Blended learning course for ultrasound-guided diagnostic skills: a design-based research study

Background: Simulation-based training has emerged as a critical modality in medical education, particularly for areas like point-of-care ultrasound. The effectiveness of the training is heavily influenced by instructional design. Design-based research offers a framework to iteratively develop, implement, and refine educational interventions, particularly in real-world settings, ensuring both practical and theoretical foundation. Objective: This study employed a design-based research approach to develop, evaluate, and implement a blended ultrasound education program for in-service medical professionals, integrating asynchronous e-learning with high-fidelity simulation. Methods: The study was conducted at a single academic institution and involved 51 practicing healthcare professionals. The course was designed, including needs assessment, iterative curriculum development, and multiple cycles of implementation and evaluation. Online module performance, pre- and post-test assessments, and subgroup analysis of curriculum completers were used to evaluate learning outcomes. Instructional decisions were revised based on observed performance trends. Suitable interventions in the design framework were also planned according to all the feedback and data captured. Results: = 0.0033). Lung and ocular ultrasound modules showed low variability and high scores, according to module-wise analysis, suggesting good instructional design. Subgroup analysis confirmed the significance of structured progression by showing a correlation between full curriculum engagement and improved performance and consistency. The cardiac ultrasound module showed high variability and lower mean scores, guiding a redesign recommendation for scaffolded instruction. Conclusion: The design-based approach enabled the systematic development of the ultrasound-guided diagnostics course, ensuring alignment between instructional strategies and learner needs. This study highlights the value of evidence-informed design in enhancing clinical competency in ultrasound procedures and offers a scalable simulation-integrated model for future medical education.