4C/ ID Methodology For The Training Of Physiotherapists In Point Of Care Lung Ultrasonography

Lidiane Andrade Monteiro de Souza1 , Ramon Gonzalez Paredes2 , Aline Maria Heidemann2 , Tiago Giraldi1 , Mário Henrique Franco1 , Marco Antonio Carvalho-Filho1 , Luciana Castilho de Figueiredo2 , Thiago Martins Santos1

1 School of Medical Sciences – University of Campinas (UNICAMP) – Campinas (SP), Brasil; 2 General Hospital Of The University of Campinas (UNICAMP) – Campinas (SP), Brasil


To evaluate whether the 4C / ID instructional model (Four Components Instructional Design Model) is useful for the acquisition of knowledge of “Point-of-care” lung ultrasound (POCUS) for physiotherapists.


Physiotherapists that work in ICUs and medical wards from a University Hospital were recruited.

According to 4C / ID, the support information consisted of two lectures in virtual learning environment (VLE): Principles of Ultrasound and Lung Ultrasonography. That was followed by the 5.5 hour pre-course with a theoretical reinforcement Pulmonary Ultrasonography lecture and hands-on activity, followed by a realistic simulation and discussion of clinical cases.

To evaluate the acquisition of knowledge, a questionnaire with 30 objective questions was applied in three moments: In the VLE, before the virtual classes (preVLE); immediately before the pre-course and immediately after the pre-course. A score of 0 to 10 points was established for the correct answers.


Twenty physiotherapists were included. There was a progressive increase in the average score between the pre-VLE and pre-course (3.6 ± 1.3 and 5.8 ± 1.6 with p<0.001); pre-course and post-course (5.8 ± 1.6 and 8.3 ± 1.0 with p<0.001); and pre-VLE and post-course (3.6 ± 1.3 and 8.3 ± 1.0 with p<0.001).


The 4C / ID methodology seems to be effective for acquiring knowledge about POCUS in the studied group. More studies are needed to evaluate the acquisition and retention of knowledge in the medium and long term.

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