Holger Buggenhagen

Introduction: Scientific Competence (SC) is a central objective in medical education, but its conceptualization remains insufficiently differentiated, particularly regarding the relationship between evidence use and participation in scientific knowledge generation. Objective: This study reconstructs how physiology educators conceptualized SC and related different forms of scientific engagement within their professional orientation frameworks. Methods: Three group discussions were conducted in 2015–2016 with physiology educators from two German medical faculties and a didactic workshop of the German Physiological Society (n = 30). Bohnsack’s documentary method was used to reconstruct shared and contrasting professional orientation frameworks. Results: SC encompassed scientific thinking, scientific practices, and scientific agency. Critical appraisal, methodological understanding, and evidence-informed medical practice were consistently constructed as relevant to future physicians. Autonomous participation in knowledge generation was also valued, but its curricular positioning varied: participants differed in whether authentic inquiry should be expected of all students or whether more sustained independent research participation should primarily be associated with research-oriented trajectories. Conclusions: This historically situated reconstruction suggests that the central curricular question is not simply whether SC should be developed, but which forms of scientific participation should be expected of all physicians and which remain more closely associated with research-oriented trajectories. The findings offer conceptual hypotheses for examining this distinction in contemporary medical education.

Background: Digitalisation is transforming medical education, but its integration into ultrasound training remains limited. This study evaluates the needs of students and physicians regarding digitally supported ultrasound education. Materials and Methods: A multi-year cross-sectional study (2017–2022) employed two standardised questionnaires. The first assessed the perceived relevance of ultrasound in medical education, the desirability of compulsory teaching, and the integration of digital media and case-based learning. The second explored user-centred requirements for e-learning formats, including functionality, multimedia design, usability, interactivity, and financing, as well as current use of digital devices and reference materials. Data were collected using dichotomous and 7-point Likert scales (1 = high need/strong agreement, 7 = low need/weak agreement). Results: A total of 3479 responses were analysed (2821 students; 658 physicians). Both groups showed strong support for integrating ultrasound into curricula (1.3 ± 0.7) and mandatory education (1.4 ± 0.9), with students expressing significantly greater support (p < 0.001). There was broad agreement on the integration and development of digital media (1.7 ± 1.0), as well as the use of case studies (1.4 ± 0.8), with no significant differences between groups (p > 0.05). Case-based learning as a stand-alone format was less favoured (3.4 ± 1.9). In the user-centred needs analysis, both groups rated features like search functions (1.4 ± 0.8), usability (1.5 ± 0.9), and learning objective checks (2.7 ± 1.6) as important. High-quality media (1.5 ± 0.9) and pathology explanations (1.6 ± 1.1) were also highly valued. Students primarily relied on digital platforms, while physicians used a more varied mix of digital platforms, guidelines, and textbooks. Conclusions: The study highlights the need for more extensive, digitally supported ultrasound training, with a focus on functionality and usability. Standardisation through structured certification processes should be considered for future implementation.

Introduction: This study investigated the effectiveness of e-learning compared to traditional teaching methods in ultrasound education, centring on a focus cardiac ultrasound (FoCUS) course for third-year undergraduate medical students. With the rise of digital teaching methods, it is essential to evaluate their impact on the development of theoretical and practical skills in ultrasound training. Methods: A prospective, randomised, controlled trial was conducted involving two groups of students participating in a one-day FoCUS course delivered in a flipped classroom format. The study group used e-learning resources, while the control group used hard-copy lecture notes. Assessments were conducted at three stages: before the course, during the preparation phase, and after the course. Evaluations included self-assessment surveys, theory tests, and practical exams using direct observation of procedural skills (DOPS) tests. The study group had 15% less practice time compared to the control group. Results: A total of 109 complete datasets (study group, n = 52; control group, n = 57) were analysed. Both groups showed an equivalent initial level of and a continuous and significant (p < 0.01) increase in subjective and objective skills over the evaluated time frame. The study group achieved significantly (p = 0.03) higher results in DOPS (T2) than the control group. No significant differences were found in the total scores of the theory tests (T2 + T3) or DOPS (T3). Both groups rated their teaching materials, motivation, and the course concept in similarly high scale ranges. Conclusions: The findings suggest that e-learning is as effective as traditional methods in developing ultrasound skills and may serve as a viable alternative, even with reduced face-to-face interaction. These results indicate that accreditation processes could be applied similarly to those for traditional formats without requiring in-person training as a prerequisite for quality

Background/Objectives: Acute obstructions of the upper respiratory tract are emergencies that may require a cricothyrotomy as ultima ratio. For this, precise identification of the conic ligament is essential. Point-of-care ultrasound (POCUS) offers a reliable tool for anatomical localization in challenging cases and could be used by a range of emergency medicine workers. This prospective, controlled observational study assesses the development of competencies of paramedics (PMs) in point-of-care ultrasound (POCUS) assisted identification of the conic ligament after structured training, and compares their competence level to emergency physicians (EPs). Methods: PMs and a control group of EPs received an identical structured training program as part of an ultrasound course. It included a 10-min theoretical introduction, a 10-min video, and a 45-min practical session with ultrasound devices. Questionnaires and a practical test assessed both group’s previous experiences, satisfaction with training, and the development of subjective and objective competencies before (T₁) and after (T₂) the training. Results: A total of 120 participants (N = 92 PMs and N = 28 EPs) participated. A minority had previously performed a cricothyrotomy even in training settings (PMs 17%; EPs 11%), and none had identified the conic ligament using POCUS. The study group’s subjective and objective competencies increased significantly (p < 0.001). At T2, the study group demonstrated comparable subjective (p = 0.22) and objective (p = 0.81) competencies to those of the control group. The study group needed significantly (p < 0.01) less time to perform the DOPS. While both groups were satisfied with the study material (PMs 2.2 ± 1.2 vs. Eps 1.6 ± 1.0; p = 0.02) and the training (PMs 1.8 ± 1.0 vs. EPs 1.4 ± 0.7, p = 0.03), the study group rated both significantly better. Conclusions: After structured training, paramedics successfully identified the conic ligament using POCUS comparably to emergency physicians. Integrating POCUS into paramedic training may improve prehospital airway management and enhance patient safety. Further studies should investigate long-term skill retention and real-life application.

