Early Acquisition of E-fast Ultrasound Skills in Medical Students: An Observational Study Comparing Portable and Conventional Devices

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Its structured format and diagnostic relevance make it ideal for early clinical training. The aim of this study was to assess the feasibility of teaching E-FAST ultrasound skills to medical students starting in their second academic year and to compare the educational effectiveness of portable versus conventional ultrasound devices. Methods A structured mixed- learning program was implemented across four academic years at the University of Granada. Students participated in online modules and hands-on workshops supervised by experienced clinicians. Performance was evaluated across five E-FAST windows, assessing probe selection, image acquisition, and anatomical identification. Comparative analysis examined outcomes by year and device type. Results Of 317 participants, even second-year students achieved elevated levels of competency in probe handling, image acquisition, and structure recognition. Conventional ultrasound systems were significantly more effective than portable devices in producing interpretable images and aiding anatomical identification (p < 0.001). Conclusions E-FAST training is feasible from the early years of medical education. Conventional systems remain superior for instructional purposes despite the convenience of portable devices. E-FAST POCUS medical education medical training Figures Figure 1 Figure 2 BACKGROUND The incorporation of ultrasound into clinical practice has profoundly enhanced bedside diagnostics across multiple medical disciplines[ 1 – 4 ]. Among the various applications, the Extended Focused Assessment with Sonography in Trauma (E-FAST) protocol has become a cornerstone in the rapid evaluation of critically ill and trauma patients, enabling prompt detection of life-threatening conditions such as pneumothorax, hemoperitoneum, and pericardial effusion[ 5 , 6 ]. Its structured, reproducible approach makes it not only clinically indispensable but also pedagogically well-suited for medical education[ 7 ]. In recent years, point-of-care ultrasound (POCUS) has gained traction as an educational tool in undergraduate medical training. Early exposure to ultrasound has been associated with improved anatomical understanding, enhanced clinical reasoning, and increased diagnostic confidence among students[ 8 – 10 ]. Despite this growing interest, the implementation of ultrasound teaching remains variable across institutions, and questions persist regarding the optimal timing for its introduction and the most effective educational tools to support learning[ 11 , 12 ]. The emergence of portable ultrasound devices—compact probes connected to smartphones or tablets—has generated new opportunities for accessible and flexible instruction. While these devices are increasingly adopted in clinical settings due to their portability and lower cost, concerns remain about their image resolution and usability for novice learners [ 13 , 14 ]. In contrast, conventional ultrasound systems offer superior image quality and user interface, which may be particularly valuable in early-stage training. At the University of Granada, a structured educational initiative was launched to introduce E-FAST training in the preclinical phase of medical education, starting in the second academic year. We hypothesized that even students without prior clinical or sonographic experience could acquire basic ultrasound skills when guided by a protocolized approach such as E-FAST. Furthermore, we sought to assess whether the type of ultrasound device—portable versus conventional—would significantly influence learning outcomes in image acquisition and anatomical identification. This study aims to evaluate the feasibility and effectiveness of early E-FAST instruction and to compare educational performance based on the ultrasound technology employed. The results are intended to inform curriculum design and guide resource allocation for optimal ultrasound training in medical schools. METHODS Study design This study is an observational study performed in an academic centre in Spain including medical students without previous ultrasound experience. Study population Medical students from the 2nd to 5th academic years without previous experience in POCUS voluntarily enrolled in a multi-phase training course focused on the E-FAST protocol. Students were stratified by year of training, device used, and number of educational sessions attended and consented to participate in educational research as approved by the university's academic board. Educational intervention The educational program comprised a blended-learning approach with two main components: Online Pre-Learning Module : all participants were granted access to a self-guided online course via the university’s PRADO platform (available at https://prado.ugr.es/ ). Content included theoretical principles of ultrasound, probe types, safety measures, and detailed steps of the E-FAST protocol. Completion of this module was mandatory prior to practical sessions. Practical workshops : students were assigned to small groups (5:1 student-tutor ratio) for hands-on practice sessions in the Clinical Skills Laboratory of the Faculty of Medicine. Each 90-minute workshop included introduction and safety briefing, demonstration of probe handling and anatomy identification, supervised scanning on healthy volunteers across five E-FAST windows: subxiphoid, hepatorenal, splenorenal, bladder, and pleural and finally use of both portable (Butterfly iQ, Butterfly network, USA) and conventional ultrasound systems (SonoScape S60, SonoScape Medical Corp, China) Outcomes Participants' performance was evaluated using a structured rubric completed by trained clinical tutors. Each student was assessed on the following: proper probe selection, adequate positioning and orientation, ability to acquire an interpretable image, recognition of normal anatomical structures and identification of normal vs. pathological patterns (in theoretical vignettes). An additional questionnaire assessed device preferences and subjective confidence. Statistical analysis Descriptive statistics summarized frequencies, means, and standard deviations. Chi-squared tests were used to evaluate associations between academic year, device type, and performance outcomes. All the analysis were performed with Jamovi software [The jamovi project (2024). jamovi. (Version 2.6). Retrieved from https://www.jamovi.org ]. Statistical significance was set at p < 0.05. Ethical issues This study involved the collection of identifiable academic data from medical students during an educational innovation project. The study protocol was reviewed and approved by the Comité de Ética de la Investigación Biomédica de la Provincia de Granada (approval code: 2024-J-19212). All procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki and national regulations. Prior to participation, all students were informed of the study objectives and voluntarily provided written informed consent. RESULTS Out of 317 students