Education and training in lung ultrasound: a systematic review

Background: Despite being widely implemented, and international consensus guidelines exist, there are no international recommendations of how to educate physicians in lung ultrasound (LUS). Societies require an arbitrary number of examinations or fixed timeframe for certification, but this does not equal obtained competencies or skills. The paradigm in medical education has changed. Objective: The aim of the systematic review is to create an overview of existing literature in LUS training and to find out the evidence and effect of their strategies. Methods: According to PRISMA guidelines, three databases were searched and two reviewers examined the results. Publications were described and assessed for level of evidence and risk of bias according to the guidelines from Oxford Centre for Evidence-Based Medicine and Cochrane Collaboration Tool for Risk of Bias assessment. Results: Of 7,796 studies screened, 16 studies were included. Twelve pretest-posttest studies, three descriptive studies and one randomized controlled trial were identified. 933 trainees participated, from novices to experienced physicians. None of the studies used assessment tests with established evidence for validity. Highest level of evidence score was 2, remaining scored 4. Risk of bias was assessed high in 11 of 16 studies. Conclusion: Even though the literature proved increased theoretical and practical skills obtained, heterogeneity of the studies, especially methods of assessment, makes it difficult to compare the results, and establish recommendations. When looking at research in medical education in general and simulation training, this could have great potential for reproducible, objective assessment and effects on skill and behaviour