Focused cardiac ultrasound training in medical students: Using an independent, simulator-based curriculum to objectively measure skill acquisition and learning curve

Echocardiography. 2020 Apr;37(4):491-496. doi: 10.1111/echo.14641. Epub 2020 Mar 25.


Background: Using simulators built and validated at the University of Washington (UW), the study sought to test whether medical students can learn the basic skills of focused cardiac ultrasound (FoCUS) from an individually paced, simulator-based curriculum, how skills improve, and the rate at which these skills are acquired.

Methods: The curriculum presented didactic material interspersed with hands-on practice. Psychomotor skill was measured by the angle error of the acquired image view plane relative to the correct image view plane. The rate of learning was assessed at baseline, after 7 practice cases, and after 10 cases. To assess the rate of learning, the same case was repeatedly presented at all three tests. To assess students' ability to apply their learning, a previously unseen post-test was included.

Results: A total of 41 students completed the course. Average angle error improved from 43° ± 24 pretraining to 23° ± 16 post-training, with most students falling within one SD of the view angle acquired by sonographers. Regarding learning curve, or the rate of skill acquisition, an angle error of 43 ± 24° (pre) changed to 22 ± 14° (interim test, P < .0001 vs. pretest) and remained at that level for the post-test evaluation on both the repeated case (23 ± 16°) and the new case (26 ± 18°).

Conclusions: This study describes the learning curve and technical skill acquisition in FoCUS. A simulator-based curriculum improved medical student's skills in an objective and quantifiable manner. The individually paced curriculum allowed for independent knowledge and skill attainment, without facilitator oversight.

Keywords: FoCUS; bedside echo; education; learning curve; medical student; simulator; ultrasound.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Clinical Competence
  • Curriculum
  • Educational Measurement
  • Humans
  • Learning Curve
  • Students, Medical*