who participated, complete data were available for 279 students. Most of them (54.6%) were in their third academic year, followed by 23.2% in second year, 15.1% in fourth year, and 5.3% in fifth year. Students were distributed across five E-FAST windows, and their performance was analysed in relation to both their academic year and the type of ultrasound device used. Table 1 shows the overall characteristics of study participants. Table 1 Characteristics of student sample population attending the E-FAST evaluation. Variable Total Number of Students 317 Age, yrs. Mean (SD) 21.7 (1.5) Sex, n, (%) Female 196 (61.8%) Male 101 (31.8%) Not reported 20 (6.3%) Type of US, n (%) C- US 180 (64.5%) P- US 137 (35.5%) Sessions Attended, n (%) Not reported 30 (9.4%) 1 session 168 (52.9%) 2 sessions 73 (23.0%) 3 + sessions 46 (14.5%) US: ultrasound; C- US: conventional ultrasound machine; P- US: portable ultrasound machine (Butterfly probe) Table 2 Characteristics of student sample population attending the E-FAST evaluation regarding student year. Student Variable 2nd Year 3rd Year 4th Year 5th Year Total Number of Students 66 155 43 15 279 Percentage (%) 23.7% 55.6% 15.4% 5.3% 100% Age, yrs. Mean(SD) 20.1 (1.2) 21.5 (1.3) 22.8 (1.1) 23.9 (1.4) 21.7 (1.5) Sex, female n, (%) 48 (72.7%) 92 (59.4%) 29 (67.4%) 11 (73.3%) 180 (64.5%) Sessions Attended, n (%) 1 session 48 (72.7%) 92 (59.4%) 31 (72.1%) 10 (66.7%) 181 (64.9%) 2 sessions 12 (18.2%) 45 (29.0%) 9 (20.9%) 4 (26.7%) 70 (25.1%) 3 + sessions 6 (9.1%) 18 (11.6%) 3 (7.0%) 1 (6.7%) 28 (10.0%) Descriptive analysis revealed that most participants received limited training to ultrasound, with 58.3% reporting participation in only one training session. Regarding ability to follow a systematic in exploration, 92.2%, 96.5%, 92.9%, 96.5% and 96.8% of the students could follow it among the subxiphoid, liver & renal, spleen & renal, bladder and thoracic stations, respectively. Moreover, 91% of students correctly identified normal anatomical structures in at least four out of five scanning stations. The liver & renal and bladder windows yielded the highest rates of accurate image acquisition and anatomical identification across all academic years. Performance did not vary across academic years. Students in their second year showed a similar percentage of good image acquisition in all the E-FAST views to those of students in higher academic years, without statistical differences between academic years (Fig. 1 a). The same pattern could also be observed when looking at the percentage of participants identifying normal anatomical structures, where the performance of the second-year students was like those on fifth year (Fig. 1 b) and the ability of identifying normality pattern (Fig. 1 c). The subxiphoid view displayed the lowest percentage of good image quality acquisition across academic years, suggesting a higher technical complexity associated with this scanning window. When comparing performance by type of ultrasound device (Table 3 and Fig. 2 ), conventional systems outperformed portable devices in most parameters. Students using conventional systems achieved better image quality in all five scanning windows, with statistically significant differences observed in subxiphoid (p < 0.001), spleen & renal (p = 0.018), bladder (p = 0.014), thorax (p = 0.001), and liver & renal (p = 0.034). The recognition of normal anatomical structures was also higher with conventional systems, though statistical significance was only approached in the bladder window (p = 0.096). For normality pattern identification, conventional devices again demonstrated higher percentages, with significant differences in subxiphoid (p = 0.016), bladder (p = 0.006), and thorax (p = 0.039). Table 3 Comparison between conventional ultrasound (C-US) and portable ultrasound (P-US) performance among study participants and different evaluated items. Image quality Identification of Anatomical Structures Identification of normal pattern E-FAST Window C-US (n, %) P- US (n, %) p-value C-US (n, %) P- US (n, %) p-value C-US (n, %) P- US (n, %) p-value Subxiphoid < 0.001 0.435 0.016 No 0 (0.0%) 7 (5.1%) 1 (0.6%) 3 (2.2%) 0 (0.0%) 1(0.7%) Partial 41 (22.8%) 50 (36.5%) 37 (20.8%) 27 (19.7%) 8 (4.4%) 17 (12.4%) Yes 139 (77.2%) 80(58.4%) 140 (78.7%) 107 (78.1%) 172 (95.6%) 119 (86.9%) Liver & Renal 0.034 0.317 0.982 No 1 (0.6%) 2 (1.5%) 0 (0.0%) 1 (0.7%) 1 (0.6%) 1 (0.7%) Partial 16 (8.9%) 25 (18.2%) 14 (7.8%) 15 (10.9%) 4 (2.2%) 3 (2.2%) Yes 162 (90.5%) 110 (80.3%) 166 (92.2%) 121 (88.3%) 174 (97.2%) 133 (97.1%) Spleen & Renal 0.018 0.305 0.872 No 1(0.6%) 4 (2.9%) 1 (0.6%) 0 (0.0%) 1 (0.6%) 1 (0.7%) Partial 25 (13.9%) 32 (23.4%) 22 (12.4%) 24 (17.5%) 6 (3.3%) 6 (4.4%) Yes 154 (85.6%) 78 (58.8%) 155 (87.1%) 113 (82.5%) 173 (96.1%) 130 (94.9%) Bladder 0.014 0.096 0.006 No 0 (0.0%) 0 (0.0%) 0 (0.0%) 2 (1.5%) 0 (0.0%) 0 (0.0%) Partial 16 (8.9%) 25 (18.2%) 15 (8.3%) 18 (13.1%) 3 (1.7%) 11 (8.0%) Yes 164 (91.1%) 112 (81.8%) 165 (91.7%) 117 (85.4%) 177 (98.3%) 126 (92.0%) Thorax 0.0001 0.346 0.039 No 0 (0.0%) 0 (0.0%) 0 (0.0%) 1 (0.7%) 0 (0.0%) 1 (0.7%) Partial 7 (3.9%) 19 (13.9%) 18 (10.0%) 18 (13.1%) 3 (1.7%) 9 (6.6%) Yes 173 (96.1%) 118 (86.1%) 162 (90.0%) 118 (86.1%) 177 (98.3%) 127 (92.7%) Tutors reported that portable devices frequently presented challenges related to probe stability and image resolution. This complicates the process of properly orienting the probe and interpreting the sonographic anatomy, thereby impeding the students' ability to successfully complete the task. These difficulties were most prominent in views requiring deeper penetration or finer resolution, such as the subxiphoid and spleen & renal windows. DISCUSSION This study demonstrates that E-FAST ultrasound training can be effectively introduced as early as the second year of medical school. Students with no prior ultrasound experience were able to acquire good-quality images, recognize anatomical structures, and identify normality patterns across five standard E-FAST windows, with performance comparable to students in their fifth academic year. These findings reinforce the pedagogical value of structured, protocol-driven training even at the earliest stages of medical education. Our results align with previous studies highlighting the utility of POCUS in improving anatomical understanding and diagnostic skills in undergraduate medical curricula[ 8 , 9 , 15 – 20 ]. The structured nature of the E-FAST protocol likely played a leading role in enabling students to achieve rapid procedural competence. Notably, the similarity in performance across academic years suggests that early acquisition of POCUS skills does not necessarily require prior clinical exposure. This supports the integration of ultrasound-based teaching as a foundational component of medical training alongside basic sciences such as anatomy and physiology[ 21 , 22 ]. However, the number of training sessions completed varied across participants, with a majority receiving only a single practical workshop. This raises the possibility of a ceiling effect in simple tasks such as probe selection or identification of normal anatomy, but