# Influence of Clinical Experience on Learning the Focused Assessment With Sonography for Trauma (FAST) Protocol: A Pilot Study

## TL;DR

A pilot study found that physicians and medical students with no prior ultrasound experience improved similarly after a short FAST ultrasound training, suggesting early training is effective regardless of clinical background.

## Contribution

Demonstrates that structured FAST training can effectively teach ultrasound skills to novices, regardless of prior clinical experience.

## Key findings

- Physicians scored higher on written tests than students before and after training, but both groups showed significant improvement.
- Students performed practical tasks faster than physicians, though diagnostic accuracy was high in both groups.
- The study suggests that FAST training can be effective for novices, supporting early ultrasound education in medical curricula.

## Abstract

Background

Point-of-care ultrasound (POCUS), and specifically the Focused Assessment with Sonography for Trauma (FAST) protocol, is widely used to expedite the assessment of trauma patients at the bedside, but optimal strategies for teaching FAST and the role of prior clinical experience in learning remain unclear. Brief, structured training programs are increasingly proposed for undergraduate and early postgraduate curricula, yet evidence comparing learners with different clinical backgrounds is limited.

Objective

This study aimed to compare the performance of physicians and final-year medical students without prior ultrasound experience in learning the FAST protocol after structured training.

Materials and methods

This is a quasi-experimental, non-blinded pilot study. Participants were non-imaging physicians and final-year medical students. All received a standardized four-hour theoretical-practical FAST training and completed pre- and post-written tests. Two weeks later, the participants underwent practical assessments on human models and an ultrasound simulator. Scores were converted to percentages for comparability. Normality was assessed with the Shapiro-Wilk test. Descriptive analyses were done. Comparative analysis included between-group comparisons and pre- and post-test paired comparisons, including effect size. Parametric or non-parametric tests were used as appropriate. Two-sided tests were used with α = 0.05. Effect sizes and p-values were computed in JASP v0.19.3 (University of Amsterdam, Netherlands).

Results

Forty volunteers participated (physicians n = 19; final-year medical students n = 21). Physicians scored higher than students on both pre- and post-training written tests (pre-test total: 53.6% vs. 39.0%, p = 0.004; post-test total: 76.1% vs. 60.6%, p < 0.001). Paired analyses showed significant improvements across all written components for both groups, with very large paired effect sizes (rank-biserial correlation (RBC) ranged from 0.77 to 1.00); the largest absolute gain was in image identification among students (+29.5 percentage points, RBC = 0.86) and in theoretical assessment among physicians (+28.1 points, RBC = 1.00). In Phase 2 practical assessments (n = 37), no statistically significant differences were found between groups in overall or FAST-specific scores, but students completed tasks substantially faster (mean time ≈5 min vs. ≈10 min for physicians; p < 0.001). Diagnostic accuracy in the simulated cases was high in both groups; only one physician made an incorrect diagnosis (p = 0.245). Overall, brief structured FAST training produced large within-subject gains in knowledge and skills across both learner groups.

Conclusions

Brief structured FAST training produced substantial gains in knowledge and skills for both groups. Comparable practical performance between physicians and students suggests that procedural competence can be effectively acquired through structured training regardless of prior clinical experience, supporting early integration of ultrasonography training into undergraduate curricula.