Effectiveness of a Web-Based Training Intervention in Teaching Emergency Physicians First-Trimester Point-of-Care...

Area of Science:

• Emergency Medicine
• Medical Education
• Diagnostic Imaging

Background:

• Point-of-care ultrasound (POCUS) is crucial for first-trimester pregnancy assessment.
• Accurate interpretation of POCUS findings is essential for timely diagnosis and management.
• Standardized education may enhance emergency physician proficiency in this skill.

Purpose of the Study:

• To evaluate an educational intervention's effectiveness on emergency physicians' accuracy in identifying first-trimester pregnancy-related ultrasound findings.
• To identify specific case features associated with correct diagnoses in early pregnancy ultrasounds.

Main Methods:

• A multicenter prospective cross-sectional study involving emergency physicians in the US and Canada.
• An unsupervised, web-based education intervention using 400 first-trimester POCUS cases (transabdominal and transvaginal).
• Physicians practiced until achieving a defined mastery standard for image interpretation.

Main Results:

• Participants demonstrated significant learning gains in accuracy (15.2%), sensitivity (15.1%), and specificity (14.3%).
• 64.7% of physicians achieved the mastery standard, with a median of 60 practice cases.
• Transvaginal images and fetal heartbeat increased the odds of a correct intrauterine pregnancy diagnosis, while specific findings like subchorionic hemorrhage decreased it.

Conclusions:

• The education intervention effectively improved first-trimester POCUS interpretation skills among emergency physicians.
• The study identified challenging diagnostic variables, informing future educational strategies.
• This work provides a foundation for expanding learning opportunities in critical POCUS skills for emergency medicine.