also suggests that brief, well-designed interventions can still yield substantial skill acquisition. The impact of repetitive exposure and longitudinal integration into curricula warrants further exploration. Importantly, this study identified significant differences in performance based on the type of ultrasound device used. Conventional ultrasound systems consistently outperformed portable devices in terms of image quality, anatomical identification, and recognition of normality patterns—particularly in more technically demanding views such as subxiphoid and splenorenal. These findings are consistent with prior literature indicating that high-resolution imaging and ergonomic stability enhance learning outcomes in novice users[ 13 , 14 ]. Although handheld devices offer cost-effective and flexible solutions, their limitations—such as reduced image resolution and sensitivity to probe motion—pose challenges for early learners. These constraints were frequently reported by tutors and observed across multiple scanning windows. Institutions seeking to incorporate portable ultrasound into preclinical education must consider hybrid strategies that combine the accessibility of handheld tools with the instructional advantages of conventional systems. From a broader curricular perspective, our results support early and standardized integration of ultrasound training into medical education. While logistical and financial constraints may limit access to conventional equipment, prioritizing their use in foundational phases may enhance student competence and confidence. Additionally, adopting competency-based assessment tools and ensuring faculty development in POCUS instruction remain essential for program success. Several limitations must be acknowledged. First, the study was conducted at a single academic institution, which may limit generalizability. Second, we did not assess long-term retention of ultrasound skills or their translation into clinical performance. Third, although tutors were trained in evaluation, observer bias may have influenced subjective assessments. Finally, the non-randomized nature of device allocation may have introduced unmeasured confounding. In summary, E-FAST training is both feasible and effective from the early years of medical education. While portable devices expand educational access, conventional ultrasound systems offer superior performance and should remain central to structured POCUS training models. CONCLUSIONS E-FAST ultrasound can be effectively taught from the second year of medical school. While portable devices expand access, conventional ultrasound systems remain superior for achieving educational objectives related to image quality and anatomical identification. Abbreviations E-FAST extended focus assessment of sonography for trauma POCUS Point of care ultrasound Declarations Acknowledgements The authors would like to thank the other student interns and the staff of the Department of Medicine for their invaluable help in developing this project. Author contributions: ARL, JDLTN, AGM, SCM, MAEV, MCR, INP, SLF, CHC, PJRP collected, analysed, and interpreted data and revised the article. BAN analysed data and drafted the initial article. PJRP was responsible for the conception and design of the work, with some assistance from BAN. BAN and PJRP revised and finalized the article. All authors read and approved the final manuscript. Funding This project has been funded by the University of Granada (PID Code 24/64) among the Innovation Program and Good Teaching Practices Call. Disclosures The authors declare no competing interests. Data availability The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Consent for publication Not applicable References Díaz-Gómez JL, Mayo PH, Koenig SJ. Point-of-Care Ultrasonography. N Engl J Med. 2021;385:1593–602. Romero Romero B, Vollmer Torrubiano I, Martín Juan J, Heili Frades S, Pérez Pallares J, Pajares Ruiz V, et al. Ultrasound in the Study of Thoracic Diseases: Innovative Aspects. Arch Bronconeumol. 2024;60:33–43. Romero-Romero B, Botana-Rial M, Martínez R, Elias-Hernandez T, Rodrigues-Gómez RM, Valdivia MM. Thoracic Ultrasound in Others Scenarios: An Expanding Tool. Open respiratory archives. 2024;6 Suppl 2:100420. Muñoz Moreno JF, Rubio Prieto E, Magro Martín MÁ. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7009103","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":498910133,"identity":"c1513993-545c-4cbb-97e2-295833ce4e8a","order_by":0,"name":"Bernardino 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of Granada, Instituto biosanitario de Granada (ibs.GRANADA)","correspondingAuthor":false,"prefix":"","firstName":"Isabel","middleName":"Navarro","lastName":"Pelayo","suffix":""},{"id":498910148,"identity":"910f0d92-f0f7-4896-91d0-59b1091823e1","order_by":8,"name":"Silvia López-Fernández","email":"","orcid":"","institution":"University of Granada, Instituto biosanitario de Granada (ibs.GRANADA)","correspondingAuthor":false,"prefix":"","firstName":"Silvia","middleName":"","lastName":"López-Fernández","suffix":""},{"id":498910151,"identity":"27c940ba-f482-4e04-a024-e52fd0ad022d","order_by":9,"name":"Clara Heredia Carrasco","email":"","orcid":"","institution":"University of Granada, Instituto biosanitario de Granada (ibs.GRANADA)","correspondingAuthor":false,"prefix":"","firstName":"Clara","middleName":"Heredia","lastName":"Carrasco","suffix":""},{"id":498910154,"identity":"e795bc24-f133-461c-8e34-8286574ab6c6","order_by":10,"name":"Pedro J Romero Palacios","email":"","orcid":"","institution":"University of Granada, Instituto biosanitario de Granada (ibs.GRANADA)","correspondingAuthor":false,"prefix":"","firstName":"Pedro","middleName":"J Romero","lastName":"Palacios","suffix":""}],"badges":[],"createdAt":"2025-06-30 09:53:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7009103/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7009103/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-025-08396-w","type":"published","date":"2025-12-05T15:58:05+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":88970102,"identity":"70335b67-ce0a-4c54-8303-bd4b58b6a347","added_by":"auto","created_at":"2025-08-13 09:35:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":121112,"visible":true,"origin":"","legend":"\u003cp\u003ePercentage of study participants achieving a) good image quality, b) identification of normal anatomical structures and c)identification of normality pattern across the different ultrasound stations of the E-FAST protocol and divided based on the academic year\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7009103/v1/e70a73299ee01372910e1e2c.png"},{"id":88971573,"identity":"d3f0cc92-c72b-4ddb-91ec-83515fedf90b","added_by":"auto","created_at":"2025-08-13 09:43:15","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":105422,"visible":true,"origin":"","legend":"\u003cp\u003ePercentage of study participants achieving a) good image quality, b) identification of normal anatomical structures and c)identification of normality pattern across the different ultrasound stations of the E-FAST protocol and divided based on the use of portable or conventional ultrasound device.