Effects of undergraduate ultrasound education on cross-sectional image understanding and visual-spatial ability - a prospective study

Abstract

Introduction/aim: Radiological imaging is crucial in modern clinical practice and requires thorough and early training. An understanding of cross-sectional imaging is essential for effective interpretation of such imaging. This study examines the extent to which completing an undergraduate ultrasound course has positive effects on the development of visual-spatial ability, knowledge of anatomical spatial relationships, understanding of radiological cross-sectional images, and theoretical ultrasound competencies.

Material and methods: This prospective observational study was conducted at a medical school with 3rd year medical students as part of a voluntary extracurricular ultrasound course. The participants completed evaluations (7-level Likert response formats and dichotomous questions "yes/no") and theoretical tests at two time points (T1 = pre course; T2 = post course) to measure their subjective and objective cross-sectional imaging skills competencies. A questionnaire on baseline values and previous experience identified potential influencing factors.

Results: A total of 141 participants were included in the study. Most participants had no previous general knowledge of ultrasound diagnostics (83%), had not yet performed a practical ultrasound examination (87%), and had not attended any courses on sonography (95%). Significant subjective and objective improvements in competencies were observed after the course, particularly in the subjective sub-area of "knowledge of anatomical spatial relationships" (p = 0.009). Similarly, participants showed improvements in the objective sub-areas of "theoretical ultrasound competencies" (p < 0.001), "radiological cross-section understanding and knowledge of anatomical spatial relationships in the abdomen" (p < 0.001), "visual-spatial ability in radiological cross-section images" (p < 0.001), and "visual-spatial ability" (p = 0.020).

Conclusion: Ultrasound training courses can enhance the development of visual-spatial ability, knowledge of anatomical spatial relationships, radiological cross-sectional image understanding, and theoretical ultrasound competencies. Due to the reciprocal positive effects of the training, students should receive radiology training at an early stage of their studies to benefit as early as possible from the improved skills, particularly in the disciplines of anatomy and radiology.

Keywords: Anatomical spatial relationships; Cross-sectional image understanding; Interpretation of radiological images; Ultrasound; Undergraduate Radiology Education; Undergraduate Ultrasound Education; Visual–spatial ability.

Fig. 1

Study design including course model and evaluation time points. After the study was designed (a), the participants were recruited and pooled in groups (b). Participants took part in the training program and the assessment time points (c). TU: Teaching unit (45 min)

Fig. 2

Overview of competencies and their relationships (7, 12, 15, 16, 24, 27, 30, 32, 33, 39, 42, 44, 48). Arrow (black): Influences investigated by other studies; Arrow (red): Investigated influences from our study

Fig. 3

Results of the theory tests at time points T1(Theory_pre) and T2 (Theory_post). Box plots visualizing the respective overall score (a) as well as the score of the competencies: “VSA: visual-spatial ability” (b), “VSA-RC: Visual-spatial ability in radiological cross-sectional images” (c), “RCU-ASR- abd: Understanding of radiological cross-sectional images and knowledge of anatomical spatial relationships in CT and MRI images in the abdomen” (d), “RCU-ASR-neck: Understanding of radiological cross-sectional images and knowledge of anatomical spatial relationships in CT and MRI images in the neck” (e), and “UsC: theoretical ultrasound competences” (f). A high number implies a high percentage performance in the test. The median (black lines), mean (red dots), and the effect size r are shown