Abstract: Objective To investigate the effectiveness of ultrasound tomography (UT) as a teaching tool in musculoskeletal(MSK) ultrasound anatomy training. Methods Sixty-eight trainee physicians in MSK ultrasound were randomly assigned to a control group (n=34) or an experimental group (n=34). The control group received conventional teaching,while the experimental group received additional UT-based instruction. After four weeks,both groups were compared on anatomical structure recognition scores,spatial structure understanding test results,and standard plane acquisition ability. A 5-point Likert scale was used to evaluate teaching outcomes. Baseline characteristics between groups were compared,and intergroup differences were analyzed using the Mann-Whitney U test or chi-square test as appropriate. Results No significant differences in baseline characteristics were found between the two groups (all P＞0.05),confirming their comparability. The experimental group significantly outperformed the control group in all three objective assessments: anatomical structure recognition, spatial structure understanding,and standard plane acquisition (all P＜0.01). Trainees′ acceptance of UT teaching was high,with a mean total Likert scale score of 25.04±6.26 (out of 30) and mean item scores ranging from 4.15 to 4.19 (out of 5); the proportion of those who agreed or strongly agreed was ≥85.3% for all six items. The scale demonstrated excellent internal consistency (Cronbach′s α=0.993) and good test-retest reliability. Conclusions The integration of ultrasound tomography into MSK ultrasound training significantly improves trainees′ anatomical recognition,spatial understanding,and standard plane acquisition skills. UT is an effective teaching method with strong potential for broader application in clinical education.

Key words: ultrasound tomography, musculoskeletal ultrasound, anatomical teaching, spatial cognition, continuing medical education