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7009103/v1/091a71b655f16430f8461130.png"},{"id":97724627,"identity":"9eecf20b-3328-470b-abee-f721a10c61ac","added_by":"auto","created_at":"2025-12-08 16:12:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1140944,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7009103/v1/7f622c91-9026-4eee-946f-09a1aed95d85.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eEarly Acquisition of E-fast Ultrasound Skills in Medical Students: An Observational Study Comparing Portable and Conventional Devices\u003c/p\u003e","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eThe incorporation of ultrasound into clinical practice has profoundly enhanced bedside diagnostics across multiple medical disciplines[\u003cspan additionalcitationids=\"CR2 CR3\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Among the various applications, the Extended Focused Assessment with Sonography in Trauma (E-FAST) protocol has become a cornerstone in the rapid evaluation of critically ill and trauma patients, enabling prompt detection of life-threatening conditions such as pneumothorax, hemoperitoneum, and pericardial effusion[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Its structured, reproducible approach makes it not only clinically indispensable but also pedagogically well-suited for medical education[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn recent years, point-of-care ultrasound (POCUS) has gained traction as an educational tool in undergraduate medical training. Early exposure to ultrasound has been associated with improved anatomical understanding, enhanced clinical reasoning, and increased diagnostic confidence among students[\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Despite this growing interest, the implementation of ultrasound teaching remains variable across institutions, and questions persist regarding the optimal timing for its introduction and the most effective educational tools to support learning[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe emergence of portable ultrasound devices\u0026mdash;compact probes connected to smartphones or tablets\u0026mdash;has generated new opportunities for accessible and flexible instruction. While these devices are increasingly adopted in clinical settings due to their portability and lower cost, concerns remain about their image resolution and usability for novice learners [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In contrast, conventional ultrasound systems offer superior image quality and user interface, which may be particularly valuable in early-stage training.\u003c/p\u003e\u003cp\u003eAt the University of Granada, a structured educational initiative was launched to introduce E-FAST training in the preclinical phase of medical education, starting in the second academic year. We hypothesized that even students without prior clinical or sonographic experience could acquire basic ultrasound skills when guided by a protocolized approach such as E-FAST. Furthermore, we sought to assess whether the type of ultrasound device\u0026mdash;portable versus conventional\u0026mdash;would significantly influence learning outcomes in image acquisition and anatomical identification.\u003c/p\u003e\u003cp\u003eThis study aims to evaluate the feasibility and effectiveness of early E-FAST instruction and to compare educational performance based on the ultrasound technology employed. The results are intended to inform curriculum design and guide resource allocation for optimal ultrasound training in medical schools.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cb\u003eStudy design\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study is an observational study performed in an academic centre in Spain including medical students without previous ultrasound experience.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy population\u003c/b\u003e\u003c/p\u003e\u003cp\u003eMedical students from the 2nd to 5th academic years without previous experience in POCUS voluntarily enrolled in a multi-phase training course focused on the E-FAST protocol. Students were stratified by year of training, device used, and number of educational sessions attended and consented to participate in educational research as approved by the university's academic board.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEducational intervention\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe educational program comprised a blended-learning approach with two main components:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eOnline Pre-Learning Module\u003c/b\u003e: all participants were granted access to a self-guided online course via the university\u0026rsquo;s PRADO platform (available at \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://prado.ugr.es/\u003c/span\u003e\u003cspan address=\"https://prado.ugr.es/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cem\u003e).\u003c/em\u003e Content included theoretical principles of ultrasound, probe types, safety measures, and detailed steps of the E-FAST protocol. Completion of this module was mandatory prior to practical sessions.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003ePractical workshops\u003c/b\u003e: students were assigned to small groups (5:1 student-tutor ratio) for hands-on practice sessions in the Clinical Skills Laboratory of the Faculty of Medicine. Each 90-minute workshop included introduction and safety briefing, demonstration of probe handling and anatomy identification, supervised scanning on healthy volunteers across five E-FAST windows: subxiphoid, hepatorenal, splenorenal, bladder, and pleural and finally use of both portable (Butterfly iQ, Butterfly network, USA) and conventional ultrasound systems (SonoScape S60, SonoScape Medical Corp, China)\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eOutcomes\u003c/b\u003e\u003c/p\u003e\u003cp\u003eParticipants' performance was evaluated using a structured rubric completed by trained clinical tutors. Each student was assessed on the following: proper probe selection, adequate positioning and orientation, ability to acquire an interpretable image, recognition of normal anatomical structures and identification of normal vs. pathological patterns (in theoretical vignettes). An additional questionnaire assessed device preferences and subjective confidence.\u003c/p\u003e\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eDescriptive statistics summarized frequencies, means, and standard deviations. Chi-squared tests were used to evaluate associations between academic year, device type, and performance outcomes. All the analysis were performed with Jamovi software [The jamovi project (2024). jamovi. (Version 2.6). Retrieved from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.jamovi.org\u003c/span\u003e\u003cspan address=\"https://www.jamovi.org\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cem\u003e].