Background: the use of handheld ultrasonography (HHUS) devices is well established in prehospital emergency diagnostics, as well as in intensive care settings. This is based on several studies in which HHUS devices were compared to conventional high-end ultrasonography (HEUS) devices. Nonetheless, there is limited evidence regarding potential variations in B-scan quality among HHUS devices from various manufacturers, and regarding whether any such differences hold clinical significance in intensive care medicine settings. Methods: this study included the evaluation of eight HHUS devices sourced from diverse manufacturers. Ultrasound videos of five previously defined sonographic questions (volume status/inferior vena cava, pleural effusion, pulmonary B-lines, gallbladder, and needle tracking in situ) were recorded with all devices. The analogue recording of the same pathologies with a HEUS device served as gold standard. The corresponding findings (HHUS and HEUS) were then played side by side and evaluated by sixteen intensive care physicians experienced in sonography. The B-scan quality and the clinical significance of the HHUS were assessed using a five-point Likert scale (5 points = very good; 1 point = insufficient). Results: both in assessing the quality of B-scans and in their ability to answer clinical questions, the HHUS achieved convincing results—regardless of the manufacturer. For example, only 8.6% (B-scan quality) and 9.8% (clinical question) of all submitted assessments received an “insufficient” rating. One HHUS device showed a significantly higher (p < 0.01) average points score in the assessment of B-scan quality (3.9 ± 0.65 points) and in the evaluation of clinical significance (4.03 ± 0.73 points), compared to the other devices. Conclusions: HHUS systems are able to reliably answer various clinical intensive care questions and are—while bearing their limitations in mind—an acceptable alternative to conventional HEUS devices. Irrespective of this, the present study was able to demonstrate relevant differences in the B-scan quality of HHUS devices from different manufacturers.

Introduction: Ultrasound diagnostics is an important examination method in everyday clinical practice, but student education is often inadequate for acquiring sufficient basic skills. Individual universities have therefore started integrating (extra)curricular training concepts into medical education. This study aimed to evaluate sustainable skills development through participation in peer-assisted ultrasound courses. Methods: From 2017, students in the clinical part of medical school could opt for extracurricular peer-assisted ultrasound courses. Depending on the format (10-week course/2-day compact course) these comprised 20 teaching units focusing on abdominal and emergency ultrasonography. Students attending compulsory workshops at the start of their practical year were enrolled in this study, allowing for a comparison between the study group (attended ultrasound course) and the control group (did not attend ultrasound course). Competency from two out of four practical exams (subjects: “aorta”, “gallbladder”, “kidney” and “lung”) was measured, and a theory test on the same subject areas (“pathology recognition”) was administered. Additional questions concerned biographical data, subjective competency assessment (7-point Likert scale), and “attitude to ultrasound training in the curriculum”. Results: Analysis included 302 participants in total. Ultrasound courses had been attended on average 2.5 years earlier (10-week course) and 12 months earlier (2-day compact course), respectively. The study group (n = 141) achieved significantly better results than the control group (n = 161) in the long-term follow-up. This applies both to practical exams (p < 0.01) and theory tests (p < 0.01). After course attendance, participants reported a significantly higher subjective assessment of theoretical (p < 0.01) and practical (p < 0.01) ultrasound skills. Conclusions: Peer-assisted ultrasound courses can sustainably increase both theoretical and practical competency of medical students. This highlights the potential and need for standardised implementation of ultrasound courses in the medical education curriculum.

In Germany, progress assessments in head and neck ultrasonography training have been carried out mainly theoretically and lack standardisation. Thus, quality assurance and comparisons between certified courses from various course providers are difficult. This study aimed to develop and integrate a direct observation of procedural skills (DOPS) in head and neck ultrasound education and explore the perceptions of both participants and examiners. Five DOPS tests oriented towards assessing basic skills were developed for certified head and neck ultrasound courses on national standards. DOPS tests were completed by 76 participants from basic and advanced ultrasound courses (n = 168 documented DOPS tests) and evaluated using a 7-point Likert scale. Ten examiners performed and evaluated the DOPS after detailed training. The variables of “general aspects” (6.0 Scale Points (SP) vs. 5.9 SP; p = 0.71), “test atmosphere” (6.3 SP vs. 6.4 SP; p = 0.92), and “test task setting” (6.2 SP vs. 5.9 SP; p = 0.12) were positively evaluated by all participants and examiners. There were no significant differences between a basic and advanced course in relation to the overall results of DOPS tests (p = 0.81). Regardless of the courses, there were significant differences in the total number of points achieved between individual DOPS tests. DOPS tests are accepted by participants and examiners as an assessment tool in head and neck ultrasound education. In view of the trend toward “competence-based” teaching, this type of test format should be applied and validated in the future.

Kohlenmonoxid (CO) entsteht bei jeder unvollständigen Verbrennung. Reichert sich dies in der Atemluft an, kann das lebensgefährliche Folgen haben. Woran erkennt man die unspezifischen Vergiftungssymtpome und worauf muss man bei der Versorgung des Patienten achten?