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Observational Study
. 2024 Feb 21;24(1):166.
doi: 10.1186/s12909-024-05148-0.

Lung ultrasound training: how short is too short? observational study on the effects of a focused theoretical training for novice learners

Silvia Mongodi  1 , Raffaella Arioli  2 , Attilio Quaini  3 , Giuseppina Grugnetti  3 , Anna Maria Grugnetti  3 , Francesco Mojoli  2   4
Affiliations
Observational Study

Lung ultrasound training: how short is too short? observational study on the effects of a focused theoretical training for novice learners

Silvia Mongodi et al. BMC Med Educ. .

Abstract

Background: Lung ultrasound has been increasingly used in the last years for the assessment of patients with respiratory diseases; it is considered a simple technique, now spreading from physicians to other healthcare professionals as nurses and physiotherapists, as well as to medical students. These providers may require a different training to acquire lung ultrasound skills, since they are expected to have no previous experience with ultrasound. The aim of the study was to assess the impact of a short theoretical training focused on lung ultrasound pattern recognition in a population of novice nurse learners with no previous experience with ultrasound.

Methods: We included the nurses attending a critical care advanced course for nurses performed at the University of Pavia. Images' interpretation skills were tested on two slide sets (a 25-clip set focused on B-pattern recognition and a 25-clip set focused on identification of pleural movement as lung sliding, lung pulse, lung point, no movement) before and after three 30-minute teaching modules dedicated to general ultrasound principles, B-lines assessment and lung sliding assessment. A cut off of 80% was considered acceptable for correctly interpreted images after this basic course.

Results: 22 nurses were enrolled (age 26.0 [24.0-28.0] years; men 4 (18%)); one nurse had previous experience with other ultrasound techniques, none of them had previous experience with lung ultrasound. After the training, the number of correctly interpreted clips improved from 3.5 [0.0-13.0] to 22.0 [19.0-23.0] (p < 0.0001) for B-pattern and from 0.5 [0.0-2.0] to 8.5 [6.0-12.0] (p < 0.0001) for lung sliding assessment. The number of correct answers for B-pattern recognition was significantly higher than for lung sliding assessment, both before (3.5 [0.0-13.0] vs. 0.5 [0.0-2.0]; p = 0.0036) and after (22.0 [19.0-23.0] vs. 8.5 [6.0-12.0]; p < 0.0001) the training. After the training, nurses were able to correctly recognize the presence or the absence of a B-pattern in 84.2 ± 10.3% of cases; lung sliding was correctly assessed in 37.1 ± 15.3% of cases.

Conclusions: Lung ultrasound is considered a simple technique; while a short, focused training significantly improves B-pattern recognition, lung sliding assessment may require a longer training for novice learners.

Trial registration: Not applicable.

Keywords: LUS; Lung ultrasound; Nurse teaching; Nurse training; Point-of-care ultrasound.

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Conflict of interest statement

FM received fees for lectures from GE Healthcare, Hamilton Medical, SEDA SpA, outside the present work. SM received fees for lectures from GE Healthcare, outside the present work. A research agreement is active between University of Pavia and Hamilton Medical. The other authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Longitudinal scans of an intercostal space. (A) The pleural line (red arrow) is visualized between the ribs; reverberation artifacts beneath the pleura (A-lines– white arrows) indicate normal aeration and rule out cardiogenic edema. (B) 3 B-lines are visualized: vertical artifacts deriving from the pleura, reaching the bottom of the screen while erasing the A-lines: this B-pattern supports the diagnosis of a cardiogenic edema as the cause of acute dyspnea
See this image and copyright information in PMC

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