\u003c/em\u003e Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEthical issues\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study involved the collection of identifiable academic data from medical students during an educational innovation project. The study protocol was reviewed and approved by the \u003cem\u003eComit\u0026eacute; de \u0026Eacute;tica de la Investigaci\u0026oacute;n Biom\u0026eacute;dica de la Provincia de Granada\u003c/em\u003e (approval code: 2024-J-19212). All procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki and national regulations. Prior to participation, all students were informed of the study objectives and voluntarily provided written informed consent.\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eOut of 317 students who participated, complete data were available for 279 students. Most of them (54.6%) were in their third academic year, followed by 23.2% in second year, 15.1% in fourth year, and 5.3% in fifth year. Students were distributed across five E-FAST windows, and their performance was analysed in relation to both their academic year and the type of ultrasound device used. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the overall characteristics of study participants.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of student sample population attending the E-FAST evaluation.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of Students\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e317\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge, yrs. Mean (SD)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e21.7 (1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex, n, (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e196 (61.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e101 (31.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eNot reported\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e20 (6.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType of US, n (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eC- US\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e180 (64.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eP- US\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e137 (35.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSessions Attended, n (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eNot reported\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e30 (9.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e1 session\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e168 (52.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e2 sessions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e73 (23.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e3\u0026thinsp;+\u0026thinsp;sessions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e46 (14.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eUS: ultrasound; C- US: conventional ultrasound machine; P- US: portable ultrasound machine (Butterfly probe)\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of student sample population attending the E-FAST evaluation regarding student year.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e\u003cp\u003eStudent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2nd Year\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3rd Year\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4th Year\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5th Year\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of Students\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e155\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e279\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePercentage (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge, yrs. Mean(SD)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20.1 (1.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21.5 (1.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22.8 (1.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23.9 (1.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e21.7 (1.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex, female n, (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48 (72.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e92 (59.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29 (67.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11 (73.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e180 (64.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSessions Attended, n (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1 session\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48 (72.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e92 (59.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31 (72.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10 (66.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e181 (64.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2 sessions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (18.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45 (29.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9 (20.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4 (26.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e70 (25.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u0026thinsp;+\u0026thinsp;sessions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 (9.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (11.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (7.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1 (6.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28 (10.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eDescriptive analysis revealed that most participants received limited training to ultrasound, with 58.3% reporting participation in only one training session. Regarding ability to follow a systematic in exploration, 92.2%, 96.5%, 92.9%, 96.5% and 96.8% of the students could follow it among the subxiphoid, liver \u0026amp; renal, spleen \u0026amp; renal, bladder and thoracic stations, respectively. Moreover, 91% of students correctly identified normal anatomical structures in at least four out of five scanning stations. The liver \u0026amp; renal and bladder windows yielded the highest rates of accurate image acquisition and anatomical identification across all academic years.\u003c/p\u003e\u003cp\u003ePerformance did not vary across academic years. Students in their second year showed a similar percentage of good image acquisition in all the E-FAST views to those of students in higher academic years, without statistical differences between academic years (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003ea). The same pattern could also be observed when looking at the percentage of participants identifying normal anatomical structures, where the performance of the second-year students was like those on fifth year (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eb) and the ability of identifying normality pattern (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003ec). The subxiphoid view displayed the lowest percentage of good image quality acquisition across academic years, suggesting a higher technical complexity associated with this scanning window.