Institute of Primary Health Care (BIHAM)

Research-Projects

SIGNATURE-trial

Student-centred learning with near-peer tutoring compared with a standard faculty-led course for undergraduate training in abdominal ultrasound (the SIGNATURE trial). A multicentre open-label randomized controlled trial. The data acquisition ended in 2021, the results were published in 2023.

Research question

We compared a new 21-hour blended-learning ultrasound course (5 hours of e-learning and 16 hours of near-peer tutoring) with the existing 21-hour faculty-led basic ultrasound course (“Grundkurs Abdomen”). Primary outcome measurement were students’ ultrasound skills measured by a six-station OSCE six months after the end of courses.

Secondary outcome measures: students’ ultrasound skills immediately after the courses.

Methods

Together with various partner clinics and the Swiss Society for Ultrasound in Medicine (SGUM), BIHAM has developed a new teaching concept for the training of medical students - consisting of e-learning and peer tutoring (blended learning).
The SIGNATURE study was a two-arm, randomised controlled trial, enrolling 152 medical students at the Universities of Bern, Basel and Zurich. Stratified by study site, students were 1:1 randomised to either the new blended-learning course or the faculty-led 2.5-day ultrasound course. Students underwent a six-station objective structured clinical examination (OSCE) and completed an online questionnaire immediately after the course and 6 months later.

Findings

Students in the near-peer group scored 37 points (out of max. 50 points), and students in the faculty group scored 31 points (out of 50 points) six months after course completion. The difference of 5.99 points (95% CI 4.48;7.49) in favor of the near-peer group was significant (p<0.001). Scores immediately after the course were 3.8 points higher in the near-peer group (2.35; 5.25, p<0.001). Ultrasound skills decreased significantly in the six months after course completion in the faculty group (-2.41 points, [-3.39; -1.42], p<0.001]) but barely decreased in the near-peer group (-0.22 points, [-1.19; 0.75, p=0.66]).

The near-peer course that combined blended learning and spaced repetition outperformed standard faculty teaching in basic ultrasound education.

Publication

The final publication can be found via the following link.

https://doi.org/10.1055/a-2103-4787

Overview


Project leader	PD Dr. med. Roman Hari
Project team	Michael Harris, Andi Limacher, Robin Walter, Kaspar Kälin, Christoph Berendonk, Tanja Birrenbach, Raphael Bonvin, Mathieu Nendaz, Andreas Serra
Funder	SGAIM Foundation
Study design	The SIGNATURE trial was a multicentre, open-label randomized controlled non-inferiority trial with two parallel arms
Study start	September 2021
Study end	May 2023
Publication	May 2023