Ultrasound education in the digital era: Face-to-face versus webinar-teaching of head and neck ultrasound theory -a prospective multi-center study

Johannes Matthias Weimer^1*Maximilian Rink²Marie Brandt²Luisa Symeou²Benjamin Philipp Ernst³Christoph Sproll⁴Alessandro Bozzato⁵Lukas Pillong⁵Johanna Helfrich⁵Andreas Weimer⁶Marie Stäuber¹Holger Buggenhagen¹Roman Kloeckner⁷Florian Recker, MD MME⁸Thomas Beleites⁹Naglaa Mansour¹⁰Julian Künzel²

• ¹Rudolf Frey Learning Clinic, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
• ²Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Bavaria, Germany
• ³Department of Otorhinolaryngology, University Medical Center Frankfurt, Frankfurt, Germany
• ⁴Department of Oral and Maxillofacial Surgery, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
• ⁵Department of Otorhinolaryngology, University of Saarland, Homburg, Germany
• ⁶Centre for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
• ⁷Institute of Interventional Radiology, University Hospital Schleswig-Holstein - Campus Lübeck, Lübeck, Germany
• ⁸Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, North Rhine-Westphalia, Germany
• ⁹Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
• ¹⁰Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center - University of Freiburg, Freiburg, Germany

Introduction: Digitalization offers significant potential benefits to ultrasound education. This study compares the effectiveness of webinar teaching against face-to-face teaching in providing theoretical competencies in certified head and neck ultrasound (HNUS) courses.This prospective, controlled, multicenter study was conducted in 2023 at three universities with certified HNUS courses. One course used webinar lessons (S), and the others used face-to-face teaching (C). The control group courses (C) were held on two consecutive days. The first day of the study group course was held as a webinar (S) one week before the second day and was also recorded for preparatory purposes. All participants completed three assessments: a pre-course self-evaluation (Evaluation pre ), a post-course selfevaluation (Evaluation post ), and a post-course theory test (Theory Test post ). The evaluations used a Likert scale (1-7) to record the participants' subjective assessments of competencies and attitudes toward webinar teaching. Theory Test post included multiple-choice and free-answer questions on the sonographic pathologies of lymph nodes, the soft tissue of the neck, and salivary glands. A group of inexperienced medical students (V) completed the Theory Test post for validation purposes.Result: 128 data sets were analyzed (31 S; 30 C; 47 V). Both groups, S and C, rated their competencies after the courses significantly higher than before (p<0.01) but at a similar level in comparison with each other (p=0.34). Both groups supported teaching theoretical content through webinars (S: 6.7 ± 0.5 vs C: 6.2 ± 0.9). Both groups achieved similar results in the Theory Test post (p=0.54), significantly outperforming the validation group (p<0.001).Our data suggest that webinars can be an effective alternative to face-to-face lessons in teaching theoretical competencies in HNUS. Participants gave overall positive evaluations of digital teaching methods. Our findings support evidence that digital learning methods are valuable for modern ultrasound education.