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eWhen comparing performance by type of ultrasound device (Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), conventional systems outperformed portable devices in most parameters. Students using conventional systems achieved better image quality in all five scanning windows, with statistically significant differences observed in subxiphoid (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), spleen \u0026amp; renal (p\u0026thinsp;=\u0026thinsp;0.018), bladder (p\u0026thinsp;=\u0026thinsp;0.014), thorax (p\u0026thinsp;=\u0026thinsp;0.001), and liver \u0026amp; renal (p\u0026thinsp;=\u0026thinsp;0.034). The recognition of normal anatomical structures was also higher with conventional systems, though statistical significance was only approached in the bladder window (p\u0026thinsp;=\u0026thinsp;0.096). For normality pattern identification, conventional devices again demonstrated higher percentages, with significant differences in subxiphoid (p\u0026thinsp;=\u0026thinsp;0.016), bladder (p\u0026thinsp;=\u0026thinsp;0.006), and thorax (p\u0026thinsp;=\u0026thinsp;0.039).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison between conventional ultrasound (C-US) and portable ultrasound (P-US) performance among study participants and different evaluated items.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eImage quality\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eIdentification of Anatomical Structures\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e\u003cp\u003eIdentification of normal pattern\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eE-FAST Window\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eC-US\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eP- US\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eC-US\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eP- US\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eC-US\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eP- US\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSubxiphoid\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.435\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.016\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (5.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1 (0.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3 (2.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1(0.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePartial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41 (22.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50 (36.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e37 (20.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27 (19.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e8 (4.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e17 (12.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e139 (77.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e80(58.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e140 (78.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e107 (78.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e172 (95.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e119 (86.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLiver \u0026amp; Renal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.034\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.317\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.982\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 (0.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (1.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (0.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1 (0.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1 (0.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePartial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 (8.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25 (18.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14 (7.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e15 (10.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e4 (2.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3 (2.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e162 (90.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e110 (80.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e166 (92.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e121 (88.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e174 (97.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e133 (97.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSpleen \u0026amp; Renal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.305\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.872\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1(0.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (2.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1 (0.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1 (0.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1 (0.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePartial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25 (13.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32 (23.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e22 (12.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e24 (17.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6 (3.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e6 (4.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e154 (85.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e78 (58.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e155 (87.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e113 (82.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e173 (96.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e130 (94.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBladder\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.014\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.006\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2 (1.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePartial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 (8.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25 (18.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15 (8.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18 (13.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3 (1.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e11 (8.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e164 (91.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e112 (81.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e165 (91.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e117 (85.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e177 (98.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e126 (92.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThorax\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.346\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.039\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (0.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1 (0.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePartial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7 (3.