Council on Medical Student Education in Pediatrics


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Two is better than one

The Effect of Dyad versus Individual Simulation-based Ultrasound Training on Skills Transfer. Tolsgaard MG et al. Medical Education 2015: 49: 286-295.

Reviewed by Olubukola Ojuola

What was the study question?
Is the transfer of simulation-based ultrasound skills to clinical setting compromised when medical students are trained in pairs compared with individual training?

How was the study done?
Thirty ultrasound naïve final year medical students at the University of Copenhagen were randomly assigned to dyad or single-student groups. All students received a two-hour training on a transvaginal ultrasound simulator using both computer and teacher assisted learning methods. Paired partners worked collaboratively, taking turns as the active sonogram practitioner, while single students worked independently. Performance was evaluated before and after the training. Skills transfer tests involved performing transvaginal ultrasounds on gynecology patients. Performance on the skills transfer test was evaluated using a validated tool, the Objective Structured Assessment of Ultrasound Skills (OSAUS).

What were the results?
All participants completed the pre and post training assessment, and 24 completed the transfer test. Both groups demonstrated significant increases in their performance scores pre-and post-training. OASUS scores for the dyad training group were not inferior to single-student training scores. More dyad (71.4%) than single (30%) students achieved OASUS scores above a pre-determined pass/fail score on the transfer test. Additionally, the dyad group showed higher training efficiency with regards to simulator score per number of attempts when compared with the single-student group.

What are the implications of these findings?
This study showed that learning clinical skills in pairs resulted in a more efficient use of resources without compromising learning and transfer of skills. Fourth year medical students may benefit from collaborative, peer learning while in training. Clerkship and sub-internship directors might consider introducing paired learning opportunities to enhance students’ diagnostic competency as they prepare for residency.

Editor’s note: I can think of lots of skills that could be more effectively taught/learned in pairs, a situation where each person observes and assists the partner (RR).

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