Randomized study of effectiveness of computerized ultrasound simulators for an introductory course for residents in Brazil

Abstract

Purpose:This study aimed to assess the impact of ultrasound simulation (SonoSim) on educational outcomes of an introductory point-of-care ultrasound course compared to hands-on training with live models alone.Methods:Fifty-three internal medicine residents without ultrasound experience were randomly assigned to control or experimental groups. They participated in an introductory point-of-care ultrasound course covering eight topics in eight sessions from June 23, 2014 until July 18, 2014. Both participated in lecture and hands-on training, but experimental group received an hour of computerized simulator training instead of a second hour of hands-on training. We assessed clinical knowledge and image acquisition with written multiple-choice and practical exams, respectively. Of the 53 enrolled, 40 participants (75.5%) completed the course and all testing.Results:For the 30-item written exam, mean score of the experimental group was 23.1±3.4 (n=21) vs. 21.8±4.8 (n=19), (P>0 .05). For the practical exam, mean score for both groups was 8.7 out of 16 (P>0 .05).Conclusion:The substitution of eight hours of ultrasound simulation training for live model scanning in a 24 hour training course did not enhance performance on written and image acquisition tests in an introductory ultrasound course for residents. This result suggests that ultrasound simulation technology used as a substitute for live model training on an hour-for-hour basis, did not improve learning outcomes. Further investigation into simulation as a total replacement for live model training will provide a clearer picture of the efficacy of ultrasound simulators in medical education.

The Use of Ultrasound Simulators to Strengthen Scanning Skills in Medical Students: A Randomized Controlled Trial

“…The results concur with previous studies on the benefits and the noninferiority of ultrasound simulators in the training of novice ultrasound learners. In 2016, Silva et al and Bentley et al found no significant difference in the ultrasound skills and knowledge of students trained using an ultrasound simulator versus students trained using live models. In addition, Tolsgaard et al showed significant improvement in the performance of gynecologic ultrasound examinations by residents when the use of an ultrasound simulator was added to their clinical training.…”

“…Of the 14 studies in the review, only 5 included a control group, and only 2 of those were randomized. Since this publication, multiple controlled randomized trials have reported the potential benefits of ultrasound simulators . In addition, ultrasound simulators allow trainees to practice multiple times the same ultrasound modality without the need of supervisors or models.…”

“…In Canada, a similar situation exists, with less than 50% of medical schools teaching ultrasound. Canadian medical schools offer on average 1 to 5 hours of ultrasound education per year, with 17% of schools teaching more than 10 hours per year …”

“…For novice learners, obtaining that number of scans within 1 to 5 hours of training is unrealistic. In addition, the lack of ultrasound machines, infrastructure, and time are important obstacles for medical schools attempting to integrate ultrasound training into their curriculum …”

“…Multiple studies have assessed the use of ultrasound simulators to teach trainees. These simulators are often equipped with self‐directed training modules and require little supervision . It follows that their use may reduce the need for instructors and supervised training sessions and the related mobilization of infrastructure and equipment.…”