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Point-of-care ultrasound tele-didactic teaching for prehospital emergency personnel (POCUS TT study): a randomized
Josef Michael Lintschinger1,2, Benedikt Degischer1, Luca Dronigi1
1Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Spitalgasse 23, Vienna, Austria.
Background:
Point-of-care ultrasound (POCUS) is increasingly used in prehospital emergency medical services (EMS), including non-physician providers. However, access to high-quality hands-on training is often limited. Tele-didactic approaches may provide a scalable alternative, but comparative evidence is scarce. This study evaluated whether tele-didactic training is non-inferior to face-to-face instruction for teaching the extended Focused Assessment with Sonography for Trauma (eFAST) protocol.
Methods:
In this multicenter, prospective, randomized controlled non-inferiority trial, non-physician EMS personnel from Austria and Hungary with limited prior POCUS experience were randomly assigned to either tele-didactic or face-to-face hands-on training. All participants first completed a standardized e-learning course, followed by a one-hour practical training session according to group allocation. Performance was subsequently evaluated in a simulated scenario using the Objective Structured Assessment of Ultrasound Skills (OSAUS; range 7-35), with assessments conducted by blinded experts. The inferiority limit was set at a difference in means of 7 OSAUS score points. The analysis was conducted according to the per-protocol principle. Secondary outcomes included OSAUS subdomain scores, time to task completion, cognitive load as measured by the NASA Task Load Index, and user experience.
Results:
A total of 90 participants were analyzed (45 per group). Mean OSAUS scores were 26.6 ± 4.6 (face-to-face) and 27.6 ± 4.3 (tele-didactic), with a mean difference of 1.0 (lower 97.5% confidence limit: -0.8), demonstrating non-inferiority (p < 0.001). No significant differences were observed in adjusted analyses or OSAUS subdomains. Time to completion and cognitive load were comparable between groups. Tele-didactic training showed high technical feasibility and user satisfaction, with minimal technical issues.
Conclusion:
Tele-didactic training achieved comparable short-term performance outcomes and was well accepted by participants, supporting its potential as a feasible approach to expanding access to eFAST training for non-physician EMS providers.
Trial Registration:
This study was registered on clinicaltrials.gov (NCT06824675; 07-Feb-2025).
