Ultrasound during Critical Care Simulation: A Randomized Crossover Study

Abstract

Objectives: We sought to compare two ultrasound simulation interventions used during critical care simulation. The primary outcome was trainee and instructor preference for either intervention. Secondary outcomes included the identification of strengths and weaknesses of each intervention as well as overall merits of ultrasound simulation during high-fidelity, critical care simulation. The populations of interest included emergency medicine trainees and physicians.Methods: This was a randomized crossover study with two ultrasound simulation interventions. 25 trainees and eight emergency physician instructors participated in criticalcare simulation sessions. Instructors were involved in session debriefing and feedback. Pre-and post-intervention responses were analyzed for statistically significant differences using t test analyses. Qualitative data underwent thematic analysis and triangulation. Results: Both trainees and instructors deemed ultrasound simulation valuable by allowing trainees to demonstrate knowledge of indications, correct image interpretation, and clinical integration (p < 0.05). Trainees described increased motivation to develop and use ultrasound skills. The edus2 was the preferred intervention, as it enabled functional fidelity and the integration of ultrasound into resuscitation choreography. Instructors preferred the edus2, as it facilitated better assessment of trainees' skills, thus influencing feedback. Conclusions: These findings support the use of ultrasound simulation during critical care simulations. The increased functional fidelity associated with edus2 suggests that it is the preferred intervention. Further study of the impact on clinical performance is warranted. RÉSUMÉObjectifs: L'étude visait à comparer deux interventions échographiques simulées, dans le cadre de séances de formation en soins intensifs. Le principal critère d'évaluation consistait à déterminer la préférence des stagiaires et celle des instructeurs pour l'une ou l'autre des interventions. Les critères d'évaluation secondaires comprenaient les points forts et les points faibles de chacune des interventions ainsi que les avantages généraux de la simulation d'échographie dans le cadre de séances de formation réaliste en soins intensifs. La population concernée se composait de stagiaires en médecine d'urgence et d'urgentologues. Méthode: Il s'agit d'une étude croisée, à répartition aléatoire, qui comptait deux interventions échographiques simulées. Vingt-cinq stagiaires et huit urgentologues instructeurs ont participé aux séances de simulation en soins intensifs. Les instructeurs étaient chargés des séances de compte rendu et de la rétroaction des stagiaires. Il y a eu analyse des réponses recueillies avant et après les interventions afin de dégager des écarts statistiquement significatifs à l'aide d'analyses fondées sur le test t. Quant aux données qualitatives, elles ont été soumises à une analyse thématique, puis à la triangulation. Résultats: Tant les stagiaires que les instructeurs ont jugé intéressante ...

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“…3 The edus2 simulator uses a modified ultrasound probe and laptop to display pre-recorded video clips when the user passes the probe over a radio frequency identification device card placed beneath the HFS mannequin's skin. This device was compared with a laptop placed on a cart, on which the trainee could select and view a labeled video clip from within a case folder.…”

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