Integrating ultrasound teaching is associated with higher medical student assessment performance and positive perceptions of learning anatomy: A multi‐site mixed‐methods study

The integration of ultrasound imaging into preclinical anatomy teaching is often questioned with respect to its objective impact on anatomical knowledge. This study aimed to (i) evaluate short‐term knowledge gain following ultrasound‐integrated anatomy teaching, (ii) characterize students' perceptions of the learning experience, and (iii) assess the feasibility of delivery across rural, metropolitan, and international settings. Integrated ultrasound sessions were delivered to preclinical medical students in four settings (rural Australian graduate‐entry, metropolitan Australian direct‐entry, and metropolitan and rural Malaysian direct‐entry). Short‐term knowledge gain was assessed in the Australian rural cohort using a pretest‐posttest design with counterbalanced parallel forms, analyzed with linear mixed‐effects models. Student feedback underwent content analysis and feasibility was summarized using key implementation descriptors. In the short‐term knowledge gain study (103 students; 193 observed assessments), posttest performance was significantly higher than pretest performance ( adjusted mean difference 0.66 correct answers, 95% confidence interval [CI] 0.23–1.08; p = 0.003). Students reported benefits for in situ visualization, spatial understanding, and clinical relevance. Delivery was feasible at all four sites, including by videoconference where no local ultrasound unit was available. In conclusion, integrated ultrasound was feasible across diverse settings and, in the Australian rural cohort, was associated with higher assessment performance immediately after teaching. As the design had no parallel comparator, this finding indicates short‐term knowledge gain rather than a causal effect or long‐term retention. Together, these findings support ultrasound as a complementary preclinical tool, rather than being reserved solely for post‐curricular clinical skill acquisition.