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19 (13.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18 (10.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18 (13.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3 (1.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e9 (6.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e173 (96.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e118 (86.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e162 (90.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e118 (86.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e177 (98.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e127 (92.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTutors reported that portable devices frequently presented challenges related to probe stability and image resolution. This complicates the process of properly orienting the probe and interpreting the sonographic anatomy, thereby impeding the students' ability to successfully complete the task. These difficulties were most prominent in views requiring deeper penetration or finer resolution, such as the subxiphoid and spleen \u0026amp; renal windows.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study demonstrates that E-FAST ultrasound training can be effectively introduced as early as the second year of medical school. Students with no prior ultrasound experience were able to acquire good-quality images, recognize anatomical structures, and identify normality patterns across five standard E-FAST windows, with performance comparable to students in their fifth academic year. These findings reinforce the pedagogical value of structured, protocol-driven training even at the earliest stages of medical education.\u003c/p\u003e\u003cp\u003eOur results align with previous studies highlighting the utility of POCUS in improving anatomical understanding and diagnostic skills in undergraduate medical curricula[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The structured nature of the E-FAST protocol likely played a leading role in enabling students to achieve rapid procedural competence. Notably, the similarity in performance across academic years suggests that early acquisition of POCUS skills does not necessarily require prior clinical exposure. This supports the integration of ultrasound-based teaching as a foundational component of medical training alongside basic sciences such as anatomy and physiology[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eHowever, the number of training sessions completed varied across participants, with a majority receiving only a single practical workshop. This raises the possibility of a ceiling effect in simple tasks such as probe selection or identification of normal anatomy, but also suggests that brief, well-designed interventions can still yield substantial skill acquisition. The impact of repetitive exposure and longitudinal integration into curricula warrants further exploration.\u003c/p\u003e\u003cp\u003eImportantly, this study identified significant differences in performance based on the type of ultrasound device used. Conventional ultrasound systems consistently outperformed portable devices in terms of image quality, anatomical identification, and recognition of normality patterns\u0026mdash;particularly in more technically demanding views such as subxiphoid and splenorenal. These findings are consistent with prior literature indicating that high-resolution imaging and ergonomic stability enhance learning outcomes in novice users[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAlthough handheld devices offer cost-effective and flexible solutions, their limitations\u0026mdash;such as reduced image resolution and sensitivity to probe motion\u0026mdash;pose challenges for early learners. These constraints were frequently reported by tutors and observed across multiple scanning windows. Institutions seeking to incorporate portable ultrasound into preclinical education must consider hybrid strategies that combine the accessibility of handheld tools with the instructional advantages of conventional systems.\u003c/p\u003e\u003cp\u003eFrom a broader curricular perspective, our results support early and standardized integration of ultrasound training into medical education. While logistical and financial constraints may limit access to conventional equipment, prioritizing their use in foundational phases may enhance student competence and confidence. Additionally, adopting competency-based assessment tools and ensuring faculty development in POCUS instruction remain essential for program success.\u003c/p\u003e\u003cp\u003eSeveral limitations must be acknowledged. First, the study was conducted at a single academic institution, which may limit generalizability. Second, we did not assess long-term retention of ultrasound skills or their translation into clinical performance. Third, although tutors were trained in evaluation, observer bias may have influenced subjective assessments. Finally, the non-randomized nature of device allocation may have introduced unmeasured confounding.\u003c/p\u003e\u003cp\u003eIn summary, E-FAST training is both feasible and effective from the early years of medical education. While portable devices expand educational access, conventional ultrasound systems offer superior performance and should remain central to structured POCUS training models.\u003c/p\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eE-FAST ultrasound can be effectively taught from the second year of medical school. While portable devices expand access, conventional ultrasound systems remain superior for achieving educational objectives related to image quality and anatomical identification.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eE-FAST\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eextended focus assessment of sonography for trauma\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePOCUS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePoint of care ultrasound\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the other student interns and the staff of the Department of Medicine for their invaluable help in developing this project.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eARL, JDLTN, AGM, SCM, MAEV, MCR, INP, SLF, CHC, PJRP collected, analysed, and interpreted data and revised the article. BAN analysed data and drafted the initial article. PJRP was responsible for the conception and design of the work, with some assistance from BAN. BAN and PJRP revised and finalized the article. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis project has been funded by the University of Granada (PID Code 24/64) among the Innovation Program and Good Teaching Practices Call.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eD\u0026iacute;az-G\u0026oacute;mez JL, Mayo PH, Koenig SJ. Point-of-Care Ultrasonography. 