Blended-learning with half the face-to-face time versus conventional abdominal ultrasound training in undergraduate medical education: a randomized controlled non-inferiority trial.

BACKGROUND

Ultrasonography is an essential clinical tool, offering rapid, bedside, imaging that supports timely clinical decision-making. Its effectiveness, however, depends heavily on examiner skill, requiring structured, practice-oriented training. Traditional tutor-led ultrasound teaching is limited by personnel and resource shortages. Blended learning, combining self-directed digital preparation with targeted hands-on teaching, may help overcome these constraints while maintaining educational quality. This randomized controlled non-inferiority trial evaluated whether a blended-learning abdomen ultrasound curriculum with reduced face-to-face teaching is as effective as a conventional full-day peer-teaching course.

METHODS

Clinical-phase medical students at Philipps University Marburg were eligible to participate. After enrollment and written informed consent, students were randomized to either a conventional one-day (8-hour) face-to-face curriculum or a blended-learning curriculum consisting of online preparatory modules, followed by a shortened, 4-hour hands-on session. Both formats were delivered by trained student peer tutors. The primary outcome was performance in an Objective Structured Clinical Examination (OSCE; 0–20 points). Secondary outcomes included theoretical knowledge assessed through a written test (0–20 points) and student perceptions measured via a Likert-scale questionnaire.

RESULTS

A total of 118 students were randomized (60 blended learning; 58 conventional). Blended learning was non-inferior to the conventional curriculum in OSCE performance (14.68 ± 2.72 vs. 14.86 ± 2.67; mean difference 0.18; 95% CI − 0.80 to 1.16), with the confidence interval fully within the non-inferiority margin of Δ = 4. Mean theoretical knowledge scores did not differ significantly (16.35 ± 2.74 vs. 16.59 ± 2.69; p = 0.35). Student evaluations indicated high perceived knowledge and skills gain in both groups, with comparable acceptance and course organization ratings.

CONCLUSIONS

A blended-learning curriculum that shifts theoretical instruction from face-to-face teaching to structured self-directed online preparation, was non-inferior to a conventional full-day ultrasound course in teaching practical abdominal ultrasound skills. This approach provides an effective and resource-efficient strategy to broaden access to ultrasound education while preserving instructional quality. TRIAL REGISTRATION: Not applicable.