Tele-Ultrasound in the Wilderness: A Tutorial Experience for Medical Students.

Introduction: Providers can evaluate patients who sustain trauma during outdoor activities by using the extended focused assessment with sonography for trauma (FAST) and the limited knee ultrasound. Remote tele-mentored ultrasound (RTMUS) can help minimally trained providers in the wilderness if they have difficulty obtaining a view or have questions about the interpretation of an image. The goal of our study was to determine the feasibility of using RTMUS to teach the FAST exam and knee ultrasound exam to ultrasound-naive medical students during a wilderness medicine outdoor activity.

Methods: Medical students from two large academic institutions were randomized to receive either in-person or RTMUS education during a wilderness activity 1 d before completion of FAST and knee ultrasound exams. All students received limited ultrasound instruction before the event. The images obtained by the students were compared. Two ultrasound-trained emergency physicians evaluated the images for their ability to identify structures and support a diagnosis from the images. Simple descriptive statistics were performed.

Results: There was a statistically significant difference between the RTMUS group and the in-person group. The images captured by the in-person group were more likely to identify structures and support a diagnosis than those captured by the RTMUS group.

Conclusions: In this study, ultrasound-naive medical students who received in-person education on conducting the knee exam and FAST exam obtained higher-quality images than students who received RTMUS education. This study suggests that if RTMUS is used for medical purposes, increased ultrasound training may be needed prior to initiation of RTMUS.