Integrating ultrasound into early medical education: a quasi-experimental mixed-methods study in a first-year anatomy course

Anatomy education represents a fundamental component of medical training and has increasingly incorporated clinical tools aimed at promoting active learning and strengthening connections between foundational sciences and clinical practice. In this context, ultrasound has emerged as an educational resource that enables real-time visualization of living anatomical structures and provides learning experiences more closely aligned with clinical settings. This study evaluated the educational value of integrating ultrasound into a first-year anatomy curriculum focused on upper limb topographical anatomy. A mixed-methods quasi-experimental study was conducted with 79 first-year medical students (intervention group, n = 42; control group, n = 37). Students were distributed into four laboratory sections based on a randomly ordered cohort list; the sections were subsequently assigned to the intervention and control conditions for logistical reasons without randomization. Both groups completed a 15-item multiple-choice pretest and posttest, the posttest being administered one week after the laboratory session. The intervention group participated in a laboratory session integrating ultrasound into three of six learning stations, while the control group used traditional anatomical resources. Quantitative outcomes were analyzed using t-tests, chi-square tests, effect sizes (Cohen’s d), and Pearson correlations, complemented by a 2 × 2 mixed-model ANOVA and an ANCOVA adjusted for pretest scores; 95% confidence intervals are reported throughout. Student perceptions were explored through a Likert-scale questionnaire and semi-structured interviews. Baseline performance was comparable between groups ( p = 0.885). Both groups improved significantly from pretest to posttest ( p < 0.001), with no significant differences in posttest performance between groups (mean difference 0.69 points, 95% CI − 0.67 to 2.04; p = 0.315). The group × time interaction was not statistically significant (F(1,77) = 0.81, p = 0.370, ηp² = 0.010). The intervention group demonstrated a larger within-group effect size (d = 0.78) than the control group (d = 0.59), whereas the between-group effect size was small (d = 0.23). Students reported highly positive perceptions regarding educational value, motivation, and clinical applicability. In exploratory analyses, learning gains were inversely related to baseline performance in both groups (intervention r = − 0.65, 95% CI − 0.80 to − 0.43; control r = − 0.54, 95% CI − 0.73 to − 0.26), with no statistically significant difference between the two coefficients ( p = 0.447). Ultrasound did not produce significantly greater immediate knowledge acquisition than traditional instruction but was highly valued by students as a learning resource. Its integration into anatomy education may support student engagement and may help students relate foundational anatomical content to clinical practice, although the present data do not demonstrate superior knowledge outcomes.