Effectiveness of blended E-Learning for FAST ultrasound training: a comparative study of emergency medical technicians and junior resident physicians: a prospective observational study

The potential for task shifting in prehospital emergency care has increased the demand for efficient ultrasound education for emergency medical technicians (EMTs). We aimed to determine whether EMTs without prior ultrasound certification could achieve focused assessment with sonography in trauma (FAST) image-acquisition performance that met a prespecified noninferiority criterion relative to junior resident physicians after standardized blended learning. We conducted a prospective observational study comparing 20 EMTs and 20 postgraduate year (PGY)-1/2 junior resident physicians(residents) who completed an identical blended curriculum consisting of online and practical phantom-based training. Performance was evaluated using a task-specific checklist (TSC) and total examination time across four sequential sessions. The primary outcome was the mean TSC score with a prespecified 5-point noninferiority margin. Secondary outcomes included learning curves and questionnaire-based evaluations. Across sessions, EMTs showed TSC scores that met the prespecified noninferiority criterion relative to those of residents, with 95% confidence intervals remaining within the noninferiority margin (all one-sided p < .001). Residents scored higher in the Douglas pouch view ( p = .002); however, other site-specific scores were comparable between the groups. EMTs required longer examination times initially ( p = .003) but showed a significantly more rapid learning curve, and examination times converged by the final session. EMTs reported higher satisfaction and greater self-efficacy regarding the online learning program than residents. A standardized blended learning program combining online instruction with brief practical training enabled EMTs to achieve FAST image-acquisition performance that met the prespecified noninferiority criterion relative to residents.