RWTH Aachen University 12th EFORT Congress Copenhagen, 1 - 4 June 2011 Long-living knowledge of students in the field of shoulder ultrasound: results of a randomized prospective comparative study using the peer assisted learning system (PAL) Knobe M1, Holschen M1, Sellei RM1, Sopka S2, Beckers S2, Pape HC1 1 Dpt. of Trauma Surgery, Medical Faculty, RWTH Aachen University, Germany 2 AIXTRA – Centre for Interdisciplinary Training in Medical Education, RWTH Aachen University, Germany INTRODUCTION Clinical skills can be improved through the use of Peer-assisted Learning (PAL) as well as the incorporation of various diagnostic tools such as the ultrasound. The purpose of this study was the quantitative and qualitative evaluation of the PAL concept using the musculoskeletal ultrasound (MSUS) as a model system (RCT). Due to the dependence of this procedure on an operator, adequate training is very important in order to ensure the safe and competent use of MSUS. An important quality criterion of teaching is the sustainability of the imparted knowledge, which this study should identify after one year. RESULTS Assessment of the students’ theoretic grasp of the topic was achieved through a multiple choice test. Here, both groups showed a similar damage of knowledge (p1 vs. p2; pts.; PG 6.3 vs. 4.5; p=0.002 and SG 6.1 vs. 4.0; p=0.006). During the practical assessment (OSCE), average total points awarded to the PG were 17.7 (p1) and 13.3 (p2; p=0.008), while that to the SG were 17.9 (p1) and 15.0 (p2; p=0.185). Statistically relevant differences could not be observed in the average time required by the two groups to adequately produce the desired image (p1 vs. p2; sec; PG 37.0 vs. 34.0; p=0.420 and SG 34.5 vs. 28.9; p=0.335). Evaluation of differences in the theoretical and practical faculty between the two groups showed no differences between the PG and SG after one week or one year. METHODS Medical students, with strong motivation to learn shoulder ultrasound, were enrolled in the study between 2007 and 2008 (n=43, male/female 12/31, 23.3 yrs., 6.9 semester). Students were randomly (per computer) assigned to a PAL group (PG, n=24, taught by two student-teachers after one week self-teaching) or a staff group (SG, n=19, taught by two ultrasound-experienced physicians). Sessions (n=3 a 120 minutes, only shoulder sonography) included both a theoretical and a praxis component (EULAR, Toshiba Nemio™ XG, 10 MHz). A multiple choice questionnaire (MCQ, max 10 pts.) and an Objective Structured Clinical Examination (OSCE) were performed after one week (p1) and one year (p2). STATISTICS The analysis was performed using SPSS™ 17.0 (SPSS Inc., Chicago, IL, USA). In the cases where a normal distribution was present (MCQ, OSCE), a student t-test, as well as a one factor ANOVA was carried out; otherwise (qualitative assessment by Likert scale), non-parametric test methods, such as the Mann Whitney Wilcoxon Test were used. CONCLUSION Our results show that the skills necessary to perform a shoulder ultrasound can be adequately and efficiently taught to students using the PAL system. Complicated technical skills like MSUS taught by experienced physicians may be longer on hand than skills taught by peers. Assessment of the theoretic knowledge showed weak results after one year, regardless the way of teaching. Correspondence: Matthias Knobe, MD Dpt. of Trauma Surgery RWTH Aachen University Pauwelsstraße 30 52074 Aachen +49241/80-35134 mknobe@ukaachen.de 1 Topping KJ. The effectiveness of peer tutoring in further and higher education: a typology and review of the literature. Higher Education 1996;32:321-45. 2 Knobe M, Münker R, Sellei RM et al. Peer teaching: a randomised controlled trial using student-teachers to teach musculoskeletal ultrasound. Med Educ 2010 Feb;44(2):148-55.