[Quality control of sonography courses in advanced training of physicians: analysis of present status and potential for improvement].

AIM: Since 1995 sonography represents the diagnostic imaging procedure most commonly applied (52 %) by physicians working in the public health sector. On the account of the high cost of sonography (around 2,5 billion DM in 1998) it seems justified to intensify the quality control of advanced sonography training courses for physicians. This study was set out to evaluate the learning efficiency and teaching quality of sonography training courses for doctors. We also aimed at testing, evaluating and carefully optimising modern concepts for sonography training based on recognised didactic criteria. METHODS: 34 courses in B-mode sonography and colour-Doppler sonography of 5 regional and national institutions were evaluated on the basis of standardised questionnaires by observers taking part in the courses incognito. The control group was formed by 332 physicians taking part in ten sonography courses which were structured in the way of alternating training modules with practical final exams based on OSCE criteria. With the help of modern imaging media it was intended to make these courses as illustrative as possible, including practical exercises in small groups of up to five people. Subsequent evaluation was based on standardised questionnaires. The attendance quota of the participants served as an additional comparative value for the acceptance of different teaching concepts. RESULTS: We observed significant deficits in the didactic concepts of numerous ultrasound courses offered externally: there was a high prevalence of extended frontal teaching with noticeably tiring effects as well as unstructured practical exercises in large groups which resulted in high numbers of absenteeism of the participants. The evaluation of the newly drawn up course concepts, however, demonstrated highly significant and unquestionable advantages of alternating teaching in small groups. DISCUSSION: Background information from the field of pedagogical psychology is supplied and the application of current learning theories to new concepts of ultrasound courses is demonstrated. CONCLUSION: Instructors of sonography courses need to be well trained in modern teaching methods. This study shows a variety of current concepts and provides a list of easily applicable didactic quality criteria for the conception of ultrasound courses.