Background: Accurate diagnosis of ascites is crucial before abdominal paracentesis can be performed. Physical examination alone can be inaccurate and lead to incorrect clinical decision making.
Objective: We aimed to evaluate and compare the accuracy of physical examination and ultrasound conducted by clinical year medical students after short ultrasound training session.
Materials and Methods: This was a prospective quasi experimental study conducted from January 2020 to April 2020. The sample consisted of 18 clinical-year medical students at Srinagarind Hospital Emergency Department. Ultrasound training (intervention) was provided by one specialist in emergency ultrasound. Five volunteer patients were evaluated for ascites using two modalities (physical examination [PE; pre-intervention] and ultrasound [post-intervention]). Participants then responded to a questionnaire constructed to evaluate the relative ease of use of each modality as well as students’ confidence and satisfaction. Data were compared using the McNemar test, and p<0.05 was considered statistically significant.
Results: Eighteen medical students were included. Participants were able to diagnose ascites in the five patient volunteers using PE with a sensitivity of 74.2%, specificity of 94.4%, positive predictive value (PPV) of 95.2%, and negative predictive value (NPV) of 70.8%. Subsequent ultrasound examination yielded a sensitivity of 90.7%, specificity of 97.2%, PPV of 98%, and NPV of 87.5%. Use of ultrasound increased diagnostic accuracy from 82.2% to 93.3% and yielded higher mean ease and satisfaction scores. However, the average confidence score was lower and time required to perform the procedure was longer.
Conclusion: Medical students were able learn to use an ultrasound device after a short training session with an expert. Ultrasound yielded higher diagnostic accuracy for ascites. Future studies should be conducted regarding the inclusion of ultrasound training programs in medical education curricula.

Keywords: Ultrasound, Ascites, Emergency medicine, Medical curriculum