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J Ultrasound Med. 2016;35:413\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRussell FM, Zakeri B, Herbert A, Ferre RM, Leiser A, Wallach PM. The State of Point-of-Care Ultrasound Training in Undergraduate Medical Education: Findings from a National Survey. Acad Med. 2022;97:723\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKrause C, Krause R, Krause R, Gomez N, Jafry Z, Dinh VA. Effectiveness of a 1-Hour Extended Focused Assessment With Sonography in Trauma Session in the Medical Student Surgery Clerkship. J Surg Educ. 2017;74:968\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMeyer HL, Einloft J, Bedenbender S, Russ P, Schlicker N, Ganser A, et al. Impact and reception of point-of-care ultrasound training across medical education levels. BMC Med Educ. 2025;25:255.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCevik AA, Noureldin A, El Zubeir M, Abu-Zidan FM. Assessment of EFAST training for final year medical students in emergency medicine clerkship. Turk J Emerg Med. 2018;18:100\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHaji-Hassan M, Capraș RD, Bolboacă SD. Efficacy of Handheld Ultrasound in Medical Education: A Comprehensive Systematic Review and Narrative Analysis. Diagnostics. 2023;13.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePl\u0026ouml;ger R, Matschl J, Walter A, Gembruch U, Strizek B, Behning C, et al. Medical student training with next-generation handheld ultrasound devices - hands on examination of fetal biometry in obstetrics. BMC Med Educ. 2025;25:103.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBoulger C, Liu RB, De Portu G, Theyyunni N, Lewis M, Lewiss RE, et al. A national point-of-care ultrasound competition for medical students. J Ultrasound Med. 2019;38:253\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRocic P, Garrison R, Stitle K, Reynolds A, Andrews-Dickert R. Third-year medical students\u0026rsquo; perceptions of confidence and readiness to perform EFAST after training. BMC Med Educ. 2024;24:1493.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKameda T, Taniguchi N, Konno K, Koibuchi H, Omoto K, Itoh K. Ultrasonography in undergraduate medical education: a comprehensive review and the education program implemented at Jichi Medical University. J Med Ultrason. 2022;49:217\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLyon M, Kriegel D, Lockett E, Best G, Seymore D, Kuchinski AM, et al. Ultrasound Curriculum Implementation into a State-Wide Family Medicine Clerkship. Med Sci Educ. 2019;29:795\u0026ndash;801.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRocic P, Garrison R, Stitle K, Reynolds A, Andrews-Dickert R. Third-year medical students\u0026rsquo; perceptions of confidence and readiness to perform EFAST after training. BMC Med Educ. 2024;24.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKoster G, Kaufmann T, Hiemstra B, Wiersema R, Vos ME, Dijkhuizen D, et al. Feasibility of cardiac output measurements in critically ill patients by medical students. Ultrasound J. 2020;12:1.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCelebi N, Griewatz J, Malek NP, Krieg S, Kuehnl T, Muller R et al. Development and implementation of a comprehensive ultrasound curriculum for undergraduate medical students - A feasibility study. BMC Med Educ. 2019;19.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRajendram R, Alrasheed AO, Boqaeid AA, Alkharashi FK, Qasim SS, Hussain A. Investigating medical students\u0026rsquo; perceptions of point-of-care ultrasound integration into preclinical education. BMC Med Educ. 2024;24.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"E-FAST, POCUS, medical education, medical training","lastPublishedDoi":"10.21203/rs.3.rs-7009103/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7009103/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe E-FAST (Extended Focused Assessment with Sonography in Trauma) protocol is an essential diagnostic tool in emergency medicine. Its structured format and diagnostic relevance make it ideal for early clinical training. The aim of this study was to assess the feasibility of teaching E-FAST ultrasound skills to medical students starting in their second academic year and to compare the educational effectiveness of portable versus conventional ultrasound devices.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA structured mixed- learning program was implemented across four academic years at the University of Granada. Students participated in online modules and hands-on workshops supervised by experienced clinicians. Performance was evaluated across five E-FAST windows, assessing probe selection, image acquisition, and anatomical identification. Comparative analysis examined outcomes by year and device type.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eOf 317 participants, even second-year students achieved elevated levels of competency in probe handling, image acquisition, and structure recognition. Conventional ultrasound systems were significantly more effective than portable devices in producing interpretable images and aiding anatomical identification (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eE-FAST training is feasible from the early years of medical education. Conventional systems remain superior for instructional purposes despite the convenience of portable devices.\u003c/p\u003e","manuscriptTitle":"Early Acquisition of E-fast Ultrasound Skills in Medical Students: An Observational Study Comparing Portable and Conventional Devices","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-13 09:35:10","doi":"10.21203/rs.3.rs-7009103/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-06T08:19:38+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-01T16:28:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"212578984799045210523148294122043655843","date":"2025-09-23T11:09:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-24T20:38:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-22T15:32:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"37387223025394157543438693939864369509","date":"2025-08-18T14:49:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"222861252718051570187292267861353808348","date":"2025-08-08T11:13:23+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-08T05:18:37+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-06T13:52:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-17T06:45:05+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-16T17:55:05+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-07-16T17:51:38+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"939d4b32-412d-4e71-9f41-72fdb4378ce7","owner":[],"postedDate":"August 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T16:09:39+00:00","versionOfRecord":{"articleIdentity":"rs-7009103","link":"https://doi.org/10.1186/s12909-025-08396-w","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-12-05 15:58:05","publishedOnDateReadable":"December 5th, 2025"},"versionCreatedAt":"2025-08-13 09:35:10","video":"","vorDoi":"10.1186/s12909-025-08396-w","vorDoiUrl":"https://doi.org/10.1186/s12909-025-08396-w","workflowStages":[]},"version":"v1","identity":"rs-7009103","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7009103","identity":"rs-7009103","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}