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Did you know that ultrasound iss the only diagnostic imaging modality ever routinely transported into true space aboard the International Space Station? Unlike X-ray, CT, or MRI, ultrasound is lightweight, safe, and energy-efficient. However, one of the most compelling reasons as to why ultrasound is uniquely adapted to use in space is explained by Andrew Kirkpatrick and colleagues in their 2022 review, Patient Self-Performed Point-of-Care Ultrasound: Using Communication Technologies to Empower Patient Self-Care, where they detail how International Space Station astronauts have successfully performed ultrasound examinations despite the absence of trained sonographers onboard. The authors explain that this has been achieved through remote guidance from expert sonographers and physicians on Earth. The ground-based experts direct the astronaut in real time, instructing them where to place the probe, how to angle it, and how to optimise the images being acquired.
This process is known as Remote Telementored Ultrasonography (RTMUS). The expert watches the live ultrasound feed, provides immediate feedback, and guides image acquisition while simultaneously interpreting the findings.
Kirkpatrick highlights:
“Of all the imaging technologies, ultrasound imaging has long consisted of two linked but separate processes—image generation and image interpretation.”
The authors note that even within major hospitals across departments of different imaging modalities, these functions are often separated, with sonographers acquiring images and radiologists or specialist clinicians interpreting them. This skill distinction means that the diagnostician does not necessarily need to be physically present with the patient and furthermore, a person does not need years of scanning experience before they can begin producing clinically useful images under appropriate guidance. As fundamental characteristics of ultrasound, these two factors enable its success in space medicine and has driven the development of online ultrasound programmes worldwide.
The space programme did not stop at having one astronaut scan another; researchers went even further, demonstrating that astronauts could perform ultrasound examinations on themselves while receiving guidance (RTMSPUS). Astronauts successfully performed examinations of the abdomen, heart, urinary system, neck veins, and even muscle mass measurements while specialists remotely supervised the process.
The implications are profound- if astronauts floating hundreds of kilometres above Earth can acquire diagnostically useful ultrasound images under remote guidance, then geographical distance is clearly not the barrier many people assume it to be. The same paper goes on to argue that remote ultrasound guidance has tremendous potential not only for space exploration but also for rural healthcare, telemedicine, pandemic response, and patient self-care. The authors conclude that this approach can support “nearly any medical question poised in a conscious individual with internet connectivity able to follow the directions of a remote expert.” (Kirkpatrick et al., 2022)
The success of remote ultrasound in space also teaches us something important about how ultrasound is learned. Many people assume that scanning itself is the most difficult aspect of ultrasound, when in reality, the greatest challenge is often developing a deep understanding of anatomy, image optimisation, and interpretation. The evidence from remote ultrasound programmes suggests that individuals can learn to obtain useful images far more quickly than they can learn to understand what those images mean- this is why remote mentoring works.
A specialist can guide someone with relatively limited hands-on experience to acquire diagnostic images because the expert possesses the anatomical knowledge, pattern recognition skills, and interpretative expertise that ultimately determine the value of the examination.
The lessons from space medicine translate directly into ultrasound education.
Understanding anatomy, recognising normal and abnormal appearances, interpreting findings, optimising machine settings, and learning clinical decision-making are all knowledge-based skills. These are ideally suited to online teaching through:
A pilot study by Fisher et al. investigated whether healthcare professionals could improve their focused echocardiography interpretation skills through a programme consisting largely of remote lectures and serial image interpretation exercises. The researchers found a clear and progressive improvement in diagnostic accuracy, with average reporting scores increasing from 66% to 78% as participants reviewed more scans. Confidence in identifying potentially life-threatening pathology also increased throughout the programme:
“Healthcare professionals undertaking remote training with recorded lectures, followed by multiple reporting tasks were capable of interpreting focused echocardiograms. Reporting accuracy and confidence in identifying life-threatening pathology increased with the number of scans interpreted” (Fisher et al., 2024).
These findings reinforce a principle already demonstrated through decades of tele-ultrasound work in space medicine: the most intellectually demanding aspects of ultrasound practice are not necessarily the physical act of holding a probe, but rather understanding anatomy, recognising normal and abnormal appearances, and accurately interpreting what is displayed on the screen.
A student can learn these concepts from anywhere in the world with an internet connection, while the practical scanning component is different; whether scanning humans, dogs, cats, horses, livestock, or exotic species, confidence comes from performing scans repeatedly over time. This is why successful ultrasound practitioners understand that scanning proficiency is built through patience, perseverance and actively seeking out opportunities to build up practise hours.
No classroom, whether physical or virtual, can completely replace the value of accumulated scanning experience. However, online education can provide the knowledge framework that allows learners to make sense of what they are seeing while they build that experience.
This educational philosophy is reflected in the AUA training programmes that we promote at ScanX.
ScanX was founded on the principle that ultrasound technology is most powerful when combined with expert education and ongoing support from experienced sonographers. The company actively promotes ultrasound training pathways for learners at every stage, from aspiring paraprofessionals through to veterinary surgeons seeking advanced echocardiography skills.
Among the most successful AUA programmes is the VIP Scanning Academy, which combines pre-recorded learning materials, live mentoring sessions, and ongoing tutor support. The programme was specifically designed to accommodate different learning styles and busy schedules, allowing students to learn at their own pace before receiving personalised guidance from qualified sonographers. Participants also benefit from continued access to expert support and scan review services.
This model closely mirrors the principles demonstrated by remote ultrasound programmes in both space medicine and terrestrial healthcare:
The continued success of online programmes such as the VIP Scanning Academy provides further evidence that high-quality ultrasound education does not require students to sit in a classroom every week. What matters most is access to knowledgeable instructors, structured learning, meaningful feedback, and the motivation to continue scanning and improving.
The story of ultrasound in space offers a powerful lesson for educators and learners alike: if astronauts can successfully acquire diagnostic ultrasound images while being guided by experts thousands of miles away, then the concept of learning ultrasound remotely should no longer seem unusual. In fact, it is one of the strongest real-world demonstrations of how effective remote ultrasound education can be.
Space medicine has already proven that ultrasound expertise can travel across vast distances, online ultrasound education simply applies the same principle here on Earth.
Kirkpatrick AW, McKee JL, Couperus K, Colombo CJ. Patient Self-Performed Point-of-Care Ultrasound: Using Communication Technologies to Empower Patient Self-Care. Diagnostics. 2022;12(11):2884. https://doi.org/10.3390/diagnostics12112884
Fisher R, Zayan A, Gosling J, Ramos J, Nasr M, Garry D, Papachristidis A, Caetano F, Hopkins P. Serial image interpretation tasks improve accuracy and increase confidence in Level 1 echocardiography reporting: a pilot study. Echo Research & Practice. 2024.
https://link.springer.com/article/10.1186/s44156-023-00018-9
