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.

Background: ultrasound diagnostics have a broad spectrum of applications, including among diseases of the musculoskeletal system. Accordingly, it is important for the users to have a well-founded and up-to-date education in this dynamic examination method. The right balance between online and in-class teaching still needs to be explored in this context. Certifying institutions are currently testing digitally transformed teaching concepts to provide more evidence. Methods: this study compared two musculoskeletal ultrasound blended learning models. Model A was more traditional, with a focus on in-person teaching, while Model B was more digitally oriented with compulsory webinar. Both used e-learning for preparation. Participants completed evaluations using a seven-point Likert scale, later converted to a 0–1 scale. Digital teaching media (e-learning) were used for preparation in both courses. Results: the analysis included n = 41 evaluations for Model A and n = 30 for Model B. Model B received a better overall assessment (median: 0.73 vs. 0.69, p = 0.05). Model B also excelled in “course preparation” (p = 0.02), “webinar quality” (p = 0.04), and “course concept” (p = 0.04). The “gain of competence” (p = 0.82), “learning materials” (p = 0.30), and “tutor quality” (p = 0.28) showed no significant differences. Conclusion: participants favorably assessed blended learning in ultrasound teaching. Certifying institutions should consider accrediting models that combine digital methods (e.g., internet lectures/webinars) and materials (e.g., e-learning) with hands-on ultrasound training. Further research is needed to validate these subjective findings for a stronger evidential basis.

Over the last few years, there has been an increasing focus on integrating artificial intelligence (AI) into existing imaging systems. This also applies to ultrasound. There are already applications for thyroid and breast lesions that enable AI-assisted sonography directly on the device. However, this is not yet the case for lymph nodes.The aim was to test whether already established programs for AI-assisted sonography of breast lesions and thyroid nodules are also suitable for identifying and measuring superficial lymph nodes. For this purpose, the two programs were used as a supplement to routine ultrasound examinations of superficial lymph nodes. The accuracy of detection by AI was then evaluated using a previously defined score. If available, a comparison was made with cross-sectional imaging.The programs that were used are able to adequately detect lymph nodes in the majority of cases (78.6%). Problems were caused in particular by a high proportion of echo-rich fat, blurred differentiation from the surrounding tissues and the occurrence of lymph node conglomerates. The available cross-sectional images did not contradict the classification of the lesion as a lymph node in any case.In the majority of cases, the tested programs are already able to detect and measure superficial lymph nodes. Further improvement can be expected through specific training of the software. Further developments and studies are required to assess risk of malignancy.

Zusammenfassung: Hintergrund Verlegungen der oberen Atemwege stellen akute Notfälle dar. Ultima Ratio zur Sicherung der Atemwege ist die Durchführung einer Koniotomie nach Identifizierung des Lig. conicum. Hier kann die Sonografie unterstützen. Ziel dieser Studie war die Etablierung eines Trainings zur Vermittlung dieser Kompetenzen. Material Methoden Das Training bestand aus einer theoretischen Schulung mit anschließender Videopräsentation (je 10min) sowie einem praktischen Training (45min). Zur Messung der Vorerfahrungen, der Zufriedenheit mit dem Training sowie des subjektiven und objektiven Kompetenzlevels wurden vor (T1) und nach (T2) dem Training Evaluationen bearbeitet. Zu T2 wurde zudem eine praktische Prüfung von n=113 Teilnehmenden (TN) absolviert. Die Ergebnisse der praktischen Prüfung wurden durch einen standardisierten Bogen dokumentiert. Ergebnisse Der größte Teil der TN hatte weder eine Koniotomie gesehen (64,6%) noch eigenständig durchgeführt (79,6%). In der subjektiven Kompetenzeinschätzung konnte eine signifikante Verbesserung (T1 zu T2) gemessen werden (p<0,001). Das Trainingsprogramm wurde in allen abgefragten Items positiv bewertet. In den praktischen Prüfungen erreichten die TN durchschnittlich 89,2% der möglichen Punkte und benötigten für die Identifizierung des Lig. conicum im Mittelwert 101±23 Sekunden. Schlussfolgerung Strukturiertes Training zur sonografischen Identifizierung des Lig. conicum führt bereits in kurzer Zeit zu einer deutlichen Verbesserung der subjektiven Kompetenzen sowie zu einem hohen objektiven Kompetenzlevel. Zukünftig sollten solche Trainingsprogramme standardisiert in der Kopf-Hals-Ultraschallausbildung etabliert werden.

Metastatic cervical lymph nodes are a frequent finding in head and neck squamous cell carcinoma (HNSCC). If a non-surgical approach is primarily chosen, a therapy response evaluation of the primary tumor and the affected lymph nodes is necessary in the follow-up. Supplementary contrast-enhanced ultrasound (CEUS) can be used to precisely visualize the microcirculation of the target lesion in the neck, whereby malignant and benign findings differ in their uptake behavior. The same applies to many other solid tumors. For various tumor entities, it has already been shown that therapy monitoring is possible through regular contrast-enhanced sonography of the primary tumor or the affected lymph nodes. Thus, in some cases, maybe in the future, a change in therapy strategy can be achieved at an early stage in the case of non-response or, in the case of therapy success, a de-escalation of subsequent (surgical) measures can be achieved. In this paper, a systematic review of the available studies and a discussion of the potential of therapy monitoring by means of CEUS in HNSCC are presented.