Abstract
BACKGROUND: High-risk pulmonary embolism is a significant cause of morbidity and mortality in the emergency department. Point-of-care ultrasonography is a valuable tool for identifying high-risk pulmonary embolism at the bedside, but many physicians lack proficiency. A flipped classroom model may enhance point-of-care ultrasound training, but its effectiveness compared to standard teaching remains unclear. METHODS: Emergency physicians and residents at a single academic centre were randomized to either a flipped classroom or standard teaching after a baseline assessment of their ability to identify high-risk pulmonary embolism using a database of ultrasound clips. The flipped classroom group completed an online module, while the standard teaching group attended an in-person seminar. Both groups participated in an in-person workshop and subsequently underwent post-training testing. The primary outcome was the difference in final test scores. Statistical analysis included Student’s t-test for mean comparisons, while Fisher’s exact test and one-way ANOVA were used to assess differences between teaching methods, with significance set at p ≤ 0.05. RESULTS: A total of 30 participants completed the study (15 in the flipped classroom and 15 in the standard teaching group). Most (80%) reported low baseline confidence in identifying high-risk pulmonary embolism with point-of-care ultrasound. There were no significant differences in baseline scores between the groups (65.0% ± 24.7% for the flipped classroom vs. 64.3% ± 24.9% for standard teaching, p = 0.93). Both groups demonstrated significant improvement in scores on final testing (standard teaching: 11% increase, p = 0.02; flipped classroom: 7.3% increase, p = 0.03). However, there was no significant difference in final test scores between the two groups (75.3% ± 20.1% for standard teaching vs. 72.3% ± 21.4% for the flipped classroom, p = 0.65). CONCLUSION: We found that both the flipped classroom model and standard teaching were effective for teaching the signs of high-risk pulmonary embolism using point-of-care ultrasound. The results of this study may assist future curriculum development to facilitate asynchronous learning of ultrasound skills. CLINICAL TRIAL: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12245-026-01129-w.