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Miniaturization has made ultrasound (US) technology ultraportable and, in association with their relatively low cost, made handheld devices attractive for medical education training programs. However, performing an ultrasound requires complex skills, and it is unclear whether handheld devices are suitable for the training of novices. Our study aimed to identify to what extent handheld US devices can be employed in medical undergraduates’ and residents’ education. We selected studies that evaluate the results obtained by students and/or residents who have participated in ultrasound training programs using handheld devices. The studies were included if they reported post-test (pre-test optional) achievements or a comparison with a control group (a group of experts or novices who underwent a different intervention). Twenty-six studies were selected, and their characteristics were summarized. Handheld ultrasound devices were used in training programs to learn echocardiography, abdominal, and/or musculoskeletal ultrasound. Statistically significant progress was noted in the ability of naïve participants to capture and interpret ultrasound images, but training duration influenced the outcomes. While ultrasound training using handheld devices has proven to be feasible for various body regions and purposes (e.g., better understanding of anatomy, clinical applications, etc.), the long-term impacts of handheld education interventions must be considered in addition to the short-term results to outline guidelines for targeted educational needs.

Introduction: This study explores the utility of and attitude towards medical learning applications (MLAs) among undergraduate students of medicine in Cluj-Napoca and the use of these apps in finding solutions to five case-based medical scenarios. Materials and methods: A cross-sectional design using an online survey was conducted between June 8th and July 19th, 2019. The English/Romanian students were personally invited to participate in the survey via social media platforms (Facebook/WhatsApp student groups). A three-section questionnaire was developed to anonymously collect demographic data, study habits and the answers to the five case-based medical scenarios. Results: Ninety-three students between the age of 19 and 50 (median 24 years) participated. Most of the responding students (81.7%) were in the clinical years of study and studied up to 3 hours per day (67.7%). The use of MLAs ≥2 hours per day is reported by 18.3% of respondents. The MLAs were mainly used for studying throughout the semester (69.1%); 30.9% of the students used MLAs only for their exam preparation. The top-three MLAs were ‘AMBOSS’ (30/93), ‘Medscape’ (9/93) and ‘Dr. Najeeb Lectures’ (6/93). In around half of the cases, the students paid for the MLA (46.4%). The maximum obtainable score (6 points) in the clinical cases was reached only by 3 students without significant differences between the scores of those students who used or did not use resources (MLAs, books, other) to find the case solutions (Mann-Whitney test P=0.594, median of correct answers = 3 for both groups) or between the scores of those who used or did not use MLAs for learning (P=0.594, median of correct answers = 3 for both groups). Conclusion: One third of the participating students used MLAs but this is not reflected in the number of correctly answered clinical cases.

The professional association has already developed guidelines on the appropriate use of handheld ultrasound devices, especially in an emergency setting. Handheld ultrasound devices are seen as the ‘stethoscope of the future’ to assist in physical examination. Our exploratory study evaluated whether the measurements of cardiovascular structures and the agreement in identifying aortic, mitral, and tricuspid valve pathology made by a resident with a handheld device (HH, Kosmos Torso-One) reach the results reported by an experienced examiner who used a high-end device (STD). Patients referred for cardiology examination in a single center from June to August 2022 were eligible for the study. Patients who agreed to participate underwent two heart ultrasound examinations scanned by the same two operators. A cardiology resident performed the first examination with a HH ultrasound device, and an experienced examiner performed the second examination with an STD device. Forty-three consecutive patients were eligible, and forty-two were included in the study. One obese patient was excluded because none of the examiners succeeded in performing the heart examination. The measurements obtained with HH were generally higher than those obtained with STD, with the highest mean difference of 0.4 mm, but without significant differences (all 95% confidence intervals of the differences contain the value of 0). For valvular disease, the lowest agreement was observed for mitral valve regurgitation (26/42, with a Kappa concordance coefficient of 0.5321), which was missed in almost half of the patients with mild regurgitation and underestimated in half of the patients with moderate mitral regurgitation. The measurements performed by the resident with the handheld Kosmos Torso-One device showed high concordance with those conducted by the experienced examiner with a larger high-end ultrasound device. The learning curve of the resident could explain the limited performance in identifying valvular pathologies between examiners.

Background: The ultrasound examination is a surface technique with an accurate diagnosis of pathological processes adjacent to the pleural line. The purpose of the study was to evaluate the role of hand-held ultrasound devices (visual stethoscopes) in the diagnosis of peripheral lung disease. Methods: We conducted a systematic search of literature comparing the diagnostic accuracy of truly hand-held ultrasound devices compared to conventional high-end ultrasound devices, chest X-rays, thoracic CT (computer tomography), or physical examinations to diagnose peripheral lung lesions. ScienceDirect, PubMed, and PubMed Central bibliographic databases were searched within a time limit of 15 years. Results: The applied search strategy retrieved 439 studies after removing duplicates; 34 were selected for full-text review, and 15 articles met all inclusion criteria and were included in the analysis. When comparing hand-held ultrasound devices to chest X-rays, negative predictive values were above 90%, while positive predictive values tended to be lower (from 35% to 75.8%). Hand-held ultrasound reached a correlation of 0.99 as associated with conventional ultrasound with a Bland–Altman bias close to zero. Conclusions: Being accessible, radiation-free, and comparatively easy to decontaminate, hand-held ultrasound devices could represent a reliable tool for evaluating peripheral lung diseases. This method can be successfully employed as an alternative to repeated X-ray examinations for peripheral lung disease monitoring.

Introduction: This study explored the utility and attitude towards medical learning applications (MLA) among undergraduate students (general medicine) in Cluj-Napoca and the use of these apps in finding solutions to five case-based medical scenarios. Materials and methods: A cross-sectional design using an online survey was conducted between June 8th and July 19th, 2019. The English/Romanian students were personally invited to participate in the survey via social media platforms (Facebook/WhatsApp student groups). A three-section questionnaire was developed to anonymously collect demographic data, study habits and the answers to the five case-based medical scenarios. Results: Ninety-three students between the age of 19 and 50 (75% younger than 25 years, 54.5% males) participated. Most of the responding students (81.7%) were in the clinical years of study and studied up to 3 hours per day (67.7%). The use of at least one MLA was reported by 54.8%, while 18.3% of these use MLA ≥2 hours per day. The MLA were mainly used for studying throughout the semester (70.1%), 29.9% used MLA only for their exam preparation. The top-three MLA were ‘Amboss’ (34/88), ‘Medscape’ (10/88) and ‘Dr. Najeeb’ (7/88). In most of the cases the students paid for the MLA (62.7%). The maximum obtainable score (6 points) in the clinical cases was reached only by 3 students without significant differences either between the scores of those students who used or not used resources to find the case solutions (Mann-Whitney test P=0.594, median of correct answers = 3 for both groups), or in the scores of those who used or does not use MLA for learning (P=0.788, median of correct answers = 3 for both groups). Conclusion: More than half of the participating students used MLA but this is not reflected in the number of correctly answered clinical cases.