group, students worked through pulmonary ultrasound cases with direct supervision, clinical reasoning guidance, and feedback from a tutor. In the self-directed learning group, students used MEDQUIZ, a purpose-built digital learning tool that presented clinical cases, patient information, and lung ultrasound video clips in an interactive format.

The primary outcomes were based on pre-training and post-training assessments using ultrasound video cases. Students were assessed on three levels of competency: recognition of the anatomical structure shown in the ultrasound clip, classification of the finding as physiological or pathological, and identification of the specific pulmonary condition when a pathological finding was present. An overall case resolution score was also calculated.

Secondary outcomes included student satisfaction with the simulation-based learning experience, assessed at the end of the internship.

Inclusion criteria

• Third-year medical students enrolled in the "Approach to Ultrasound" curricular internship at the University of Turin
• Limited or no prior ultrasound experience
• No previous formal specialized ultrasound training
• Provision of informed consent for data collection

Exclusion criteria

• Inability to attend the complete ultrasound training session and both assessment sessions
• Physical or medical conditions limiting participation in hands-on ultrasound practice
• Refusal to provide informed consent for data collection